National Healthcare Quality and Disparities Report
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- Adverse Drug Events (ADE) (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 45 Research Studies DisplayedAnchan RM, Spies JB, Zhang S
Long-term health-related quality of life and symptom severity following hysterectomy, myomectomy, or uterine artery embolization for the treatment of symptomatic uterine fibroids.
This study compared the different surgical procedures used for uterine fibroids with respect to long-term health-related quality of life outcomes and symptom improvement. The authors examined differences in change from baseline to 1-, 2-, and 3-year follow-up in health-related quality of life and symptom severity among patients who underwent abdominal myomectomy, laparoscopic or robotic myomectomy, abdominal hysterectomy, laparoscopic or robotic hysterectomy, or uterine artery embolization. A subset of the COMPARE-UF registry, a multiinstitutional prospective observational cohort study of women undergoing treatment for uterine fibroids was used. A subset of 1384 women aged 31 to 45 years who underwent either abdominal myomectomy (n=237), laparoscopic myomectomy (n=272), abdominal hysterectomy (n=177), laparoscopic hysterectomy (n=522), or uterine artery embolization (n=176) were included. They obtained demographics, fibroid history, and symptoms using questionnaires at enrollment and at 1, 2, and 3 years posttreatment. The Uterine Fibroid Symptom and Quality of Life (UFS-QoL) questionnaire was used to ascertain symptom severity and health-related quality of life scores among participants. Those undergoing hysterectomy and uterine artery embolization reported the longest duration of fibroid symptoms with a mean of 6.3 years. The most common fibroid symptoms were heavy bleeding (menorrhagia) (75.3%), bulk symptoms (74.2%), and bloating (73.2%), with more than half (54.9%) of participants reported anemia, and 9.4% women reported a history of blood transfusion. Across all modalities, total health-related quality of life and symptom severity score markedly improved from baseline to 1-year with the largest improvement in the laparoscopic hysterectomy group. Those undergoing abdominal myomectomy, laparoscopic myomectomy, and uterine artery embolization also demonstrated significant improvement in health-related quality of life and symptom severity at 1 year, and the improvement persisted from baseline for uterine-sparing procedures during second and third year, posttreatment intervals, however with a trend toward decline in degree of improvement from years 1 and 2.
AHRQ-funded; HS023418.
Citation: Anchan RM, Spies JB, Zhang S .
Long-term health-related quality of life and symptom severity following hysterectomy, myomectomy, or uterine artery embolization for the treatment of symptomatic uterine fibroids.
Am J Obstet Gynecol 2023 Sep; 229(3):275.e1-75.e17. doi: 10.1016/j.ajog.2023.05.020..
Keywords: Quality of Life, Women, Surgery
Gupta N, Kucirka L, Semerjian A
Practice patterns regarding female reproductive organ-sparing and nerve-sparing radical cystectomy among urologic oncologists in the United States.
The purpose of this study was to describe practice patterns regarding female reproductive organ-sparing (ROS) and nerve-sparing radical cystectomy nerve-sparing radical cystectomy (RC) among US urologists. The researchers conducted a cross-sectional survey of members of the Society of Urologic Oncology to evaluate provider-reported frequency of ROS and nerve-sparing RC in premenopausal and postmenopausal patients with non-muscle-invasive bladder cancer that failed intravesical therapy or clinically localized muscle-invasive bladder cancer. The study found that among 101 urologists, 79.2% reported that they routinely resect the uterus/cervix, 67.3% the neurovascular bundle, 48.5% the ovaries, and 18.8% a portion of the vagina when performing RC in premenopausal patients with organ-confined disease. When asked about changes to approach in postmenopausal patients, 70.3% reported that they were less likely to spare the uterus/cervix, 43.6% were less likely to spare the neurovascular bundle, 69.3% were less likely to spare the ovaries, and 22.8% were less likely to spare a portion of the vagina.
AHRQ-funded; HS026120.
Citation: Gupta N, Kucirka L, Semerjian A .
Practice patterns regarding female reproductive organ-sparing and nerve-sparing radical cystectomy among urologic oncologists in the United States.
Clin Genitourin Cancer 2023 Aug; 21(4):e236-e41. doi: 10.1016/j.clgc.2023.01.010..
Keywords: Practice Patterns, Women, Sexual Health, Surgery, Cancer
Schumacher JR, Zahrieh D, Chow S
Increasing socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial.
This paper describes the protocol for a multisite randomized trial to test the impact of a newly developed decision aid to increase socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making. The study will be conducted through 10 surgical clinics within the National Cancer Institute Community Oncology Research Program (NCORP). A stepped-wedge design with clinics will be randomized to the time of transition from usual care to the decision aid arm. Study participants will be female, aged ≥18 years, with newly diagnosed stage 0-III breast cancer who are planning breast surgery. Data collection will include a baseline surgeon survey, baseline patient survey, audio-recording of the surgeon-patient consultation, a follow-up patient survey and medical record data review. A subset of patients, surgeons, and clinic stakeholders will participate in interviews and focus groups.
AHRQ-funded; HS025194.
Citation: Schumacher JR, Zahrieh D, Chow S .
Increasing socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial.
BMJ Open 2022 Nov 17;12(11):e063895. doi: 10.1136/bmjopen-2022-063895..
Keywords: Cancer: Breast Cancer, Cancer, Patient and Family Engagement, Shared Decision Making, Patient-Centered Healthcare, Surgery, Women
Warren DK, Peacock KM, Nickel KB
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
The authors investigated factors associated with post-discharge prophylactic antibiotic use after mastectomy with and without immediate reconstruction and the impact on surgical-site infection (SSI). They found that anti-methicillin-sensitive Staphylococcus aureus antibiotics were associated with decreased risk of SSI for patients who had mastectomy only and those who had mastectomy with immediate reconstruction. They concluded that the high numbers needed to treat suggest that potential benefits of post-discharge antibiotics should be weighed against potential harms associated with antibiotic overuse.
AHRQ-funded; HS019455.
Citation: Warren DK, Peacock KM, Nickel KB .
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
Infect Control Hosp Epidemiol 2022 Oct;43(10):1382-88. doi: 10.1017/ice.2021.400..
Keywords: Antibiotics, Cancer: Breast Cancer, Cancer, Medication, Surgery, Healthcare-Associated Infections (HAIs), Prevention, Women, Practice Patterns
Roberson ML, Nichols HB, Olshan AF
Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality.
The authors sought to examine trends in the surgical treatment of breast cancer by age, rurality, and among Black women in a populous, racially diverse, state in the Southeastern United States of America. Using data from the North Carolina Central Cancer Registry, they found declining mastectomy rates in the early 2000s in a Southern US state with a racially and geographically diverse population. These decreasing trends were consistent among key subgroups affected by cancer inequities, including Black and White rural women.
AHRQ-funded; HS027299.
Citation: Roberson ML, Nichols HB, Olshan AF .
Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality.
Breast Cancer Res Treat 2022 Jun;193(2):445-54. doi: 10.1007/s10549-022-06564-w..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery, Racial and Ethnic Minorities, Rural Health
Kho RM, Desai VB, Schwartz PE
Endometrial sampling for preoperative diagnosis of uterine leiomyosarcoma.
This retrospective cohort study examined the effectiveness of endometrial sampling for preoperative detection of uterine leiomyosarcoma in women undergoing hysterectomy, identified factors associated with missed diagnosis, and compared the outcomes of patients who had a preoperative diagnosis with those patients who had a missed diagnosis. A total of 79 patients with uterine leiomyosarcoma were included in the study. Of those patients, 46 (58.2%) were diagnosed preoperatively and 33 postoperatively. The groups were similar in age, race/ethnicity, bleeding symptoms, and comorbidities. Women who had endometrial sampling performed with hysteroscopy had a higher likelihood of preoperative diagnosis. Patients with localized stage (vs distant stage) or tumor size >11 cm were less likely to be diagnosed preoperatively.
AHRQ-funded; HS024702.
Citation: Kho RM, Desai VB, Schwartz PE .
Endometrial sampling for preoperative diagnosis of uterine leiomyosarcoma.
J Minim Invasive Gynecol 2022 Jan;29(1):119-27. doi: 10.1016/j.jmig.2021.07.004.
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Keywords: Cancer, Diagnostic Safety and Quality, Surgery, Women
Su WK, Coleman CM, Bossick AS
Racial differences in planned hysterectomy procedure route.
The objective of this study was to assess any racial differences in the likelihood of having a planned minimally invasive surgical (MIS) hysterectomy. Using data from the Henry Ford Health System, findings showed that Black women were not less likely than White women to have planned an MIS hysterectomy.
AHRQ-funded; HS022417
Citation: Su WK, Coleman CM, Bossick AS .
Racial differences in planned hysterectomy procedure route.
J Womens Health 2022 Jan;31(1):31-37. doi: 10.1089/jwh.2021.0132..
Keywords: Women, Racial and Ethnic Minorities, Surgery
Hughes TM, Ellsworth B, Berlin NL
Statewide episode spending variation of mastectomy for breast cancer.
The purpose of this study was to characterize variations in episode spending related to volume and complication rates for mastectomy. A secondary study aim was to identify patient- and facility-level determinants of variation. The researchers assessed mean spending for 7,342 patients undergoing mastectomy at 74 facilities across Michigan state. The study found that mean 30-day spending by facility ranged from $11,129 to $20,830 and ninety-day spending ranged from $17,303 to $31,060. Patient-level factors associated with greater spending included bilateral surgery, simultaneous breast reconstruction, length of stay, and readmission. The researchers concluded that Michigan hospitals have considerable variation in mastectomy spending, and that reducing the frequency of bilateral surgery and length of stay may increase value, without risking patient safety or oncologic outcomes.
AHRQ-funded; HS026030.
Citation: Hughes TM, Ellsworth B, Berlin NL .
Statewide episode spending variation of mastectomy for breast cancer.
J Am Coll Surg 2022 Jan;234(1):14-23. doi: 10.1097/xcs.0000000000000005..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery
Kuijer A, Dominici LS, Rosenberg SM
Arm morbidity after local therapy for young breast cancer patients.
This study assessed patient-reported arm morbidity in the Young Women's Breast Cancer Study (YWS). Participants were over 1300 women with breast cancer diagnosed at age 40 or younger and who were enrolled in the YWS. Findings showed that high rates of self-reported arm morbidity in young breast cancer survivors were reported, particularly in patients receiving axillary lymph node dissection and post-mastectomy radiation therapy. Recommendations included attention to the risks and benefits of differing local therapy strategies for axillary lymph node dissection and post-mastectomy radiation therapy patients.
AHRQ-funded; HS023680.
Citation: Kuijer A, Dominici LS, Rosenberg SM .
Arm morbidity after local therapy for young breast cancer patients.
Ann Surg Oncol 2021 Oct;28(11):6071-82. doi: 10.1245/s10434-021-09947-3..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery
Dominici L, Hu J, Zheng Y
Association of local therapy with quality-of-life outcomes in young women with breast cancer.
Researchers examined the association of surgery with longer-term satisfaction and quality of life (QOL) in young breast cancer survivors. Participants were women 40 years or older who enrolled in the Young Women's Breast Cancer Study. The results suggested that local therapy in young breast cancer survivors is persistently associated with poorer scores in multiple QOL domains, particularly among those treated with mastectomy and radiotherapy, irrespective of breast reconstruction. Socioeconomic stressors also appear to play a role.
AHRQ-funded; HS023680.
Citation: Dominici L, Hu J, Zheng Y .
Association of local therapy with quality-of-life outcomes in young women with breast cancer.
JAMA Surg 2021 Oct;156(10):e213758. 2021. doi: 10.1001/jamasurg.2021.3758..
Keywords: Cancer: Breast Cancer, Cancer, Quality of Life, Women, Surgery
Xu X, Desai VB, Wright JD
Hospital variation in responses to safety warnings about power morcellation in hysterectomy.
This study aimed to examine whether hospitals varied in their use of laparoscopic supracervical hysterectomy after safety warnings about power morcellation and compare the risk of surgical complications at hospitals that had different response trajectories in use of laparoscopic supracervical hysterectomy. The investigators found that hospitals varied in their use of laparoscopic supracervical hysterectomy after safety warnings about power morcellation. Complication risk increased at hospitals that shifted considerably toward open abdominal hysterectomy.
AHRQ-funded; HS024702.
Citation: Xu X, Desai VB, Wright JD .
Hospital variation in responses to safety warnings about power morcellation in hysterectomy.
Am J Obstet Gynecol 2021 Jun;224(6):589.e1-89.e13. doi: 10.1016/j.ajog.2020.12.1207..
Keywords: Patient Safety, Surgery, Risk, Women
Baskin AS, Wang T, Bredbeck BC
Trends in contralateral prophylactic mastectomy utilization for small unilateral breast cancer.
This study describes trends in contralateral prophylactic mastectomy (CPM) utilization for small unilateral breast cancer instead of breast-conserving surgery (BCS) which is recommended. The authors used the National Cancer Database to identify women with unilateral, T1 breast cancer. Of the total cohort of 765,487, 69% underwent BCS and 31% chose mastectomy. Of 176,673 women aged 70 years or older, 75% underwent BCS and 25% chose mastectomy. CPM rates have increased in both cohorts since 2006. Patient factors such as younger age, white rate, private insurance, tumor factors, and facility factors were associated with increased CPM rates compared with unilateral mastectomy.
Citation: Baskin AS, Wang T, Bredbeck BC .
Trends in contralateral prophylactic mastectomy utilization for small unilateral breast cancer.
J Surg Res 2021 Jun;262:71-84. doi: 10.1016/j.jss.2020.12.057..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery, Prevention, Healthcare Utilization
Pollack LM, Lowder JL, Keller M
Racial/ethnic differences in the risk of surgical complications and posthysterectomy hospitalization among women undergoing hysterectomy for benign conditions.
The objective of this retrospective cohort study was to evaluate whether 30- and 90-day surgical complication and postoperative hospitalization rates after hysterectomy for benign conditions differed by race/ethnicity and whether the differences remained after controlling for patient, hospital, and surgical characteristics. The investigators concluded that Black and Asian/Pacific Islander women had higher risk of some 30- and 90-day surgical complications after hysterectomy than white women. Black and Hispanic women had higher risk of posthysterectomy hospitalization.
AHRQ-funded; HS019455.
Citation: Pollack LM, Lowder JL, Keller M .
Racial/ethnic differences in the risk of surgical complications and posthysterectomy hospitalization among women undergoing hysterectomy for benign conditions.
J Minim Invasive Gynecol 2021 May;28(5):1022-32.e12. doi: 10.1016/j.jmig.2020.12.032..
Keywords: Surgery, Risk, Racial and Ethnic Minorities, Adverse Events, Hospitalization, Women
Wang T, Bredbeck BC, Sinco B
Variations in persistent use of low-value breast cancer surgery.
Through the Choosing Wisely campaign, surgical specialties identified 4 low-value breast cancer operations. Preliminary data suggest varying rates of deimplementation and have identified patient-level and clinician-level determinants of continued overuse. However, little information exists about facility-level variation or determinants of differential deimplementation. In this retrospective cohort study the investigators sought to identify variation and determinants of persistent use of low-value breast cancer surgical care.
AHRQ-funded; HS026030.
Citation: Wang T, Bredbeck BC, Sinco B .
Variations in persistent use of low-value breast cancer surgery.
JAMA Surg 2021 Apr;156(4):353-62. doi: 10.1001/jamasurg.2020.6942..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Women
Wegienka G, Stewart EA, Nicholson WK
Black women are more likely than White women to schedule a uterine-sparing treatment for leiomyomas.
The purpose of this study was to evaluate differences in the proportion of uterine fibroid (UF) treatments that were uterine-sparing between Black women and White women and identify factors that could explain disparities. The investigators concluded that in these participants, Black women were more likely to schedule a uterine-sparing UF treatment and a nonsurgical UF treatment than their White counterparts; the researchers indicated that this may not be true for all women though.
AHRQ-funded; HS023418.
Citation: Wegienka G, Stewart EA, Nicholson WK .
Black women are more likely than White women to schedule a uterine-sparing treatment for leiomyomas.
J Womens Health 2021 Mar;30(3):355-66. doi: 10.1089/jwh.2020.8634..
Keywords: Women, Racial and Ethnic Minorities, Surgery
Bossick AS, Katon JG, Gray KE
Concomitant bilateral salpingo-oophorectomy at hysterectomy: differences by race and menopausal status in the Veterans Affairs health care system, 2007-2014.
This study compared race and menopausal status differences in the rate of concomitant bilateral salphino-oopherectomy (BSO) at hysterectomy in the Veterans Affairs health care system from 2007-2014. The authors identified 6,785 Veterans who underwent a hysterectomy, including 2,230 with concomitant BSO. After adjustment premenopausal Black Veterans had 41% lower odds of going through BSO than their White counterparts. There was insufficient evidence in postmenopausal Veterans. Black Veterans were more likely to be single, obese, and undergo abdominal hysterectomy.
AHRQ-funded; HS013853.
Citation: Bossick AS, Katon JG, Gray KE .
Concomitant bilateral salpingo-oophorectomy at hysterectomy: differences by race and menopausal status in the Veterans Affairs health care system, 2007-2014.
J Womens Health 2020 Dec;29(12):1513-19. doi: 10.1089/jwh.2020.8503..
Keywords: Surgery, Women, Racial and Ethnic Minorities
Sangha R, Bossick A, Su WK
A prospective study of patterns of regret in the year after hysterectomy.
This study sought to identify patterns of self-reported regret after hysterectomy. Women undergoing hysterectomy for a benign indication were recruited in the 2 weeks prior to surgery. The investigators concluded that for some women, decisional regret may worsen after hysterectomy. They suggest that future studies that identify factors strongly associated with self-reported regret could lead to improved counseling about postsurgical expectations.
AHRQ-funded; HS022417.
Citation: Sangha R, Bossick A, Su WK .
A prospective study of patterns of regret in the year after hysterectomy.
J Patient Cent Res Rev 2020 Fall;7(4):329-36..
Keywords: Women, Surgery
Rosenberg SM, Dominici LS, Gelber S
Association of breast cancer surgery with quality of life and psychosocial well-being in young breast cancer survivors.
This study looked at the short-term and long-term effects of breast cancer surgery on young breast cancer survivors (aged 40 and younger). The researchers compared the effects of bilateral mastectomy (BM), unilateral mastectomy (UM), and breast conserving surgery (BCS) among women diagnosed with Stage 0-3 unilateral breast cancer between 2006 and 2016 who had surgery and completed QOL and psychosocial assessments. Out of 826 women, 45% had BM, 31% BCS, and 24% UM. Of the women who had BM/UM, 84% also underwent reconstructive surgery. Women who had BM vs BCS or UM had consistently worse sexuality and body image. Anxiety improved across all groups, but adjusted mean scores remained higher among women who had BM vs BCS/UM at 1 year. There were minimal between-group differences in depression levels.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Dominici LS, Gelber S .
Association of breast cancer surgery with quality of life and psychosocial well-being in young breast cancer survivors.
JAMA Surg 2020 Nov;155(11):1035-42. doi: 10.1001/jamasurg.2020.3325..
Keywords: Cancer: Breast Cancer, Cancer, Women, Quality of Life, Surgery
Guglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events
Gutnik L, Allen CM, Presson AP
Breast cancer surgery decision role perceptions and choice of surgery.
This study examined the finding that breast cancer patients who reported more personal responsibility for the surgery decision were more likely to undergo aggressive surgery. Retrospective cohort data was used from 100 newly diagnosed breast cancer patients. Surgery types compared were mastectomy, lumpectomy, and unilateral versus bilateral mastectomy. Patients’ decision-making role was identified using the Patient Preference Scale. Type of surgery and patient role concordance was compared as well as patient decision role performance, role perception, and provider role perception. Patient decision role and perceptions were not associated with type of surgery. Patient role preference depended on the stage of disease. Stage III patients preferred the most active roles with stage I and stage II patients preferring a more collaborative role. Providers perceived more passive patient roles in the mastectomy group.
AHRQ-funded; HS024784.
Citation: Gutnik L, Allen CM, Presson AP .
Breast cancer surgery decision role perceptions and choice of surgery.
Ann Surg Oncol 2020 Oct;27(10):3623-32. doi: 10.1245/s10434-020-08485-8.
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Keywords: Cancer: Breast Cancer, Cancer, Shared Decision Making, Surgery, Women
Yu J, Olsen MA, Margenthaler JA
Indications for readmission following mastectomy for breast cancer: an assessment of patient and operative factors.
In this study, the investigators examined the impact of patient and operative factors on 30-day hospital readmission following mastectomy for breast cancer. Using the 2011 HCUP California State Inpatient Database, they evaluated readmissions in adult women undergoing mastectomy for invasive, in situ, or history of breast cancer. The investigators found that surgical site infection and wound complications were the most common diagnoses requiring readmission and resulted in over half of readmissions in their study population at 30 days.
AHRQ-funded; HS19455.
Citation: Yu J, Olsen MA, Margenthaler JA .
Indications for readmission following mastectomy for breast cancer: an assessment of patient and operative factors.
Breast J 2020 Oct;26(10):1966-72. doi: 10.1111/tbj.14029..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Surgery, Cancer: Breast Cancer, Cancer, Women
Azad AD, Bozkurt S, Wheeler AJ
Acute pain after breast surgery and reconstruction: a two-institution study of surgical factors influencing short-term pain outcomes.
This study analyzed the relationship between differing breast cancer excisional procedures, reconstruction, and short-term pain outcomes. Women who underwent breast cancer surgery with and without reconstruction were included from two institutions: an academic hospital (AH) and a Veterans Health Administration (VHS) facility. Average pain scores at time of discharge and at 30-day follow-up were analyzed. The study included 1402 patients at AH and 1435 at VHA. Of those, 425 AH and 165 VHA patients underwent breast reconstruction. Pain scores were highest at discharge and improved over time. Younger age, preoperative opioid use, and longer length of stay were all associated with worse pain scores.
AHRQ-funded; HS024096.
Citation: Azad AD, Bozkurt S, Wheeler AJ .
Acute pain after breast surgery and reconstruction: a two-institution study of surgical factors influencing short-term pain outcomes.
J Surg Oncol 2020 Sep 15;122(4):623-31. doi: 10.1002/jso.26070..
Keywords: Pain, Cancer: Breast Cancer, Cancer, Surgery, Outcomes, Women
Smith ME, Vitous CA, Hughes TM
Barriers and facilitators to de-implementation of the Choosing Wisely((R)) guidelines for low-value breast cancer surgery.
The objective of this study was to understand why surgeons stop performing certain unnecessary cancer operations but not others and how best to de-implement entrenched and emerging unnecessary procedures. The investigators concluded that with a growing focus on the elimination of ineffective, unproven or low value practices, it is imperative that the behavioral determinants are understood and targeted with specific interventions to decrease utilization rapidly.
AHRQ-funded; HS026030.
Citation: Smith ME, Vitous CA, Hughes TM .
Barriers and facilitators to de-implementation of the Choosing Wisely((R)) guidelines for low-value breast cancer surgery.
Ann Surg Oncol 2020 Aug;27(8):2653-63. doi: 10.1245/s10434-020-08285-0..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Shared Decision Making, Guidelines, Women
Wang T, Baskin AS, Dossett LA
Deimplementation of the choosing wisely recommendations for low-value breast cancer surgery: a systematic review.
Overtreatment of early-stage breast cancer results in increased morbidity and cost without improving survival. Major surgical organizations participating in the Choosing Wisely campaign identified 4 breast cancer operations as low value. The purpose of this study was to evaluate the extent to which these procedures have been deimplemented, determine the implications of decreased use, and recognize possible barriers and facilitators to deimplementation.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin AS, Dossett LA .
Deimplementation of the choosing wisely recommendations for low-value breast cancer surgery: a systematic review.
JAMA Surg 2020 Aug;155(8):759-70. doi: 10.1001/jamasurg.2020.0322..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Shared Decision Making, Women, Evidence-Based Practice
Pollack LM, Olsen MA, Gehlert SJ
Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery.
The objective of the study was to evaluate racial/ethnic variation in hysterectomy surgical route in women likely eligible for minimally invasive hysterectomy. The investigators concluded that African American, Hispanic, and Asian/PI women eligible for minimally invasive hysterectomy were more likely than White women to receive abdominal hysterectomy. In addition, the proportion of all women undergoing abdominal hysterectomy was highest at hospitals serving higher proportions of African American persons.
AHRQ-funded; HS019455; HS022330.
Citation: Pollack LM, Olsen MA, Gehlert SJ .
Racial/ethnic disparities/differences in hysterectomy route in women likely eligible for minimally invasive surgery.
J Minim Invasive Gynecol 2020 Jul-Aug;27(5):1167-77. doi: 10.1016/j.jmig.2019.09.003..
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Racial and Ethnic Minorities, Women, Surgery