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2 results

  • 6 - Outcomes

    • By Ann Møller, The Cochrane Anaesthesia Review Group, Department of Anaesthesiology, Herlev University Hospital, Herlev, Denmark
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book:
    Evidence-based Anaesthesia and Intensive Care
    Published online:
    05 September 2009
    Print publication:
    09 October 2006, pp 39-45

  • Summary

    This chapter describes types of outcome data, deals with evaluation of outcome data, and explains the difficulties with the use of surrogate outcomes. Typical clinically relevant outcomes in the field of anaesthesia could be perioperative mortality, major postoperative complications such as respiratory failure, myocardial infarction, infections, and surgical complications needing secondary surgery. The concept of Patient Oriented Evidence that Matters (POEMs) has mostly been used in journals and articles about general practice, but the idea can be transformed to other specialities as well. A surrogate endpoint can be defined as a laboratory or physiologic measurement used as a substitute for an endpoint that measures directly how a patient feels, functions, or survives. In conclusion, the major purpose of clinical trials is to support decision-makers in health care with reliable documentation of high scientific and methodological quality.

  • Volume–outcome relationships in breast cancer

  • K. Hiotis, K. A. Skinner
  • Journal:
    Breast Cancer Online / Volume 7 / Issue 11 / 16 November 2004
    Published online by Cambridge University Press:
    05 April 2005, e31
    Print publication:
    16 November 2004
    • Article
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  • A significant effect of hospital case volume on perioperative mortality has been documented for a variety of malignancies that require technically challenging operative procedures and complex perioperative management. The effect of case volume on outcome is less clear for the more common cancers, such as breast and colon cancers, that are less technically challenging and require little in the way of specialized care in the postoperative period. For these cancers perioperative mortality is minimal and one must look at other end points such as long-term survival and functional results. The literature demonstrating improved outcomes in terms of mammographical sensitivity, breast-conservation rates, specimen to tumour volume ratios in breast-conserving surgery, sentinel node biopsy success rates, and 5-year survival is reviewed.