The results of this investigation, to be presented at the 28th Annual EAU Congress, aimed of to examine between surgeon variation with regards to oncological and patient-reported functional outcomes in one European centre.
The study included 1280 men who underwent open radical prostatectomy performed by one of nine surgeons at an academic institution in Sweden between 2 January 2001 through 16 July 2008.
Biochemical recurrence was defined as a prostate-specific antigen (PSA) value > 0.2 ng/ml with at least one confirmatory rise. The scientists measured functional outcomes preoperatively and postoperatively 18 months after the procedure by patient-administered questionnaires. Multivariate random effect models were used to evaluate heterogeneity between surgeons, adjusting for case mix – which included age, PSA, pathological stage and grade - year of surgery and surgical experience.
Of 635 men potent at baseline, 606 provided data at 18 months, of whom 100/606 (17%) were potent (nerve-sparing and non-nerve-sparing surgery), suggesting the absence of heterogeneity between surgeons (p=0.5).
The continence rate at 18 months was 85%, revealing statistically significant heterogeneity between surgeons (p=0.002). There was evidence of an unexpected negative correlation between the surgeons' adjusted probabilities of potency and continence at 18 months. At the same time, the researchers did not find any association between surgeons' adjusted probabilities of functional recovery and 5-year probability of freedom from biochemical recurrence.
"Surgeon heterogeneity suggests that at least some patients are receiving suboptimal care," write the authors. "Quality assurance measures should be considered to identify and correct suboptimal treatments to ensure patients receive optimal care."
Ivanka Moerkerken | EurekAlert!
Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland
Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
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24.03.2017 | Physics and Astronomy