Pub Date : 2025-01-08DOI: 10.1001/jamasurg.2024.6000
Shipra Arya, Lesly A Dossett, Melina R Kibbe
{"title":"Best Practices for Big Data Sources and Methods in Surgery.","authors":"Shipra Arya, Lesly A Dossett, Melina R Kibbe","doi":"10.1001/jamasurg.2024.6000","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6000","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1001/jamasurg.2024.6006
Oluwadamilola M. Fayanju, Elliott R. Haut, Kamal Itani
This Guide to Statistics and Methods summarizes the limitations and considerations when using large datasets comprising patient-level data, typically abstracted from institutional electronic health records, in health services research.
{"title":"Practical Guide to Clinical Big Data Sources","authors":"Oluwadamilola M. Fayanju, Elliott R. Haut, Kamal Itani","doi":"10.1001/jamasurg.2024.6006","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6006","url":null,"abstract":"This Guide to Statistics and Methods summarizes the limitations and considerations when using large datasets comprising patient-level data, typically abstracted from institutional electronic health records, in health services research.","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"28 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1001/jamasurg.2024.6019
Ryan P. Merkow, Alex B. Haynes, Marja A. Boermeester
This Guide to Statistics and Methods provides an overview of different types of patient-generated data sources, discusses their limitations, and recommends areas for improvement prior to widespread integration.
{"title":"Practical Guide to Patient-Generated Data Sources","authors":"Ryan P. Merkow, Alex B. Haynes, Marja A. Boermeester","doi":"10.1001/jamasurg.2024.6019","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6019","url":null,"abstract":"This Guide to Statistics and Methods provides an overview of different types of patient-generated data sources, discusses their limitations, and recommends areas for improvement prior to widespread integration.","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"348 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1001/jamasurg.2024.6009
Leah Backhus, Shaunak Adkar, Derek Klarin
This Guide to Statistics and Methods explores the benefits for disease detection and treatment of using big data sources, such as large-scale biobanks, and discusses their implications for data management and health equity.
{"title":"Practical Guide to Multiomics Big Data Sources","authors":"Leah Backhus, Shaunak Adkar, Derek Klarin","doi":"10.1001/jamasurg.2024.6009","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6009","url":null,"abstract":"This Guide to Statistics and Methods explores the benefits for disease detection and treatment of using big data sources, such as large-scale biobanks, and discusses their implications for data management and health equity.","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"15 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1001/jamasurg.2024.6022
Daniel A. Hashimoto, Justin B. Dimick, Carla M. Pugh
This Guide to Statistics and Methods summarizes the limitations and considerations when using simulation and intraoperative video data for surgical performance assessment.
本统计和方法指南总结了使用模拟和术中视频数据进行手术性能评估时的局限性和注意事项。
{"title":"Practical Guide to Use of Simulation and Video Data","authors":"Daniel A. Hashimoto, Justin B. Dimick, Carla M. Pugh","doi":"10.1001/jamasurg.2024.6022","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6022","url":null,"abstract":"This Guide to Statistics and Methods summarizes the limitations and considerations when using simulation and intraoperative video data for surgical performance assessment.","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"69 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1001/jamasurg.2024.6012
Elsie Gyang Ross, Shipra Arya, Marc L Melcher
{"title":"Practical Guide to Image-Based Big Data Research.","authors":"Elsie Gyang Ross, Shipra Arya, Marc L Melcher","doi":"10.1001/jamasurg.2024.6012","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6012","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1001/jamasurg.2024.6003
Rachel A Greenup, Danny Chu, Timothy M Pawlik
{"title":"Practical Guide to Administrative and Billing Big Data Sources.","authors":"Rachel A Greenup, Danny Chu, Timothy M Pawlik","doi":"10.1001/jamasurg.2024.6003","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.6003","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-02DOI: 10.1001/jamasurg.2024.5983
Aaron R Dezube, Virginia R Litle
{"title":"Silent Cost of Private Equity Hospitals.","authors":"Aaron R Dezube, Virginia R Litle","doi":"10.1001/jamasurg.2024.5983","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.5983","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-02DOI: 10.1001/jamasurg.2024.5913
Neslihan Cabioglu, Havva Belma Koçer, Hasan Karanlik, Mehmet Ali Gülçelik, Abdullah Igci, Mahmut Müslümanoglu, Cihan Uras, Baris Mantoglu, Didem Can Trabulus, Giray Akgül, Mustafa Tükenmez, Kazim Senol, Enver Özkurt, Ebru Sen, Güldeniz Karadeniz Çakmak, Süleyman Bademler, Selman Emiroglu, Nilüfer Yildirim, Halil Kara, Ahmet Dag, Ece Dilege, Ayse Altinok, Gül Basaran, Ecenur Varol, Ümit Ugurlu, Yasemin Bölükbasi, Yeliz Emine Ersoy, Baha Zengel, Niyazi Karaman, Serdar Özbas, Leyla Zer, Halime Gül Kiliç, Orhan Agcaoglu, Gürhan Sakman, Zafer Utkan, Aykut Soyder, Alper Akcan, Sefa Ergün, Ravza Yilmaz, Adnan Aydiner, Atilla Soran, Kamuran Ibis, Vahit Özmen
<p><strong>Importance: </strong>Increasing evidence supports the oncologic safety of de-escalating axillary surgery for patients with breast cancer after neoadjuvant chemotherapy (NAC).</p><p><strong>Objective: </strong>To evaluate the oncologic outcomes of de-escalating axillary surgery among patients with clinically node (cN)-positive breast cancer and patients whose disease became cN negative after NAC (ycN negative).</p><p><strong>Design, setting, and participants: </strong>In the NEOSENTITURK MF-1803 prospective cohort registry trial, patients from 37 centers with cT1-4N1-3M0 disease treated with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) alone or with ypN-negative or ypN-positive disease after NAC were recruited between February 15, 2019, and January 1, 2023, and evaluated.</p><p><strong>Exposure: </strong>Treatment with SLNB or TAD after NAC.</p><p><strong>Main outcomes and measures: </strong>The primary aim of the study was axillary, locoregional, or distant recurrence rates; disease-free survival; and disease-specific survival. Number of axillary lymph nodes removed was also evaluated.</p><p><strong>Results: </strong>A total of 976 patients (median age, 46 years [range, 21-80 years]) with cT1-4N1-3M0 disease underwent SLNB (n = 620) or TAD alone (n = 356). Most of the cohort had a mapping procedure with blue dye alone (645 [66.1%]) with (n = 177) or without (n = 468) TAD. Overall, no difference was found between patients treated with TAD and patients treated with SLNB in the median number of total lymph nodes removed (TAD, 4 [3-6] vs SLNB, 4 [3-6]; P = .09). Among patients with ypN-positive disease, those who underwent TAD were more likely to have a lower median lymph node ratio (TAD, 0.28 [IQR, 0.20-0.40] vs SLNB, 0.33 [IQR, 0.20-0.50]; P = .03). At a median follow-up of 39 months (IQR, 29-48 months), no significant difference was found in the rates of ipsilateral axillary recurrence (0.3% [1 of 356] vs 0.3% [2 of 620]; P ≥ .99) or locoregional recurrence (0.6% [2 of 356] vs 1.1% [7 of 620]; P = .50) between the TAD and SLNB groups, with an overall locoregional recurrence rate of 0.9% (9 of 976). The initial clinical tumor stage, pathologic complete response, and use of blue dye alone as a mapping procedure were not associated with the outcome. Even though patients with TAD demonstrated an increased disease-free survival rate compared with the SLNB group, this difference did not reach statistical significance (94.9% vs 92.6%; P = .07). Factors associated with decreased 5-year disease-specific survival were cN2-3 axillary stage (cN1, 98.7% vs cN2-3, 96.8%; P = .03) and nonluminal type tumor pathologic characteristics (luminal, 98.9% vs nonluminal, 96.9%; P = .007).</p><p><strong>Conclusions and relevance: </strong>The short-term results suggest very low rates of axillary and locoregional recurrence in a select group of patients with cN-negative disease after NAC treated with TAD alone or SLNB alone followed b
{"title":"De-Escalation of Nodal Surgery in Clinically Node-Positive Breast Cancer.","authors":"Neslihan Cabioglu, Havva Belma Koçer, Hasan Karanlik, Mehmet Ali Gülçelik, Abdullah Igci, Mahmut Müslümanoglu, Cihan Uras, Baris Mantoglu, Didem Can Trabulus, Giray Akgül, Mustafa Tükenmez, Kazim Senol, Enver Özkurt, Ebru Sen, Güldeniz Karadeniz Çakmak, Süleyman Bademler, Selman Emiroglu, Nilüfer Yildirim, Halil Kara, Ahmet Dag, Ece Dilege, Ayse Altinok, Gül Basaran, Ecenur Varol, Ümit Ugurlu, Yasemin Bölükbasi, Yeliz Emine Ersoy, Baha Zengel, Niyazi Karaman, Serdar Özbas, Leyla Zer, Halime Gül Kiliç, Orhan Agcaoglu, Gürhan Sakman, Zafer Utkan, Aykut Soyder, Alper Akcan, Sefa Ergün, Ravza Yilmaz, Adnan Aydiner, Atilla Soran, Kamuran Ibis, Vahit Özmen","doi":"10.1001/jamasurg.2024.5913","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.5913","url":null,"abstract":"<p><strong>Importance: </strong>Increasing evidence supports the oncologic safety of de-escalating axillary surgery for patients with breast cancer after neoadjuvant chemotherapy (NAC).</p><p><strong>Objective: </strong>To evaluate the oncologic outcomes of de-escalating axillary surgery among patients with clinically node (cN)-positive breast cancer and patients whose disease became cN negative after NAC (ycN negative).</p><p><strong>Design, setting, and participants: </strong>In the NEOSENTITURK MF-1803 prospective cohort registry trial, patients from 37 centers with cT1-4N1-3M0 disease treated with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) alone or with ypN-negative or ypN-positive disease after NAC were recruited between February 15, 2019, and January 1, 2023, and evaluated.</p><p><strong>Exposure: </strong>Treatment with SLNB or TAD after NAC.</p><p><strong>Main outcomes and measures: </strong>The primary aim of the study was axillary, locoregional, or distant recurrence rates; disease-free survival; and disease-specific survival. Number of axillary lymph nodes removed was also evaluated.</p><p><strong>Results: </strong>A total of 976 patients (median age, 46 years [range, 21-80 years]) with cT1-4N1-3M0 disease underwent SLNB (n = 620) or TAD alone (n = 356). Most of the cohort had a mapping procedure with blue dye alone (645 [66.1%]) with (n = 177) or without (n = 468) TAD. Overall, no difference was found between patients treated with TAD and patients treated with SLNB in the median number of total lymph nodes removed (TAD, 4 [3-6] vs SLNB, 4 [3-6]; P = .09). Among patients with ypN-positive disease, those who underwent TAD were more likely to have a lower median lymph node ratio (TAD, 0.28 [IQR, 0.20-0.40] vs SLNB, 0.33 [IQR, 0.20-0.50]; P = .03). At a median follow-up of 39 months (IQR, 29-48 months), no significant difference was found in the rates of ipsilateral axillary recurrence (0.3% [1 of 356] vs 0.3% [2 of 620]; P ≥ .99) or locoregional recurrence (0.6% [2 of 356] vs 1.1% [7 of 620]; P = .50) between the TAD and SLNB groups, with an overall locoregional recurrence rate of 0.9% (9 of 976). The initial clinical tumor stage, pathologic complete response, and use of blue dye alone as a mapping procedure were not associated with the outcome. Even though patients with TAD demonstrated an increased disease-free survival rate compared with the SLNB group, this difference did not reach statistical significance (94.9% vs 92.6%; P = .07). Factors associated with decreased 5-year disease-specific survival were cN2-3 axillary stage (cN1, 98.7% vs cN2-3, 96.8%; P = .03) and nonluminal type tumor pathologic characteristics (luminal, 98.9% vs nonluminal, 96.9%; P = .007).</p><p><strong>Conclusions and relevance: </strong>The short-term results suggest very low rates of axillary and locoregional recurrence in a select group of patients with cN-negative disease after NAC treated with TAD alone or SLNB alone followed b","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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