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!
New study first to predict which oil and gas wells are leaking methane
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Droughts boost emissions as hydropower dries up
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The scientific and political community alike stress the importance of German Antarctic research
Joint Press Release from the BMBF and AWI
The Antarctic is a frigid continent south of the Antarctic Circle, where researchers are the only inhabitants. Despite the hostile conditions, here the Alfred...
World first experiments on sensor that may revolutionise everything from medical devices to unmanned vehicles
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Dead and alive at the same time? Researchers at the Max Planck Institute of Quantum Optics have implemented Erwin Schrödinger’s paradoxical gedanken experiment employing an entangled atom-light state.
In 1935 Erwin Schrödinger formulated a thought experiment designed to capture the paradoxical nature of quantum physics. The crucial element of this gedanken...
Cellulose obtained from wood has amazing material properties. Empa researchers are now equipping the biodegradable material with additional functionalities to produce implants for cartilage diseases using 3D printing.
It all starts with an ear. Empa researcher Michael Hausmann removes the object shaped like a human ear from the 3D printer and explains:
The phenomenon of so-called superlubricity is known, but so far the explanation at the atomic level has been missing: for example, how does extremely low friction occur in bearings? Researchers from the Fraunhofer Institutes IWM and IWS jointly deciphered a universal mechanism of superlubricity for certain diamond-like carbon layers in combination with organic lubricants. Based on this knowledge, it is now possible to formulate design rules for supra lubricating layer-lubricant combinations. The results are presented in an article in Nature Communications, volume 10.
One of the most important prerequisites for sustainable and environmentally friendly mobility is minimizing friction. Research and industry have been dedicated...
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