70 results match your criteria: "Codman Center for Clinical Effectiveness in Surgery[Affiliation]"

Variation in commercial prices for thyroidectomy and parathyroidectomy at US hospitals.

Am J Surg

November 2024

Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA; Patient-Reported Outcomes, Value, and Experience (PROVE) Center, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA.

Background: The 2021 Hospital Price Transparency Rule mandated hospitals to publicly disclose their service prices to improve competition and lower healthcare costs. Our aim was to characterize commercial price variation for thyroidectomy and parathyroidectomy.

Methods: We performed a national cross-sectional study of hospital price variation in 2022 and 2023 using the Turquoise Health dataset.

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Background: Peripheral vascular interventions (PVIs) performed under procedural sedation and analgesia (PSA) can be associated with anxiety and poor compliance with patient instructions during surgery. Mind-body interventions (MBIs) such as meditation have demonstrated the potential to decrease perioperative anxiety, though this area is understudied, and no tailored interventions have been developed for the vascular surgical patient population.

Objectives: We aimed to design a perioperative MBI that specifically targeted vascular surgical patients undergoing PVIs under PSA.

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Disparities in timely surgery among Asian American women with breast cancer.

Am J Surg

August 2024

Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA.

Background: We investigated the likelihood of timely surgery for breast cancer patients among diverse Asian subgroups.

Methods: We analyzed the National Cancer Database from 2010 to 2019 and included White and Asian women diagnosed with stage I-III breast cancer. Patients with multiple cancers, patients who received chemotherapy, and those diagnosed and treated at different hospitals were excluded.

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Does routine upper gastrointestinal swallow study after metabolic and bariatric surgery lead to earlier diagnosis of leak?

Surg Obes Relat Dis

August 2024

Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, Massachusetts; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, Duke University, Durham, North Carolina. Electronic address:

Background: It is unclear whether routine upper gastrointestinal swallow study (SS) in the immediate postoperative period is associated with earlier diagnosis of gastrointestinal leak after bariatric surgery.

Objective: To investigate the relationship between routine SS and time to diagnosis of postoperative gastrointestinal leak.

Setting: MBSAQIP-accredited hospitals in the United States and Canada.

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Background: Health-related quality-of-life (HRQoL) is one of the most important outcomes to metabolic and bariatric surgery (MBS) patients but was not measured by the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP). A patient-reported outcome measures (PROMs) program pilot started in 2016 with MBSAQIP implementation in 2019.

Objectives: To measure how MBS impacts patient HRQoL 1 and 2 years after primary laparoscopic Roux-en-Y gastric bypass (bypass) or laparoscopic sleeve gastrectomy (sleeve).

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Background: Disparities in obstetric care have been well documented, but disparities in the within-hospital population have not been as extensively explored. The objective is to assess cesarean delivery rate disparities at the hospital level in a nationally recognized low risk of cesarean delivery group.

Methods: An observational study using a national population-based database, Nationwide Inpatient Sample, from 2008 to 2011 was conducted.

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Importance: Retaining female physicians in the academic health care workforce is necessary to serve the needs of sociodemographically diverse patient populations.

Objective: To investigate differences in rates of leaving academia between male and female physicians.

Design, Setting, And Participants: This cohort study used Care Compare data from the Centers for Medicare & Medicaid Services for all physicians who billed Medicare from teaching hospitals from March 2014 to December 2019, excluding physicians who retired during the study period.

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Article Synopsis
  • The study investigates how travel distance affects outcomes and costs for patients undergoing complex aortic surgery in the U.S., focusing on the increased burden on patients as surgical care becomes more centralized.
  • A retrospective analysis was conducted on data from 8,782 patients who underwent various types of complex aortic repairs between 2011 and 2018, considering travel distances and demographic factors.
  • The findings indicate that patients who travel longer distances for surgery may face increased costs and higher rates of reintervention, with specific demographic trends observed among patients traveling the farthest.
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Time to surgery: A health equity metric in breast cancer patients.

Am J Surg

October 2023

55 Fruit St, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 55 Fruit St, Breast Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

Article Synopsis
  • The study aimed to assess whether the time it takes for patients to undergo surgery based on their race can serve as an indicator of health equity in access to surgical care.
  • Using data from the National Cancer Database involving nearly 887,000 women with stage I-III breast cancer, the research found that Black patients were significantly more likely to experience surgery delays compared to White patients.
  • The findings underscore the need to address systemic factors contributing to this inequity in cancer treatment, suggesting that timely surgery access for Black patients should be a priority for intervention efforts.
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External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement.

Colorectal Dis

June 2023

Department of General Surgery, Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.

Aim: The simple six-variable Codman score is a tool designed to reduce the complexity of contemporary risk-adjusted postoperative mortality rate predictions. We sought to externally validate the Codman score in colorectal surgery.

Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) participant user file and colectomy targeted dataset of 2020 were merged.

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Objective: Recently evolving practice patterns in complex aortic surgery have led to regionalization of care within fewer centers in the United States, and thus patients may have to travel farther for complex aortic care. Travel distance has been associated with inferior outcomes after non-vascular surgery, particularly non-index readmission. This study aims to assess the impact of patient travel distance on perioperative outcomes and readmissions after complex aortic surgery.

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Article Synopsis
  • The study evaluated the agreement between patient-reported outcomes (PROs) and clinical registry data one year after bariatric surgery.
  • Ninety-five percent of patients' reported weights were within 13 pounds of registry records, indicating that patient reports were generally reliable, particularly for diabetes and hypertension.
  • The findings suggest that using patient reports can reduce the data-collection burden while providing accurate information for postoperative follow-up.
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Gender Homophily in Interphysician Referrals to Surgeons.

J Surg Res

March 2023

Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts; Pediatric Surgery Trials and Outcomes Research Center, MassGeneral Hospital for Children, Boston, Massachusetts. Electronic address:

Introduction: The literature on gender homophily has mostly been focused on patient-physician relationship but not on interprofessional referrals. The goal of this study is to quantify interphysician gender homophily of referring physicians in surgical referrals.

Methods: An observational study of the referral data at a large academic center was performed.

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Goal: For decades, hospitals performing cardiac surgery have carried the cost of implementing quality improvement activities and reporting quality outcomes. However, the financial return of such investments is unclear, which weakens the incentive for hospitals to invest in quality improvement activities. This study explored the relationship between a hospital's measured quality and its financial performance.

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Background: High-quality care is a clear objective for hospital leaders, but hospitals must balance investing in quality with financial stability. Poor hospital financial health can precipitate closure, limiting patients' access to care. Whether hospital quality is associated with financial health remains poorly understood.

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Objective: To determine the effect of the introduction of low dose computed tomography screening in 2013 on lung cancer stage shift, survival, and disparities in the stage of lung cancer diagnosed in the United States.

Design: Quasi-experimental study using Joinpoint modeling, multivariable ordinal logistic regression, and multivariable Cox proportional hazards modeling.

Setting: US National Cancer Database and Surveillance Epidemiology End Results program database.

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Background: It has been speculated that women's productivity decreases after maternity leave. In this study, we measured if surgeon clinical productivity decreases after a maternity leave or other types of leave.

Methods: Data from a large medical center was used to measure surgeon productivity before (pre) and after (post) a leave of absence.

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Background: Four-dimensional computed tomography (4D-CT) scan to localize abnormal parathyroid glands is diagnostically superior to ultrasound (US) and sestamibi. The implementation of 4D-CT imaging is unknown.

Methods: The Collaborative Endocrine Surgery Quality Improvement Program (CESQIP) database from 2014 to 2018 was utilized.

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Predictors of Financial Distress Among Private U.S. Hospitals.

J Surg Res

November 2021

Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, Boston, MA. Electronic address:

Background: Hospitals are closing after poor financial performance leaving many patients without access to medical care. Identifying the factors associated with financial distress offers hospitals avenues for potential intervention to avoid bankruptcy and closure.

Materials And Methods: We performed a retrospective analysis of private U.

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Should all patients receive the same prophylaxis? Racial variation in the risk of venous thromboembolism after major abdominal operations.

Am J Surg

November 2021

Department of Surgery, Massachusetts General Hospital/ Harvard Medical School, 55 Fruit Street, Boston, MA, USA; Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital/ Harvard Medical School, Boston, MA, 165 Cambridge St, Suite 403, USA. Electronic address:

Background: Whether prevention strategy for postoperative venous thromboembolism (VTE) should be tailored across racial groups remains unknown.

Methods: Patients who underwent major abdominal operation in the Nationwide Inpatient Sample (NIS) were examined. Our primary outcome was postoperative VTE, and the secondary outcome was postoperative bleeding.

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Background: With the prevalence of obesity and its known association with esophageal cancer, there is increasing need to understand how obesity affects treatment.

Methods: Using The Society of Thoracic Surgeons General Thoracic Surgery Database, we retrospectively evaluated all patients who underwent esophagectomy with gastric conduit reconstruction between 2012 and 2016. Patients were categorized into five body mass index groups.

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Article Synopsis
  • The study examines the racial representation in clinical trials that form the basis of the USPSTF guidelines for lung, breast, and colorectal cancer screening.
  • Many randomized controlled trials (RCTs) either do not report race or consist of predominantly white populations, raising concerns about the guidelines' applicability to non-white individuals.
  • The research indicates that the lack of race-specific recommendations can lead to underdiagnosis and worse health outcomes for non-white individuals, highlighting the need for improved diversity in medical research and policy changes to enhance minority representation in healthcare.
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