Systematic review and meta-analysis of the volume-outcome relationship in pancreatic surgery

2011 ◽  
Vol 98 (4) ◽  
pp. 485-494 ◽  
Author(s):  
G. A. Gooiker ◽  
W. van Gijn ◽  
M. W. J. M. Wouters ◽  
P. N. Post ◽  
C. J. H. van de Velde ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Surgery ◽  
Meta Analysis ◽  
Outcome Relationship ◽  
Volume Outcome

Systematic review and meta-analysis on volume-outcome relationship of abdominal surgical procedures in Germany

2021 ◽  
Vol 86 ◽  
pp. 24-31 ◽  
Author(s):  
Anne Hendricks ◽  
Johannes Diers ◽  
Philip Baum ◽  
Stephanie Weibel ◽  
Carolin Kastner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Procedures ◽  
Meta Analysis ◽  
Outcome Relationship ◽  
Volume Outcome ◽  
Relationship Of

scholarly journals Hospital volume–outcome relationship in total knee arthroplasty: a systematic review and dose–response meta-analysis

2021 ◽  
Author(s):  
C. M. Kugler ◽  
K. Goossen ◽  
T. Rombey ◽  
K. K. De Santis ◽  
T. Mathes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dose Response ◽  
Hospital Volume ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Early Revision ◽  
Outcome Relationship ◽  
Volume Outcome ◽  
Total Knee ◽  
Cumulative Evidence

Abstract Purpose This systematic review and dose–response meta-analysis aimed to investigate the relationship between hospital volume and outcomes for total knee arthroplasty (TKA). Methods MEDLINE, Embase, CENTRAL and CINAHL were searched up to February 2020 for randomised controlled trials and cohort studies that reported TKA performed in hospitals with at least two different volumes and any associated patient-relevant outcomes. The adjusted effect estimates (odds ratios, OR) were pooled using a random-effects, linear dose–response meta-analysis. Heterogeneity was quantified using the I2-statistic. ROBINS-I and the GRADE approach were used to assess the risk of bias and the confidence in the cumulative evidence, respectively. Results A total of 68 cohort studies with data from 1985 to 2018 were included. The risk of bias for all outcomes ranged from moderate to critical. Higher hospital volume may be associated with a lower rate of early revision ≤ 12 months (narrative synthesis of k = 7 studies, n = 301,378 patients) and is likely associated with lower mortality ≤ 3 months (OR = 0.91 per additional 50 TKAs/year, 95% confidence interval [0.87–0.95], k = 9, n = 2,638,996, I2 = 51%) and readmissions ≤ 3 months (OR = 0.98 [0.97–0.99], k = 3, n = 830,381, I2 = 44%). Hospital volume may not be associated with the rates of deep infections within 1–4 years, late revision (1–10 years) or adverse events ≤ 3 months. The confidence in the cumulative evidence was moderate for mortality and readmission rates; low for early revision rates; and very low for deep infection, late revision and adverse event rates. Conclusion An inverse volume–outcome relationship probably exists for some TKA outcomes, including mortality and readmissions, and may exist for early revisions. Small reductions in unfavourable outcomes may be clinically relevant at the population level, supporting centralisation of TKA to high-volume hospitals. Level of evidence III. Registration number The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42019131209 available at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=131209).

scholarly journals The relationship between procedural volume and patient outcomes for percutaneous coronary interventions: a systematic review and meta-analysis

2021 ◽  
Vol 4 ◽  
pp. 10
Author(s):  
Kieran A. Walsh ◽  
Thomas Plunkett ◽  
Kirsty K. O'Brien ◽  
Conor Teljeur ◽  
Susan M. Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
High Volume ◽  
Percutaneous Coronary Interventions ◽  
Procedural Volume ◽  
Outcome Relationship ◽  
Percutaneous Coronary ◽  
Volume Outcome ◽  
Secondary Outcomes ◽  
The Relationship

Background: The relationship between procedural volume and outcomes for percutaneous coronary interventions (PCI) is contentious, with previous reviews suggesting an inverse volume-outcome relationship. The aim of this study was to systematically review contemporary evidence to re-examine this relationship. Methods: A systematic review and meta-analysis was undertaken to examine the relationship between PCI procedural volume (both at hospital- and operator-levels) and outcomes in adults. The primary outcome was mortality. The secondary outcomes were complications, healthcare utilisation and process outcomes. Searches were conducted from 1 January 2008 to 28 May 2019. Certainty of the evidence was assessed using ‘Grading of Recommendations, Assessment, Development and Evaluations’ (GRADE). Screening, data extraction, quality appraisal and GRADE assessments were conducted independently by two reviewers. Results: Of 1,154 unique records retrieved, 22 observational studies with 6,432,265 patients were included. No significant association was found between total PCI hospital volume and mortality (odds ratio [OR]: 0.84, 95% confidence interval [CI]: 0.69-1.03, I2 = 86%). A temporal trend from significant to non-significant pooled effect estimates was observed. The pooled effect estimate for mortality was found to be significantly in favour of high-volume operators for total PCI procedures (OR: 0.77, 95% CI: 0.63-0.94, I2 = 93%), and for high-volume hospitals for primary PCI procedures (OR: 0.77, 95% CI: 0.62-0.94, I2 = 78%). Overall, GRADE certainty of evidence was ‘very low’. There were mixed findings for secondary outcomes. Conclusions: A volume-outcome relationship may exist in certain situations, although this relationship appears to be attenuating with time, and there is ‘very low’ certainty of evidence. While volume might be important, it should not be the only standard used to define an acceptable PCI service and a broader evaluation of quality metrics should be considered that encompass patient experience and clinical outcomes. Systematic review registration: PROSPERO, CRD42019125288

Volume-Outcome Relationship in Surgery for Esophageal malignancy: Systematic Review and Meta-analysis 2000-2011

2011 ◽  
Vol 16 (5) ◽  
pp. 1055-1063 ◽  
Author(s):  
Sheraz R. Markar ◽  
Alan Karthikesalingam ◽  
Sri Thrumurthy ◽  
Donald E. Low
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Outcome Relationship ◽  
Volume Outcome ◽  
Esophageal Malignancy

scholarly journals The volume–outcome relationship for hip fractures: a systematic review and meta-analysis of 2,023,469 patients

2019 ◽  
Vol 90 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Eveline J A Wiegers ◽  
Charlie A Sewalt ◽  
Esmee Venema ◽  
Niels W L Schep ◽  
Jan A N Verhaar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Fractures ◽  
Meta Analysis ◽  
Outcome Relationship ◽  
Volume Outcome

1412 A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE VOLUME-OUTCOME RELATIONSHIP FOR THE RADICAL CYSTECTOMY: AN UPDATE FOR THE ONGOING DEBATE

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Catharina Goossens-Laan ◽  
Gea Gooiker ◽  
Willem van Gijn ◽  
Piet Post ◽  
Ruud Bosch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radical Cystectomy ◽  
Meta Analysis ◽  
Ongoing Debate ◽  
Outcome Relationship ◽  
Volume Outcome
Sign in / Sign up

Export Citation Format

Share Document