Dataset Information

Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study.

ABSTRACT:

Objective

To determine the association between surgeons' experience and postoperative complications in thyroid surgery.

Design

Prospective cross sectional multicentre study.

Setting

High volume referral centres in five academic hospitals in France.

Participants

All patients who underwent a thyroidectomy undertaken by every surgeon in these hospitals from 1 April 2008 to 31 December 2009.

Main outcome measures

Presence of two permanent major complications (recurrent laryngeal nerve palsy or hypoparathyroidism), six months after thyroid surgery. We used mixed effects logistic regression to determine the association between length of experience and postoperative complications.

Results

28 surgeons completed 3574 thyroid procedures during a one year period. Overall rates of recurrent laryngeal nerve palsy and hypoparathyroidism were 2.08% (95% confidence interval 1.53% to 2.67%) and 2.69% (2.10% to 3.31%), respectively. In a multivariate analysis, 20 years or more of practice was associated with increased probability of both recurrent laryngeal nerve palsy (odds ratio 3.06 (1.07 to 8.80), P=0.04) and hypoparathyroidism (7.56 (1.79 to 31.99), P=0.01). Surgeons' performance had a concave association with their length of experience (P=0.036) and age (P=0.035); surgeons aged 35 to 50 years had better outcomes than their younger and older colleagues.

Conclusions

Optimum individual performance in thyroid surgery cannot be passively achieved or maintained by accumulating experience. Factors contributing to poor performance in very experienced surgeons should be explored further.

SUBMITTER: Duclos A

PROVIDER: S-EPMC3256252 | biostudies-literature | 2012 Jan

REPOSITORIES: biostudies-literature

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Publications

Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study.

Duclos Antoine A Peix Jean-Louis JL Colin Cyrille C Kraimps Jean-Louis JL Menegaux Fabrice F Pattou François F Sebag Fréderic F Touzet Sandrine S Bourdy Stéphanie S Voirin Nicolas N Lifante Jean-Christophe JC

BMJ (Clinical research ed.) 20120110

<h4>Objective</h4>To determine the association between surgeons' experience and postoperative complications in thyroid surgery.<h4>Design</h4>Prospective cross sectional multicentre study.<h4>Setting</h4>High volume referral centres in five academic hospitals in France.<h4>Participants</h4>All patients who underwent a thyroidectomy undertaken by every surgeon in these hospitals from 1 April 2008 to 31 December 2009.<h4>Main outcome measures</h4>Presence of two permanent major complications (recu ...[more]

PMID: 22236412

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Project description:BackgroundIn recent years, the new generation of telecommunication technologies has profoundly changed the traditional medical industry. To alleviate the medical difficulties faced by patients with thyroid diseases, hospitals have opened web-based visits and actively combined online-to-offline outpatient services.ObjectiveThis study aims to explore differences between office and web-based outpatient services from doctors' and patients' perspectives, illustrate the effect of the COVID-19 pandemic on outpatient services, and provide clues for improving the online-to-offline mode of care for patients with thyroid diseases.MethodsWe collected the complete web-based and office outpatient records of the Thyroid Surgery Center of West China Hospital. A total of 300,884 completed patient encounters occurred (201,840 office visits and 99,044 web-based visits) from January 1, 2019, to May 31, 2022. We performed logistic regression to evaluate the association between the chosen visit type and patients' sociodemographic characteristics.ResultsThe number of web-based visits rapidly increased since March 2020 and reached 45.1% (4752/10,531) of all encounters in December 2021. The COVID-19 pandemic dramatically accelerated the development of web-based visits. Web-based visits were preferred by patients 18-45 years old (odds ratio [OR] 2.043, 95% CI 1.635-2.552, P<.001), patients with relatively high-paying jobs (technical staff: OR 1.278, 95% CI 1.088-1.479, P=.003; office clerk: OR 1.25, 95% CI 1.07-1.461, P=.005; national public servant: OR:1.248, 95% CI 1.042-1.494, P=.02), and patients living in Sichuan Province (excluding Chengdu; OR 1.167, 95% CI 1.107-1.23, P<.001). The medicine cost (P<.001) and examination cost (P<.001) of office visits were significantly higher than those of web-based visits.ConclusionsWeb-based outpatient visits have increased rapidly in recent years, and the COVID-19 pandemic has boosted their development. The preference for web-based visits was influenced by the socioeconomic and demographic characteristics of both patients and doctors.

Dataset Information

Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Publications

Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study.

Similar Datasets

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