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Elective Appendectomy Following Antibiotics for Appendicitis JAMA Surg. (IF 16.9) Pub Date : 2024-04-24 Dimitrios Moris, Theodore Pappas
This Viewpoint considers which may be the better long-term approach to appendicitis—interval elective appendectomy or nonsurgical treatment with antibiotics.
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Interval Appendectomy After Successful Antibiotic Treatment? JAMA Surg. (IF 16.9) Pub Date : 2024-04-24 David A. Talan, Peter C. Minneci
This Viewpoint discusses the pros and cons of performing interval appendectomy in patients who have recovered from successful antibiotic treatment of acute uncomplicated appendicitis.
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Plastic Wound Protector vs Surgical Gauze for Surgical Site Infection Reduction in Open GI Surgery JAMA Surg. (IF 16.9) Pub Date : 2024-04-24 Nina Yoo, Ji Yeon Mun, Bong-Hyeon Kye, Chang Woo Kim, Jae Im Lee, Youn Young Park, Byung Mo Kang, Byung Kwan Park, Han Deok Kwak, Won-Kyung Kang, Sung Uk Bae, Heung-Kwon Oh, Youngki Hong, Hyung Jin Kim
ImportanceSurgical site infections (SSIs) are prevalent hospital-acquired infections with significant patient impacts and global health care burdens. The World Health Organization recommends using wound protector devices in abdominal surgery as a preventive measure to lower the risk of SSIs despite limited evidence.ObjectiveTo examine the efficacy of a dual-ring, plastic wound protector in lowering
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Incisional Wound Irrigation for the Prevention of Surgical Site Infection JAMA Surg. (IF 16.9) Pub Date : 2024-04-24 Hannah Groenen, Nathan Bontekoning, Hasti Jalalzadeh, Dennis R. Buis, Yasmine E. M. Dreissen, Jon H. M. Goosen, Haitske Graveland, Mitchel Griekspoor, Frank F. A. IJpma, Maarten J. van der Laan, Roald R. Schaad, Patrique Segers, Wil C. van der Zwet, Ricardo G. Orsini, Anne M. Eskes, Niels Wolfhagen, Stijn W. de Jonge, Marja A. Boermeester
ImportanceSurgical site infections (SSIs) are common postoperative complications and associated with significant morbidity, mortality, and costs. Prophylactic intraoperative incisional wound irrigation is used to reduce the risk of SSIs, and there is great variation in the type of irrigation solutions and their use.ObjectiveTo compare the outcomes of different types of incisional prophylactic intraoperative
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Management of Diverticulitis JAMA Surg. (IF 16.9) Pub Date : 2024-04-17 Olivia A. Sacks, Jason Hall
ImportanceCare of patients with diverticulitis is undergoing a paradigm shift. This narrative review summarizes the current evidence for left-sided uncomplicated and complicated diverticulitis. The latest pathophysiology, advances in diagnosis, and prevention strategies are also reviewed.ObservationsTreatment is moving to the outpatient setting, physicians are forgoing antibiotics for uncomplicated
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Placebo Control and Blinding in Randomized Trials of Procedural Interventions JAMA Surg. (IF 16.9) Pub Date : 2024-04-17 Christopher A. Rajkumar, Katharine E. Thomas, Michael Foley, Sashiananthan Ganesananthan, Holli Evans, Florentina Simader, Sharan Syam, Daniel Nour, Catherine Beattie, Caitlin Khan, Rohin K. Reddy, Fiyyaz Ahmed-Jushuf, Darrel P. Francis, Matthew Shun-Shin, Rasha K. Al-Lamee
ImportanceUnlike medications, procedural interventions are rarely trialed against placebo prior to becoming accepted in clinical practice. When placebo-controlled trials are eventually conducted, procedural interventions may be less effective than previously believed.ObjectiveTo investigate the importance of including a placebo arm in trials of surgical and interventional procedures by comparing effect
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Three-Year Outcomes of Oral Antibiotics vs Intravenous and Oral Antibiotics for Uncomplicated Acute Appendicitis JAMA Surg. (IF 16.9) Pub Date : 2024-04-17 Liisa Selänne, Jussi Haijanen, Suvi Sippola, Saija Hurme, Tero Rautio, Pia Nordström, Tuomo Rantanen, Tarja Pinta, Imre Ilves, Anne Mattila, Jukka Rintala, Harri Marttila, Sanna Meriläinen, Johanna Laukkarinen, Eeva-Liisa Sävelä, Hannu Paajanen, Juha Grönroos, Paulina Salminen
ImportanceCurrent short-term evidence has shown that uncomplicated acute appendicitis can be treated successfully with oral antibiotics alone, but longer-term results are lacking.ObjectiveTo assess the treatment effectiveness of oral antibiotic monotherapy compared with combined intravenous (IV) and oral antibiotics in computed tomography–confirmed uncomplicated acute appendicitis at a longer-term
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Operating Room Organization and Methodology of Surgical Activity Regulation JAMA Surg. (IF 16.9) Pub Date : 2024-04-10 Bertrand Mathon, Frédéric Kletz
This article discusses the implementation of surgical activity regulation methodology in the operating room to reduce organizational dysfunction, improve quality of work life of the surgical staff, and decrease staff overtime.
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Extracorporeal Shockwave for Intermittent Claudication and Quality of Life JAMA Surg. (IF 16.9) Pub Date : 2024-04-10 Paris Cai, Sean Pymer, Said Ibeggazene, Ali Raza, Louise Hitchman, Ian Chetter, George Smith
ImportanceIntermittent lower limb claudication limits function and quality of life. Supervised exercise programs are not readily available, and a noninvasive alternative is needed.ObjectiveTo assess extracorporeal corporeal shockwave therapy in improving quality of life in patients with claudication.Design, Setting, and ParticipantsIn this double-blind, placebo-controlled randomized clinical trial
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Traumatic Brain Injuries After Falls From Height vs Falls at the US-Mexico Border Wall JAMA Surg. (IF 16.9) Pub Date : 2024-04-10 Alexander Tenorio, Michael G. Brandel, Carson P. McCann, Jay J. Doucet, Todd W. Costantini, Alexander A. Khalessi, Joseph D. Ciacci
This cohort study examines the incidence, severity, and mortality of fall-related injuries among migrants at the US-Mexico border in San Diego, California.
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Automated CT Analysis of Body Composition as a Frailty Biomarker in Abdominal Surgery JAMA Surg. (IF 16.9) Pub Date : 2024-04-10 Ijeamaka Anyene Fumagalli, Sidney T. Le, Peter D. Peng, Patricia Kipnis, Vincent X. Liu, Bette Caan, Vincent Chow, Mirza Faisal Beg, Karteek Popuri, Elizabeth M. Cespedes Feliciano
ImportancePrior studies demonstrated consistent associations of low skeletal muscle mass assessed on surgical planning scans with postoperative morbidity and mortality. The increasing availability of imaging artificial intelligence enables development of more comprehensive imaging biomarkers to objectively phenotype frailty in surgical patients.ObjectiveTo evaluate the associations of body composition
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Disparities in Mentorship and Implications for US Surgical Resident Education and Wellness JAMA Surg. (IF 16.9) Pub Date : 2024-04-03 Casey M. Silver, Tarik K. Yuce, Callisia N. Clarke, Cary Jo R. Schlick, Rhami Khorfan, Daniela Amortegui, Michael Nussbaum, Patricia L. Turner, Karl Y. Bilimoria, Yue-Yung Hu
ImportanceMany surgeons cite mentorship as a critical component of training. However, little evidence exists regarding factors associated with mentorship and the influence of mentorship on trainee education or wellness.ObjectivesTo evaluate factors associated with surgical trainees’ perceptions of meaningful mentorship, assess associations of mentorship with resident education and wellness, and evaluate
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Adjuvant Transarterial Chemoembolization With Sorafenib for Portal Vein Tumor Thrombus JAMA Surg. (IF 16.9) Pub Date : 2024-04-03 Zhenwei Peng, Wenzhe Fan, Zelong Liu, Han Xiao, Jian Wu, Rong Tang, Jianfei Tu, Liangliang Qiao, Fuxi Huang, Wenxuan Xie, Wenquan Zhuang, Wenbo Guo, Shaoqiang Li, Yunpeng Hua, Shunli Shen, Qiang He, Dongming Li, Jiaping Li, Ming Kuang
ImportanceCertain patients with hepatocellular carcinoma with portal vein tumor thrombus could benefit from surgical resection, and postoperative adjuvant therapy may lower the incidence of tumor recurrence.ObjectiveTo compare the efficacy and safety of sorafenib plus transarterial chemoembolization vs sorafenib alone as postoperative adjuvant therapy for patients with hepatocellular carcinoma with
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US Liver Transplant Outcomes After Normothermic Regional Perfusion vs Standard Super Rapid Recovery JAMA Surg. (IF 16.9) Pub Date : 2024-04-03 Aleah L. Brubaker, Marty T. Sellers, Peter L. Abt, Kristopher P. Croome, Shaheed Merani, Anji Wall, Phillipe Abreu, Musab Alebrahim, Roy Baskin, Humberto Bohorquez, Robert M. Cannon, Kelly Cederquist, John Edwards, Benjamin G. Huerter, Mark J. Hobeika, Lori Kautzman, Alan N. Langnas, David D. Lee, Joao Manzi, Ahmed Nassar, Nikole Neidlinger, Trevor L. Nydam, Gabriel T. Schnickel, Farjad Siddiqui, Ashley
ImportanceNormothermic regional perfusion (NRP) is an emerging recovery modality for transplantable allografts from controlled donation after circulatory death (cDCD) donors. In the US, only 11.4% of liver recipients who are transplanted from a deceased donor receive a cDCD liver. NRP has the potential to safely expand the US donor pool with improved transplant outcomes as compared with standard super
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Quality of Life After Axillary Lymph Node Dissection Among Racial and Ethnic Minority Women JAMA Surg. (IF 16.9) Pub Date : 2024-03-27 Danielle R. Heller, Bayley Axelrod, Varadan Sevilimedu, Monica Morrow, Babak J. Mehrara, Andrea V. Barrio
ImportanceHigher lymphedema rates after axillary lymph node dissection (ALND) have been found in Black and Hispanic women; however, there is poor correlation between subjective symptoms, quality of life (QOL), and measured lymphedema. Additionally, racial and ethnic differences in QOL have been understudied.ObjectiveTo evaluate the association of race and ethnicity with long-term QOL in patients with
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Year-Over-Year Ventral Hernia Recurrence Rates and Risk Factors JAMA Surg. (IF 16.9) Pub Date : 2024-03-27 Priya Bhardwaj, Maria T. Huayllani, Molly A. Olson, Jeffrey E. Janis
ImportanceRecurrence is one of the most challenging adverse events after ventral hernia repair as it impacts quality of life, utilization of resources, and subsequent need for re-repair. Rates of recurrence range from 30% to 80% after ventral hernia repair.ObjectiveTo determine the contemporary ventral hernia recurrence rate over time in patients with previous hernia repair and to determine risk factors
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Metabolic Bariatric Surgery—A Vastly Underused Treatment JAMA Surg. (IF 16.9) Pub Date : 2024-03-20 Bruce Schirmer
This Viewpoint discusses the disease of obesity: treatment options, disease management, and the need for legislation for obesity-related discrimination.
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Cost-Effectiveness of Parathyroid Cryopreservation and Autotransplantation JAMA Surg. (IF 16.9) Pub Date : 2024-03-20 C. Corbin Frye, Janessa Sullivan, Sai Anusha Sanka, Eileen R. Smith, Brian Goetz, L. Michael Brunt, William Gillanders, Taylor C. Brown, John A. Olson, Bruce Hall, T. K. Pandian
ImportanceDelayed autotransplantation of cryopreserved parathyroid tissue (DACP) is the only surgical treatment for permanent postoperative hypoparathyroidism. Studies suggest that only a small minority of cryopreserved samples are ultimately autotransplanted with highly variable outcomes. For these reasons, many have questioned the economic utility of the process, although, to the authors’ knowledge
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Modifier 22 Use in Fee-for-Service Medicare JAMA Surg. (IF 16.9) Pub Date : 2024-03-20 Christopher P. Childers, Naveen V. Manisundaram, Chung-Yuan Hu, George J. Chang
ImportanceModifier 22 is a mechanism designed for surgeons to identify cases that are more complex than their Current Procedural Terminology code accounts for. However, empirical studies of the use and efficacy of modifier 22 are lacking.ObjectiveTo assess the use of modifier 22 in common surgical procedures and the association of use with compensation.Design, Setting, and ParticipantsThis was a cross-sectional
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Morbidity After Mechanical Bowel Preparation and Oral Antibiotics Prior to Rectal Resection JAMA Surg. (IF 16.9) Pub Date : 2024-03-20 Laura Koskenvuo, Pipsa Lunkka, Pirita Varpe, Marja Hyöty, Reetta Satokari, Carola Haapamäki, Anna Lepistö, Ville Sallinen
ImportanceSurgical site infections (SSIs)—especially anastomotic dehiscence—are major contributors to morbidity and mortality after rectal resection. The role of mechanical and oral antibiotics bowel preparation (MOABP) in preventing complications of rectal resection is currently disputed.ObjectiveTo assess whether MOABP reduces overall complications and SSIs after elective rectal resection compared
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Entrustable Professional Activities in Surgery JAMA Surg. (IF 16.9) Pub Date : 2024-03-13 Kelsey B. Montgomery, John D. Mellinger, Brenessa Lindeman
ImportanceEntrustable professional activities (EPAs) compose a competency-based education (CBE) assessment framework that has been increasingly adopted across medical specialties as a workplace-based assessment tool. EPAs focus on directly observed behaviors to determine the level of entrustment a trainee has for a given activity of that specialty. In this narrative review, we highlight the rationale
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Accreditation Council for Graduate Medical Education Milestone Training Ratings and Surgeons’ Early Outcomes JAMA Surg. (IF 16.9) Pub Date : 2024-03-13 Brigitte K. Smith, Kenji Yamazaki, Ara Tekian, Benjamin S. Brooke, Erica L. Mitchell, Yoon Soo Park, Eric S. Holmboe, Stanley J. Hamstra
ImportanceNational data on the development of competence during training have been reported using the Accreditation Council for Graduate Medical Education (ACGME) Milestones system. It is now possible to consider longitudinal analyses that link Milestone ratings during training to patient outcomes data of recent graduates.ObjectiveTo evaluate the association of in-training ACGME Milestone ratings in
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Electronic Patient-Reported Symptoms After Ambulatory Cancer Surgery JAMA Surg. (IF 16.9) Pub Date : 2024-03-13 Jennifer R. Cracchiolo, Amy L. Tin, Melissa Assel, Taylor M. McCready, Cara Stabile, Brett Simon, Sigrid V. Carlsson, Andrew J. Vickers, Vincent Laudone
ImportanceComplex cancer procedures are now performed in the ambulatory surgery setting. Remote symptom monitoring (RSM) with electronic patient-reported outcomes (ePROs) can identify patients at risk for acute hospital encounters. Defining normal recovery is needed to set patient expectations and optimize clinical team responses to manage evolving problems in real time.ObjectiveTo describe the patterns
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Anatomic Liver Resection Based on Portal Territory With Margin Priority for Hepatocellular Carcinoma JAMA Surg. (IF 16.9) Pub Date : 2024-03-13 Xingru Wang, Jun Cao, Jianwei Li
This Surgical Innovation describes the use of anatomic resection of the liver based on portal territory with margin priority for the treatment of hepatocellular carcinoma.
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Robotic Technology in Emergency General Surgery Cases in the Era of Minimally Invasive Surgery JAMA Surg. (IF 16.9) Pub Date : 2024-03-06 Nicole Lunardi, Aida Abou-Zamzam, Katherine L. Florecki, Swathikan Chidambaram, I-Fan Shih, Alistair J. Kent, Bellal Joseph, James P. Byrne, Joseph V. Sakran
ImportanceAlthough robotic surgery has become an established approach for a wide range of elective operations, data on its utility and outcomes are limited in the setting of emergency general surgery.ObjectivesTo describe temporal trends in the use of laparoscopic and robotic approaches and compare outcomes between robotic and laparoscopic surgery for 4 common emergent surgical procedures.Design, Setting
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Performance in Irish Selection and Future Performance in Surgical Training JAMA Surg. (IF 16.9) Pub Date : 2024-03-06 Conor Toale, Marie Morris, Sara Gross, Dara A. O’Keeffe, Donncha M. Ryan, Fiona Boland, Eva M. Doherty, Oscar J. Traynor, Dara O. Kavanagh
ImportanceSelection processes for surgical training should aim to identify candidates who will become competent independent practitioners and should aspire to high standards of reliability and validity.ObjectiveTo determine the association between measured candidate factors at the time of an Irish selection and assessment outcomes in surgical training, examined via rate of progression to Higher Specialist
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Is Preoperative Optimization Right for Every Hernia Patient? JAMA Surg. (IF 16.9) Pub Date : 2024-03-06 Serena S. Bidwell, Brian T. Fry, Dana A. Telem
This Viewpoint discusses developing a more nuanced preoperative optimization strategy for hernia repair that considers patient and disease factors to determine the right operation for the right patient at the right time.
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Glucagon-Like Peptide-1 Receptor Agonist Use and Residual Gastric Content Before Anesthesia JAMA Surg. (IF 16.9) Pub Date : 2024-03-06 Sudipta Sen, Paul P. Potnuru, Nadia Hernandez, Christina Goehl, Caroline Praestholm, Srikanth Sridhar, Omonele O. Nwokolo
ImportanceGlucagon-like peptide-1 receptor agonist (GLP-1 RA) use is rapidly increasing in the US, driven by its expanded approval for weight management in addition to hyperglycemia management in patients with type 2 diabetes. The perioperative safety of these medications, particularly with aspiration risk under anesthesia, is uncertain.ObjectiveTo assess the association between GLP-1 RA use and prevalence
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Optimal Practices for Suspected Nodal Melanoma—The Role of the General Surgeon JAMA Surg. (IF 16.9) Pub Date : 2024-02-28 Colin J. Rog, Igor Puzanov, Joseph Skitzki
This Viewpoint describes results of trials on neoadjuvant checkpoint inhibitor immunotherapy for patients with metastatic melanoma and recommends increased use of this approach.
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Outcomes of Women Undergoing Noncardiac Surgery in Veterans Affairs Compared With Non–Veterans Affairs Care Settings JAMA Surg. (IF 16.9) Pub Date : 2024-02-28 Elizabeth L. George, Michael A. Jacobs, Katherine M. Reitz, Nader N. Massarweh, Ada O. Youk, Shipra Arya, Daniel E. Hall
ImportanceRecent legislation facilitates veterans’ ability to receive non–Veterans Affairs (VA) surgical care. Although veterans are predominantly male, the number of women receiving care within the VA has nearly doubled to 10% over the past decade and recent data comparing the surgical care of women in VA and non–VA care settings are lacking.ObjectiveTo compare postoperative outcomes among women treated
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Pathomics Signature for Prognosis and Chemotherapy Benefits in Stage III Colon Cancer JAMA Surg. (IF 16.9) Pub Date : 2024-02-28 Wei Jiang, Huaiming Wang, Xiaoyu Dong, Xian Yu, Yandong Zhao, Dexin Chen, Botao Yan, Jiaxin Cheng, Shuangmu Zhuo, Hui Wang, Jun Yan
ImportanceThe current TNM staging system may not provide adequate information for prognostic purposes and to assess the potential benefits of chemotherapy for patients with stage III colon cancer.ObjectiveTo develop and validate a pathomics signature to estimate prognosis and benefit from chemotherapy using hematoxylin-eosin (H-E)–stained slides.Design, Setting, and ParticipantsThis retrospective prognostic
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Nationwide Propensity-Matched Comparison of Surgical Site Infections in Safety Net Hospitals JAMA Surg. (IF 16.9) Pub Date : 2024-02-28 Lisa Ngo, Luis Quintero, Joshua P. Parreco
This cohort study examines the rates and risks associated with surgical site infection during admission or readmission of socioeconomically marginalized patients undergoing gastrointestinal surgery.
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Mapping the Discharge Process After Surgery JAMA Surg. (IF 16.9) Pub Date : 2024-02-21 Laura A. Graham, Samantha Illarmo, Caroline P. Gray, Alex H. S. Harris, Todd H. Wagner, Mary T. Hawn, James C. Iannuzzi, Sherry M. Wren
ImportanceCare transition models are structured approaches used to ensure the smooth transfer of patients between health care settings or levels of care, but none currently are tailored to the surgical patient. Tailoring care transition models to the unique needs of surgical patients may lead to significant improvements in surgical outcomes and reduced care fragmentation. The first step to developing
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Total Neoadjuvant Therapy With PD-1 Blockade for High-Risk Proficient Mismatch Repair Rectal Cancer JAMA Surg. (IF 16.9) Pub Date : 2024-02-21 Yingjie Li, Chaohu Pan, Yuye Gao, Li Zhang, Dengbo Ji, Xiaoli Cui, Xiaoyan Zhang, Yong Cai, Yangzi Zhang, Yunfeng Yao, Lin Wang, Jiahua Leng, Tiancheng Zhan, Dongfang Wu, Zhibo Gao, Ying-Shi Sun, Zhongwu Li, Haitao Luo, Aiwen Wu
ImportanceTotal neoadjuvant therapy (TNT) is the standard treatment for locally advanced rectal cancer, especially for patients with high-risk factors. However, the efficacy of TNT combined with immunotherapy for patients with proficient mismatch repair (pMMR) rectal cancer is unknown.ObjectivesTo evaluate the safety and efficacy of TNT with induction chemoimmunotherapy followed by long-course chemoradiation
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Surgeon Intersectionality and Academic Promotion and Retention in the US JAMA Surg. (IF 16.9) Pub Date : 2024-02-14 Josh Johnson, Andrea Mesiti, Julianna Brouwer, Amy M. Shui, Julie Ann Sosa, Heather L. Yeo
IntroductionEfforts have been made to increase the number of women and physicians who are underrepresented in medicine (UIM). However, surgery has been slow to diversify, and there are limited data surrounding the impact of intersectionality.ObjectiveTo assess the combined association of race and ethnicity and sex with rates of promotion and attrition among US academic medical department of surgery
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Academic Surgery in the Era of Large Language Models JAMA Surg. (IF 16.9) Pub Date : 2024-02-14 Timothy A. Rengers, Cornelius A. Thiels, Hojjat Salehinejad
ImportanceThis review aims to assess the benefits and risks of implementing large language model (LLM) solutions in an academic surgical setting.ObservationsThe integration of LLMs and artificial intelligence (AI) into surgical practice has generated international attention with the emergence of OpenAI’s ChatGPT and Google’s Bard. From an administrative standpoint, LLMs have the potential to revolutionize
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Access to Burn Care in the US JAMA Surg. (IF 16.9) Pub Date : 2024-02-14 Dong Gi Hur, Jacqueline Yao, Tiffany M. Yue, Clifford C. Sheckter, Jeff Choi
This cross-sectional study examines burn incidence rates and accessibility of American Burn Association–verified or self-designated burn centers from 2013 to 2019.
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Trends in Firearm Injury Prevention Research Funding, Clinical Trials, and Publications in the US, 1985-2022 JAMA Surg. (IF 16.9) Pub Date : 2024-02-07 John C. Lin, Christopher Chang, Madison S. McCarthy, Abe Baker-Butler, Guangyu Tong, Megan L. Ranney
This cross-sectional study examines federal funding, registered clinical trials, and publications to quantify trends in firearm injury prevention research in the US from 1985 to 2022.
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Presentation Acuity and Surgical Outcomes for Patients With Health Insurance Living in Highly Deprived Neighborhoods JAMA Surg. (IF 16.9) Pub Date : 2024-02-07 Susanne Schmidt, Michael A. Jacobs, Jeongsoo Kim, Daniel E. Hall, Karyn B. Stitzenberg, Lillian S. Kao, Bradley B. Brimhall, Chen-Pin Wang, Laura S. Manuel, Hoah-Der Su, Jonathan C. Silverstein, Paula K. Shireman
ImportanceInsurance coverage expansion has been proposed as a solution to improving health disparities, but insurance expansion alone may be insufficient to alleviate care access barriers.ObjectiveTo assess the association of Area Deprivation Index (ADI) with postsurgical textbook outcomes (TO) and presentation acuity for individuals with private insurance or Medicare.Design, Setting, and ParticipantsThis
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Health Insurance Status and Unplanned Surgery for Access-Sensitive Surgical Conditions JAMA Surg. (IF 16.9) Pub Date : 2024-02-07 Shukri H. A. Dualeh, Sara L. Schaefer, Nicholas Kunnath, Andrew M. Ibrahim, John W. Scott
ImportanceAccess-sensitive surgical conditions, such as abdominal aortic aneurysm, ventral hernia, and colon cancer, are ideally treated with elective surgery, but when left untreated have a natural history requiring an unplanned operation. Patients’ health insurance status may be a barrier to receiving timely elective care, which may be associated with higher rates of unplanned surgery and worse outcomes
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Should Current Laws Be Revised to Address Occupational Hazards Caused by Hand-Tool Size Mismatch Among Surgeons? JAMA Surg. (IF 16.9) Pub Date : 2024-02-07 Anna Braman, Christopher Robertson, Louise King
This Viewpoint discusses the challenges faced by surgeons with a smaller hand size—and women in particular—when using surgical tools designed for larger hands and explores potential legal remedies to address these challenges.
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Bariatric Surgery and Longitudinal Cancer Risk JAMA Surg. (IF 16.9) Pub Date : 2024-01-31 Pei-Wen Lim, Chee-Chee H. Stucky, Nabil Wasif, David A. Etzioni, Kristi L. Harold, James A. Madura, Zhi Ven Fong
ImportanceCancer is one of the leading causes of death in the United States, with the obesity epidemic contributing to its steady increase every year. Recent cohort studies find an association between bariatric surgery and reduced longitudinal cancer risk, but with heterogeneous findings.ObservationsThis review summarizes how obesity leads to an increased risk of developing cancer and synthesizes current
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Factors in Hand Surgery Access for Rheumatoid Arthritis Before vs After the Patient Protection and Affordable Care Act JAMA Surg. (IF 16.9) Pub Date : 2024-01-31 Shashank Dwivedi, Meghan N. Cichocki, Hao Wu, Celeste A. Kettaneh, Lu Wang, Kevin C. Chung
ImportanceRheumatoid arthritis (RA) has severe functional and economic consequences. The implications of the Patient Protection and Affordable Care Act (ACA) and demographic factors for access to surgical treatment are unclear.ObjectiveTo investigate factors associated with time to RA hand surgery, surgical incidence, and cost after implementation of the ACA.Design, Setting, and ParticipantsThis cross-sectional
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Timing to First Whole Blood Transfusion and Survival Following Severe Hemorrhage in Trauma Patients JAMA Surg. (IF 16.9) Pub Date : 2024-01-31 Crisanto M. Torres, Kelly M. Kenzik, Noelle N. Saillant, Dane R. Scantling, Sabrina E. Sanchez, Tejal S. Brahmbhatt, Tracey A. Dechert, Joseph V. Sakran
ImportanceCivilian trauma centers have revived interest in whole-blood (WB) resuscitation for patients with life-threatening bleeding. However, there remains insufficient evidence that the timing of WB transfusion when given as an adjunct to a massive transfusion protocol (MTP) is associated with a difference in patient survival outcome.ObjectiveTo evaluate whether earlier timing of first WB transfusion
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Representation of Women and Racially and Ethnically Marginalized Principal Investigators in Vascular Device Trials JAMA Surg. (IF 16.9) Pub Date : 2024-01-24 M. Libby Weaver, Tara Srinivas, Sanuja Bose, Sarah E. Deery, Michael Fiore Amendola, James H. Black, Caitlin W. Hicks
This quality improvement study describes the lack of diversity in trial leadership, especially in arterial disease device trials, and recommends action steps.
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National Institutes of Health Funding for Surgeon-Scientists in the US—An Update and an Expanded Landscape JAMA Surg. (IF 16.9) Pub Date : 2024-01-24 Lindsay A. Demblowski, Seth M. Steinberg, Rebecca A. Meseroll, George M. Santangelo, Martha A. Zeiger
ImportanceCurrent reports suggest that the surgeon-scientist phenotype is significantly threatened. However, a significant increase in the proportion of surgeons in the workforce funded by the National Institutes of Health (NIH) from 2010 (0.5%) to 2020 (0.7%) was recently reported and showed that surgeons primarily performed basic science research (78% in 2010; 73% in 2020) rather than clinical research
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EMS Treatment Guidelines in Major Traumatic Brain Injury With Positive Pressure Ventilation JAMA Surg. (IF 16.9) Pub Date : 2024-01-24 Joshua B. Gaither, Daniel W. Spaite, Bentley J. Bobrow, Bruce Barnhart, Vatsal Chikani, Kurt R. Denninghoff, Gail H. Bradley, Amber D. Rice, Jeffrey T. Howard, Samuel M. Keim, Chengcheng Hu
ImportanceThe Excellence in Prehospital Injury Care (EPIC) study demonstrated improved survival in patients with severe traumatic brain injury (TBI) following implementation of the prehospital treatment guidelines. The impact of implementing these guidelines in the subgroup of patients who received positive pressure ventilation (PPV) is unknown.ObjectiveTo evaluate the association of implementation
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Assessing the Ambulatory Surgery Center Volume-Outcome Association JAMA Surg. (IF 16.9) Pub Date : 2024-01-24 Siddharth Jain, Paul R. Rosenbaum, Joseph G. Reiter, Omar I. Ramadan, Alexander S. Hill, Jeffrey H. Silber, Lee A. Fleisher
ImportanceIn surgical patients, it is well known that higher hospital procedure volume is associated with better outcomes. To our knowledge, this volume-outcome association has not been studied in ambulatory surgery centers (ASCs) in the US.ObjectiveTo determine if low-volume ASCs have a higher rate of revisits after surgery, particularly among patients with multimorbidity.Design, Setting, and ParticipantsThis
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Adjuvant Radiotherapy for Surgically Resected Stage III Merkel Cell Carcinoma JAMA Surg. (IF 16.9) Pub Date : 2024-01-17 Seyed Saeed Pairawan, Chloe E. Dominguez, Naveenraj Solomon, David Caba-Molina, Michael O’Leary, Mark E. Reeves, Jukes P. Namm
This case-control study evaluates whether adjuvant radiotherapy is associated with overall survival among patients with surgically resected stage III Merkel cell carcinoma.
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Safety and Feasibility of Single-Port Robotic-Assisted Nipple-Sparing Mastectomy JAMA Surg. (IF 16.9) Pub Date : 2024-01-17 Deborah E. Farr, Nicholas T. Haddock, Juan Tellez, Imad Radi, Rodrigo Alterio, Brendan Sayers, Herbert Zeh
ImportanceRobotic-assisted nipple-sparing mastectomies with multiport robots have been described in the US since 2015; however, significant hurdles to multiport robotic surgery exist in breast surgery.ObjectiveTo demonstrate that the single-port da Vinci SP (Intuitive Surgical) robotic system is feasible in patients undergoing robotic nipple-sparing mastectomy (rNSM).Design, Setting, and ParticipantsAn
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Optimal Surveillance Interval of Branch Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas JAMA Surg. (IF 16.9) Pub Date : 2024-01-17 Youngmin Han, Wooil Kwon, Mirang Lee, Hye-Sol Jung, Won-Gun Yun, Young Jae Cho, Yoon Soo Chae, Carlos Fernández-Del Castillo, Giovanni Marchegiani, Roberto Salvia, Brian K. P. Goh, Woo Jin Lee, Jin-Young Jang
ImportanceDespite the increasing prevalence of intraductal papillary mucinous neoplasm (IPMN), data on the growth and malignant conversion rates based on long-term surveillance cohorts are limited. Many international guidelines recommend surveillance for benign lesions, but the optimal interval and duration are unclear.ObjectiveTo determine the optimal surveillance protocol for IPMN and propose which
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Population-Based Validation of the MIA and MSKCC Tools for Predicting Sentinel Lymph Node Status JAMA Surg. (IF 16.9) Pub Date : 2024-01-10 Roger Olofsson Bagge, Rasmus Mikiver, Michael A. Marchetti, Serigne N. Lo, Alexander C. J. van Akkooi, Daniel G. Coit, Christian Ingvar, Karolin Isaksson, Richard A. Scolyer, John F. Thompson, Alexander H. R. Varey, Sandra L. Wong, Johan Lyth, Edmund K. Bartlett
ImportancePatients with melanoma are selected for sentinel lymph node biopsy (SLNB) based on their risk of a positive SLN. To improve selection, the Memorial Sloan Kettering Cancer Center (MSKCC) and Melanoma Institute Australia (MIA) developed predictive models, but the utility of these models remains to be tested.ObjectiveTo determine the clinical utility of the MIA and MSKCC models.Design, Setting
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Faculty Entrustment and Resident Entrustability JAMA Surg. (IF 16.9) Pub Date : 2024-01-10 Jessica K. Millar, Niki Matusko, Julie Evans, Samantha J. Baker, Brenessa Lindeman, Sarah Jung, Rebecca M. Minter, Emily Weinstein, Francesca Goodstein, Mackenzie R. Cook, Karen J. Brasel, Gurjit Sandhu
ImportanceAs the surgical education paradigm transitions to entrustable professional activities, a better understanding of the factors associated with resident entrustability are needed. Previous work has demonstrated intraoperative faculty entrustment to be associated with resident entrustability. However, larger studies are needed to understand if this association is present across various surgical
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Practical Guide to Assessment Tool Development for Surgical Education Research JAMA Surg. (IF 16.9) Pub Date : 2024-01-03 Mohsen M. Shabahang, Todd A. Schwartz, Liane S. Feldman
This Guide to Statistics and Methods describes the process of validation and gathering validity evidence for assessment tool development for surgical education research.
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Practical Guide to Survey Research in Surgical Education JAMA Surg. (IF 16.9) Pub Date : 2024-01-03 Adnan A. Alseidi, Jason S. Haukoos, Christian de Virgilio
This Guide to Statistics and Methods describes aspects of methods of survey research in surgical education, important considerations, and pitfalls and limitations.
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Practical Guide to Pragmatic Clinical Trials in Surgical Education Research JAMA Surg. (IF 16.9) Pub Date : 2024-01-03 Karl Y. Bilimoria, Jason S. Haukoos, Gerard M. Doherty
This Guide to Statistics and Methods provides an overview of the key features of pragmatic trials within the context of surgical education research using examples from the Flexibility in Duty-Hour Requirements for Surgical Trainees trial.
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Practical Guide to Education Program Evaluation Research JAMA Surg. (IF 16.9) Pub Date : 2024-01-03 Marc de Moya, Jason S. Haukoos, Kamal M. F. Itani
This Guide to Statistics and Methods describes common methods for building evidence of validity for a program within health professional education and provides a framework for program evaluation.
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Scalability and Sustainability of a Surgical Infection Prevention Program in Low-Income Environments. JAMA Surg. (IF 16.9) Pub Date : 2023-11-29 Nichole Starr,Natnael Gebeyehu,Maia R Nofal,Jared A Forrester,Assefa Tesfaye,Tihitena Negussie Mammo,Thomas G Weiser,,Daniel Abebe Amdie,Milena Abreha,Mechal Alemu,Seleman Ally,Abdii Amin Abdukadir,Gezahegn Assefa,Yoseph Bedore,Abebe Bekele,Mahlet Berhanu,Senait Bitew Alemu,Zelalem Chimdesa,Miliard Derbew,Christina Fast,Katie Fernandez,Selam Kahsay,Ananya Kassahun,Hillena Kebede,Garoma Kitesa,Luca
Importance Surgical infections are a major cause of perioperative morbidity and mortality, particularly in low-resource settings. Clean Cut, a 6-month quality improvement program developed by the global nonprofit organization Lifebox, has demonstrated improvements in postoperative infectious complications. However, the pilot program required intense external programmatic and resource support. Objective
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Empowering Surgeons to Help Increase Value in Health Care Requires Better Data. JAMA Surg. (IF 16.9) Pub Date : 2023-11-29 Ursula Adams,Caprice C Greenberg,Jared Gallaher
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Surgeon Supply by County-Level Rurality and Social Vulnerability From 2010 to 2020. JAMA Surg. (IF 16.9) Pub Date : 2023-11-29 Vishal R Patel,Michael Liu,James P Byrne,Alex B Haynes,Andrew M Ibrahim