How Do You Know If You Are Any Good? A Surgeon Performance Feedback System for the Outcomes of Radical Prostatectomy

Vickers, Andrew J.; Sjoberg, Daniel D.; Basch, Ethan; Sculli, Frank; Shouery, Marwan; Laudone, Vincent P.; Touijer, Karim; Eastham, James A.; Scardino, Peter T.

doi:10.1016/j.eururo.2011.10.039

Cited by 28 publications

(12 citation statements)

References 15 publications

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“…Of 21,342 titles identified by the literature search, 6 publications were identified that described initiatives in which PROs were used in performance evaluation [30][31][32][33][34][35]. Three additional relevant initiatives were identified via the Google search [36][37][38] and an additional four via the e-mail distribution [39][40][41][42].…”

Section: Use Cases and Guidance Documentsmentioning

confidence: 99%

Methods for Developing Patient-Reported Outcome-Based Performance Measures (PRO-PMs)

et al. 2015

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Section: Use Cases and Guidance Documentsmentioning

confidence: 99%

Methods for Developing Patient-Reported Outcome-Based Performance Measures (PRO-PMs)

et al. 2015

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“…The urologic community should consider empirical research on differences in surgical technique, in an attempt to identify specific aspects of technique that lead to improved outcomes. Centralized outcomes measurement, modeled after the high standards set by bariatric surgeons [85], may be an ideal setting to ensure appropriate control of quality and process compliance [86]. …”

Section: Evidence Synthesismentioning

confidence: 99%

A Systematic Review of the Volume–Outcome Relationship for Radical Prostatectomy

Trinh¹,

Bjartell²,

Freedland³

et al. 2013

European Urology

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Context Due to the complexity and challenging nature of radical prostatectomy (RP), it seems reasonable to suppose that both short- and long-term outcomes strongly depend on the cumulative number of cases performed by the surgeon as well as within the hospital. Objective To review systematically the association between hospital and surgeon volume and perioperative, oncologic, and functional outcomes after RP. Evidence acquisition A systematic review of the literature was performed, searching PubMed, Embase, and Scopus databases for original and review articles between January 1, 1995, and December 31, 2011. Inclusion and exclusion criteria comprised RP, hospital and/or surgeon volume reported as a predictor variable, a measurable end point, and a description of multiple hospitals or surgeons. Evidence synthesis Overall 45 publications fulfilled the inclusion criteria, where most data originated from retrospective institutional or population-based cohorts. Studies generally focused on hospital or surgeon volume separately. Although most of these analyses corroborated the impact of increasing volume with better outcomes, some others failed to find any significant effect. Studies also differed with respect to the proposed volume cut-off for improved outcomes, as well as the statistical means of evaluating the volume–outcome relationship. Five studies simultaneously compared hospital and surgeon volume, where results appear to suggest that the importance of either hospital or surgeon volume largely depends on the end point of interest. Conclusions Undeniable evidence suggests that increasing volume improves outcomes. Although it would seem reasonable to refer RP patients to high-volume centers, such regionalization may not be entirely practical. As such, the implications of such a shift in practice have yet to be fully determined and warrant further exploration.

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“…Ongoing measurement and reporting of surgical outcomes has been shown to positively influence surgical practice and may be one way of ensuring guideline adherence. 23,24 Published trials have yet to demonstrate that ERR results in improved OS. [11][12][13] The five-year OS rates in our cohort were 72.7%, 60.0%, and 53.8%, respectively, for those who received an ERR, a DRR, and a LRR/no repeat resection.…”

Section: Discussionmentioning

confidence: 99%

Low compliance with guidelines for re-staging in high-grade T1 bladder cancer and the potential impact on patient outcomes in the province of Alberta

Gotto

Shea‐Budgell

Ruether

2016

CUAJ

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Introduction:Despite high-level evidence of benefit, early repeat resection (ERR) among high-grade T1 bladder cancer (HGT1-BC) patients remains low in several non-Canadian jurisdictions and rates in Canada are largely unreported. We evaluated rates of ERR and trends over time in Alberta. We also examined factors associated with uptake of ERR. Methods: We conducted a retrospective review of data from all patients diagnosed with HGT1-BC from 2007 through 2011. Patients were identified from the Alberta Cancer Registry. Patients with a non-urothelial carcinoma of the bladder and those with invasion into the prostate or metastatic disease were excluded. We collected demographic and clinicopathologic information from patients' electronic medical records. Results: A total of 600 patients diagnosed with HGT1-BC were included. Overall, 167 patients (27.8%) received an ERR; however, the rate increased in a non-linear fashion from 27.4% in 2007 to 37.8% in 2011. Factors associated with ERR included age <80 years (p=0.021) and centre at which the initial transurethral resection of bladder tumour (TURBT) was performed (p=0.013). Median overall survival (OS) was not reached, but five-year OS was 72.7% (95% CI 68.9, 76.5) for those who received an ERR and 55.3% (95% CI 52.5, 58.1) for those who did not. Conclusions: Use of ERR in patients with HGT1-BC is improving over time. Regional variation in practice suggests the need for implementation strategies (i.e., provincial clinical care pathways) to standardize practice and set indicators for future measurement and reporting. Targeted interventions would require further investigation around the reasons for variation in practice.

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How Do You Know If You Are Any Good? A Surgeon Performance Feedback System for the Outcomes of Radical Prostatectomy

Cited by 28 publications

References 15 publications

Methods for Developing Patient-Reported Outcome-Based Performance Measures (PRO-PMs)

Methods for Developing Patient-Reported Outcome-Based Performance Measures (PRO-PMs)

A Systematic Review of the Volume–Outcome Relationship for Radical Prostatectomy

Low compliance with guidelines for re-staging in high-grade T1 bladder cancer and the potential impact on patient outcomes in the province of Alberta

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