Quality and Outcome Assessment for Surgery

Chiche, Laurent; Yang, Han–Kwang; Abbassi, Fariba; Robles, R; Stain, Steven C.; Ko, Clifford Y.; Neumayer, Leigh; Pawlik, Timothy M.; Barkun, Jeffrey; Clavien, Pierre‐Alain

doi:10.1097/sla.0000000000006077

Cited by 4 publications

(4 citation statements)

References 67 publications

(120 reference statements)

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“…To date, only a minority of surgical studies collect and report PROMs, despite the increasing emphasis on the concept of patient-centered medicine 38,39 . A fundamental shift in data collection across the field of surgery is needed to give greater weight to the patient voice.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome Reporting. Moving from a Comic to a Tragic Opera?

Abbassi,

Pfister,

Domenghino

et al. 2024

Annals of Surgery

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Objectives: To assess the current quality of surgical outcome reporting in the medical literature, and to provide recommendations for improvement. Background: In 1996, the Lancet labelled surgery as a “comic opera” mostly referring to the poor quality of outcome reporting in the literature impeding improvement in surgical quality and patient care. Methods: We screened three 1st tier and two 2nd tier surgical journals, as well as three leading medical journals for original articles reporting on results of surgical procedures published over a recent 18-month period. The quality of outcome reporting was assessed using a pre-specified 12-item checklist. Results: 627 articles reporting surgical outcomes were analyzed, including 125 randomized controlled trials (RCT). Only 1 (0·2%) article met all 12 criteria of the checklist, while 356 articles (57%) fulfilled less than half of criteria. The poorest reporting was on cumulative morbidity burden, which was missing in 94% of articles (n=591) as well as patient reported outcomes missing in 83% of publications (n=518). Comparing journal groups for the individual criterion, we found moderate to very strong statistical evidence for better quality of reporting in high versus lower impact journals for 7 of 12 criteria, and strong statistical evidence for better reporting of patient-reported outcomes in medical versus surgical journals (P<0·001). Conclusion: The quality of outcome reporting in the medical literature remains poor lacking improvement over the past 20 years on most key endpoints. The implementation of standardized outcome reporting is urgently needed to minimize biased interpretation of data thereby enabling improved patient care and the elaboration of meaningful guidelines.

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Section: Discussionmentioning

confidence: 99%

Surgical Outcome Reporting. Moving from a Comic to a Tragic Opera?

Abbassi,

Pfister,

Domenghino

et al. 2024

Annals of Surgery

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“…Individually assessed parameters have served as surrogate benchmarks for treatment quality in the past decades [13]. As such, lymph node harvest and R0 resection, surgical quality indicators, impact long-term prognosis and the risk of disease recurrence [14].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the Outcome4Medicine Consensus Conference, a group dedicated to assessing outcomes in medical interventions, has highlighted the inadequacy of solely examining isolated metrics [13]. This approach fails to fully provide a picture of overall quality and capture the complexity of the clinical scenario.…”

Section: Introductionmentioning

confidence: 99%

“…This approach fails to fully provide a picture of overall quality and capture the complexity of the clinical scenario. In response to the limitations associated with this singular approach, the adoption of composite measures has gained increased acknowledgment, emphasizing the significance of integrating data from various domains [13]. One of the most simple and comprehensive is the "All or None" method, which refers to an approach where a specific set of criteria must be fulfilled for an individual to be considered as achieving the overall measure [20].…”

Section: Introductionmentioning

confidence: 99%

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Textbook Neoadjuvant Outcome—Novel Composite Measure of Oncological Outcomes among Gastric Cancer Patients Undergoing Multimodal Treatment

Pelc,

Sędłak,

Leśniewska

et al. 2024

Cancers

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The incidence of gastric cancer (GC) is expected to increase to 1.77 million cases by 2040. To improve treatment outcomes, GC patients are increasingly treated with neoadjuvant chemotherapy (NAC) prior to curative-intent resection. Although NAC enhances locoregional control and comprehensive patient care, survival rates remain poor, and further investigations should establish outcomes assessment of current clinical pathways. Individually assessed parameters have served as benchmarks for treatment quality in the past decades. The Outcome4Medicine Consensus Conference underscores the inadequacy of isolated metrics, leading to increased recognition and adoption of composite measures. One of the most simple and comprehensive is the “All or None” method, which refers to an approach where a specific set of criteria must be fulfilled for an individual to achieve the overall measure. This narrative review aims to present the rationale for the implementation of a novel composite measure, Textbook Neoadjuvant Outcome (TNO). TNO integrates five objective and well-established components: Treatment Toxicity, Laboratory Tests, Imaging, Time to Surgery, and Nutrition. It represents a desired, multidisciplinary care and hospitalization of GC patients undergoing NAC to identify the treatment- and patient-related data required to establish high-quality oncological care further. A key strength of this narrative review is the clinical feasibility and research background supporting the implementation of the first and novel composite measure representing the “ideal” and holistic care among patients with locally advanced esophago-gastric junction (EGJ) and GC in the preoperative period after NAC. Further analysis will correlate clinical outcomes with the prognostic factors evaluated within the TNO framework.

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How to measure quality of surgery as a component of multimodality treatment of gastric cancer

Polkowski,

Gęca,

Skórzewska

2024

Annals of Gastroent Surgery

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Gastric cancer (GC) is one of the most frequent reasons for cancer‐related death worldwide. The multimodal therapeutic strategies are now pragmatically tailored to each patient, especially in advanced GC. A radical but safe gastrectomy remains the cornerstone of the GC treatment. Moreover, the quality‐of‐life (QoL) outcome measures are now routinely utilized in order to select optimal type of gastrectomy, as well as reconstruction method. Postoperative complications are frequent, and effective diagnosis and treatment of complications is crucial to lower the mortality rates. The postoperative complications prolong hospital stay and may result in poor QoL, thus eliminating the completion of perioperative adjuvant therapy. Therefore, avoiding morbidity is not only relevant for the immediate postoperative course, but can also affect long‐term oncological outcome. Measuring outcome enables surgeons to: monitor their own results; compare quality of treatment between centres; facilitate improvement both for surgery alone and combined treatment; select optimal procedure for an individual patient. Textbook oncological outcome is a composite quality measure representing the ideal hospitalization for gastrectomy, as well as stage‐appropriate (perioperative) adjuvant chemotherapy. Standardized system for recording complications and adherence to multimodality treatment guidelines are crucial for achieving the ultimate goal of surgical quality‐improvement that can benefit patients QoL and long‐term outcomes after fast and uneventful hospitalization for gastrectomy.

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Quality and Outcome Assessment for Surgery

Cited by 4 publications

References 67 publications

Surgical Outcome Reporting. Moving from a Comic to a Tragic Opera?

Surgical Outcome Reporting. Moving from a Comic to a Tragic Opera?

Textbook Neoadjuvant Outcome—Novel Composite Measure of Oncological Outcomes among Gastric Cancer Patients Undergoing Multimodal Treatment

How to measure quality of surgery as a component of multimodality treatment of gastric cancer

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