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Article ; Online: COVID 19: Surgery & the question of race.

Collier, Karole T / Rothstein, David H

2020 Volume 220, Issue 4, Page(s) 845–846

MeSH term(s)	Betacoronavirus ; COVID-19 ; Comorbidity ; Continental Population Groups ; Coronavirus Infections/ethnology ; Health Status Disparities ; Humans ; Morbidity/trends ; Pandemics ; Pneumonia, Viral/ethnology ; SARS-CoV-2 ; Surgical Procedures, Operative ; United States/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-05-20
Publishing country	United States
Document type	Editorial
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2020.05.026
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Article: COVID 19: Surgery & the question of race

Collier, Karole T / Rothstein, David H

Am. j. surg

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32498946
Database	COVID19

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Article ; Online: COVID 19

Collier, Karole T. / Rothstein, David H.

The American Journal of Surgery

Surgery & the question of race

2020 Volume 220, Issue 4, Page(s) 845–846

Keywords	Surgery ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2020.05.026
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Article ; Online: Comparison of Simulated Outcomes of Colorectal Cancer Surgery at the Highest-Performing vs Chosen Local Hospitals.

Finn, Caitlin B / Wirtalla, Chris / Roberts, Sanford E / Collier, Karole / Mehta, Shivan J / Guerra, Carmen E / Airoldi, Edoardo / Zhang, Xu / Keele, Luke / Aarons, Cary B / Jensen, Shane T / Kelz, Rachel R

JAMA network open

2023 Volume 6, Issue 2, Page(s) e2255999

Abstract: Importance: Variation in outcomes across hospitals adversely affects surgical patients. The use of high-quality hospitals varies by population, which may contribute to surgical disparities.: Objective: To simulate the implications of data-driven ... ...

Abstract	Importance: Variation in outcomes across hospitals adversely affects surgical patients. The use of high-quality hospitals varies by population, which may contribute to surgical disparities. Objective: To simulate the implications of data-driven hospital selection for social welfare among patients who underwent colorectal cancer surgery. Design, setting, and participants: This economic evaluation used the hospital inpatient file from the Florida Agency for Health Care Administration. Surgical outcomes of patients who were treated between January 1, 2016, and December 31, 2018 (training cohort), were used to estimate hospital performance. Costs and benefits of care at alternative hospitals were assessed in patients who were treated between January 1, 2019, and December 31, 2019 (testing cohort). The cohorts comprised patients 18 years or older who underwent elective colorectal resection for benign or malignant neoplasms. Data were analyzed from March to October 2022. Exposures: Using hierarchical logistic regression, we estimated the implications of hospital selection for in-hospital mortality risk in patients in the training cohort. These estimates were applied to patients in the testing cohort using bayesian simulations to compare outcomes at each patient's highest-performing and chosen local hospitals. Analyses were stratified by race and ethnicity to evaluate the potential implications for equity. Main outcomes and measures: The primary outcome was the mean patient-level change in social welfare, a composite measure balancing the value of reduced mortality with associated costs of care at higher-performing hospitals. Results: A total of 21 098 patients (mean [SD] age, 67.3 [12.0] years; 10 782 males [51.1%]; 2232 Black [10.6%] and 18 866 White [89.4%] individuals) who were treated at 178 hospitals were included. A higher-quality local hospital was identified for 3057 of 5000 patients (61.1%) in the testing cohort. Selecting the highest-performing hospital was associated with a 26.5% (95% CI, 24.5%-29.0%) relative reduction and 0.24% (95% CI, 0.23%-0.25%) absolute reduction in mortality risk. A mean amount of $1953 (95% CI, $1744-$2162) was gained in social welfare per patient treated. Simulated reassignment to a higher-quality local hospital was associated with a 23.5% (95% CI, 19.3%-32.9%) relative reduction and 0.26% (95% CI, 0.21%-0.30%) absolute reduction in mortality risk for Black patients, with $2427 (95% CI, $1697-$3158) gained in social welfare. Conclusions and relevance: In this economic evaluation, using procedure-specific hospital performance as the primary factor in the selection of a local hospital for colorectal cancer surgery was associated with improved outcomes for both patients and society. Surgical outcomes data can be used to transform care and guide policy in colorectal cancer.
MeSH term(s)	Aged ; Humans ; Male ; Bayes Theorem ; Black People ; Colorectal Neoplasms/surgery ; Digestive System Surgical Procedures ; Hospitals ; White People ; Female ; Middle Aged
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.55999
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Article ; Online: Outcomes of the 2021-2022 APDS General Surgery Recruitment Process Recommendations.

LaFemina, Jennifer / Rosenkranz, Kari M / Aarons, Cary B / Abdelfattah, Kareem / Choi, Jennifer / Collier, Karole T / Havron, William S / Hillas, Jamie A / Lees, Jason / Serfin, Jennifer A / Terhune, Kyla P / Wise, Paul E / Smink, Douglas S

Journal of surgical education

2023 Volume 80, Issue 6, Page(s) 767–775

Abstract: Background: In recent years, mounting challenges for applicants and programs in resident recruitment have catapulted this topic into a top priority in medical education. These challenges span all aspects of recruitment-from the time an applicant applies ...

Abstract	Background: In recent years, mounting challenges for applicants and programs in resident recruitment have catapulted this topic into a top priority in medical education. These challenges span all aspects of recruitment-from the time an applicant applies until the time of the Match-and have widespread implications on cost, applicant stress, compromise of value alignment, and holistic review, and equity. In 2021-2022, the Association of Program Directors in Surgery (APDS) set forth recommendations to guide processes for General Surgery residency recruitment. Objectives: This work summarizes the APDS 2021-2022 resident recruitment process recommendations, along with their justification and program end-of-cycle program feedback and compliance. This work also outlines the impact of these data on the subsequent 2022-2023 recommendations. Methods: After a comprehensive review of the available literature and data about resident recruitment, the APDS Task Force proposed recommendations to guide 2021-2022 General Surgery resident recruitment. Following cycle completion, programs participating in the categorical General Surgery Match were surveyed for feedback and compliance. Results: About 122 of the 342 programs (35.7%) participating in the 2022 categorical General Surgery Match responded. Based on available data in advance of the cycle, recommendations around firm application and interview numbers could not be made. About 62% of programs participated in the first round interview offer period with 86% of programs limiting offers to the number of slots available; 95% conducted virtual-only interviews. Programs responded they would consider or strongly consider the following components in future cycles: holistic review (90%), transparency around firm requirements (88%), de-emphasis of standardized test scores (54%), participation in the ERAS Supplemental application (58%), single first round interview release period (69%), interview offers limited to the number of available slots (93%), 48-hour minimum interview offer response time (98%), operationalization of applicant expectations (88%), and virtual interviews (80%). There was variability in terms of the feedback regarding the timing of the single first round offer period as well as support for a voluntary, live site visit for applicants following program rank list certification. Conclusions: The majority of programs would consider implementing similar recommendations in 2022-2023. The greatest variability around compliance revolved around single interview release and the format of interviews. Future innovation is contingent upon the ongoing collection of data as well as unification of data sources involved in the recruitment process.
MeSH term(s)	Internship and Residency ; Surveys and Questionnaires ; Research Design ; Feedback ; General Surgery/education
Language	English
Publishing date	2023-03-17
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2023.02.019
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Article ; Online: Racial disparities in surgical outcomes of patients with Inflammatory Bowel Disease.

Montgomery, Samuel R / Butler, Paris D / Wirtalla, Chris J / Collier, Karole T / Hoffman, Rebecca L / Aarons, Cary B / Damrauer, Scott M / Kelz, Rachel R

American journal of surgery

2018 Volume 215, Issue 6, Page(s) 1046–1050

Abstract: Background: Inflammatory Bowel Disease (IBD) has not historically been a focus of racial health disparities research. IBD has been increasing in the black community. We hypothesized that outcomes following surgery would be worse for black patients.: ... ...

Abstract	Background: Inflammatory Bowel Disease (IBD) has not historically been a focus of racial health disparities research. IBD has been increasing in the black community. We hypothesized that outcomes following surgery would be worse for black patients. Methods: A retrospective cohort study of death and serious morbidity (DSM) of patients undergoing surgery for IBD was performed using data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP 2011-2014). Multivariable logistic regression modeling was performed to evaluate associations between race and outcomes. Results: Among 14,679 IBD patients, the overall rate of DSM was 20.3% (white: 19.3%, black 27.0%, other 23.8%, p < 0.001). After adjustment, black patients remained at increased risk of DSM compared white patients (OR: 1.37; 95% CI 1.14-1.64). Conclusions: Black patients are at increased risk of post-operative DSM following surgery for IBD. The elevated rates of DSM are not explained by traditional risk factors like obesity, ASA class, emergent surgery, or stoma creation.
MeSH term(s)	Adolescent ; Adult ; Aged ; Continental Population Groups ; Digestive System Surgical Procedures/adverse effects ; Female ; Follow-Up Studies ; Healthcare Disparities/statistics & numerical data ; Humans ; Inflammatory Bowel Diseases/ethnology ; Inflammatory Bowel Diseases/surgery ; Male ; Middle Aged ; Morbidity/trends ; Postoperative Complications/ethnology ; Quality Improvement ; Retrospective Studies ; Risk Factors ; Survival Rate/trends ; United States/epidemiology ; Young Adult
Language	English
Publishing date	2018-05-12
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2018.05.011
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Article ; Online: A preoperative prediction model for risk of multiple admissions after colon cancer surgery.

Fieber, Jennifer H / Sharoky, Catherine E / Collier, Karole T / Hoffman, Rebecca L / Wirtalla, Chris / Kelz, Rachel R / Paulson, Emily Carter

The Journal of surgical research

2018 Volume 231, Page(s) 380–386

Abstract: Background: A subset of patients who undergo colon cancer surgery may be at a high risk of multiple subsequent admissions. We developed a simplified model to predict the preoperative risk of multiple postoperative admissions (MuAdm) among patients ... ...

Abstract	Background: A subset of patients who undergo colon cancer surgery may be at a high risk of multiple subsequent admissions. We developed a simplified model to predict the preoperative risk of multiple postoperative admissions (MuAdm) among patients undergoing colon resection to aid in preoperative planning. Methods: Patients aged ≥18 y with colon cancer who underwent elective surgical resection identified in discharge claims from California and New York (2008-2011) were included. The primary outcome, MuAdm, was defined as 2 or more admissions in the year following resection. Logistic regression models were developed to identify factors predictive of MuAdm. A weighted point system was developed using beta-coefficients (P < 0.05). A random sample of 75% of the data was used for model development, which was validated in the remaining 25% sample. Results: A total of 14,780 patients underwent colon resection for cancer. Almost 30% had an admission in the year after index surgery and 9.8% had MuAdm. The significant predictors of MuAdm were higher Elixhauser comorbidity index score, metastatic disease, payer system, and the number of admissions in the year before surgery. Scores ranged from 0 to 8. Scores ≤1 had a 7% risk of MuAdm, and scores ≥6 had a >30% risk of MuAdm. Conclusions: In the year following discharge after resection of colon cancer, nearly 10% of patients are admitted 2 or more times. A simple, preoperative clinical model can prospectively predict the likelihood of multiple admissions in patients anticipating resection. This model can be used for preoperative planning and setting postoperative expectations more accurately.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colectomy ; Colonic Neoplasms/surgery ; Decision Support Techniques ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Middle Aged ; Models, Theoretical ; Patient Readmission/statistics & numerical data ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2018-06-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2018.05.079
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Article ; Online: Wind, water, wound, walk--do the data deliver the dictum?

Sonnenberg, Elizabeth M / Reinke, Caroline E / Bartlett, Edmund K / Collier, Karole T / Karakousis, Giorgos C / Holena, Daniel N / Kelz, Rachel R

Journal of surgical education

2015 Volume 72, Issue 1, Page(s) 164–169

Abstract: Objective: To evaluate the teaching dictum "wind, water, wound, walk" in the modern surgical environment.: Design: A retrospective cohort study.: Setting: Hospitals enrolled in the American College of Surgeons National Surgical Quality Improvement ...

Abstract	Objective: To evaluate the teaching dictum "wind, water, wound, walk" in the modern surgical environment. Design: A retrospective cohort study. Setting: Hospitals enrolled in the American College of Surgeons National Surgical Quality Improvement Program. Participants: We identified 11,137 patients enrolled in American College of Surgeons National Surgical Quality Improvement Program Participant Use File (2011) who were older than 18 years; underwent a general surgical procedure; and developed a postoperative pneumonia (PNA, "wind"), urinary tract infection (UTI, "water"), surgical site infection (SSI, "wound"), or venous thromboembolic event (VTE, "walk") for inclusion in the study. Patients were excluded if they had an infection present at the time of surgery or were missing information on the time of diagnosis. Results: The median day of diagnosis differed significantly according to occurrence type (median day of PNA = 5, UTI = 8, SSI = 11, and VTE = 9, p < 0.001). The sequence of occurrences diagnosed before discharge (median day of PNA = 4, UTI = 5, SSI = 7, and VTE = 5) differed from that of occurrences diagnosed following discharge (median day of PNA = 10, UTI = 14, SSI = 14, and VTE = 14). Within the predischarge and postdischarge subsets, the median day of diagnosis remained significantly different according to occurrence type (all p's < 0.001). Conclusions: The dictum should be taught as, "wind, water, walk, wound" to reflect the timing and progression of the diagnosis of PNA, UTI, VTE, and SSI. The dictum did not reflect the timing or sequence of the occurrences in the cohort diagnosed after discharge. Educators must teach trainees to apply the dictum in the appropriate patient setting. As surgical care changes, we must continue to reassess our educational pearls to ensure that they reflect the modern reality.
MeSH term(s)	Current Procedural Terminology ; General Surgery/education ; Humans ; Memory ; Pneumonia/epidemiology ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Quality Improvement ; Surgical Wound Infection/diagnosis ; Surgical Wound Infection/epidemiology ; Time Factors ; Urinary Tract Infections/diagnosis ; Urinary Tract Infections/epidemiology ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/epidemiology
Language	English
Publishing date	2015-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2014.05.019
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Article ; Online: Hospitalization in the Year Preceding Major Oncologic Surgery Increases Risk for Adverse Postoperative Events.

Sharoky, Catherine E / Collier, Karole T / Wirtalla, Christopher J / Sinnamon, Andrew J / Neuwirth, Madalyn G / Kuo, Lindsay E / Roses, Robert E / Fraker, Douglas L / Karakousis, Giorgos C / Kelz, Rachel R

Annals of surgical oncology

2017 Volume 24, Issue 12, Page(s) 3477–3485

Abstract: Background: Hospitalization is associated with negative clinical effects that last beyond discharge. This study aimed to determine whether hospitalization in the year before major oncologic surgery is associated with adverse outcomes.: Methods: ... ...

Abstract	Background: Hospitalization is associated with negative clinical effects that last beyond discharge. This study aimed to determine whether hospitalization in the year before major oncologic surgery is associated with adverse outcomes. Methods: Patients 18 years of age or older with stomach, pancreas, colon, or rectal cancer who underwent resection in California and New York (2008-2010) were included in the study. Patients with hospitalization in the year prior to oncologic resection (HYPOR) were identified. Multivariable logistic regression was used to examine the association of prior hospitalization with the following adverse outcomes: inpatient mortality, complications, complex discharge needs, and 90-day readmission. Subset analysis by cancer type was performed. Outcomes based on temporal proximity of hospitalization to month of surgical admission were evaluated. Results: Of 32,292 patients, 16.3% (n = 5276) were HYPOR. Patients with prior hospitalization were older (median age, 72 vs 67 years; p < 0.001) and had more comorbidities (Elixhauser Index ≥3, 86.5 vs 75.3%; p < 0.001). In the multivariable analysis, HYPOR was associated with complications (odds ratio [OR], 1.28; 95% confidence interval [CI] 1.18-1.40), complex discharge (OR, 1.44; 95% CI 1.34-1.55), and 90-day readmission (OR, 1.45; 95% CI 1.35-1.56). The interval from HYPOR to resection was not associated with adverse outcomes. Conclusions: Patients hospitalized in the year before oncologic resection are at increased risk for postoperative adverse events. Recent hospitalization is a risk factor that is easily ascertainable and should be used by clinicians to identify patients who may need additional support around the time of oncologic resection.
MeSH term(s)	Aged ; Aged, 80 and over ; Comorbidity ; Female ; Follow-Up Studies ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasms/complications ; Neoplasms/surgery ; Patient Readmission/statistics & numerical data ; Pennsylvania/epidemiology ; Postoperative Complications/epidemiology ; Prognosis ; Risk Assessment ; Risk Factors ; Surgical Oncology
Language	English
Publishing date	2017-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-017-6032-y
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Article: Predictive Factors of Response to Immunotherapy in Lymphomas: A Multicentre Clinical Data Warehouse Study (PRONOSTIM).

Detroit, Marion / Collier, Mathis / Beeker, Nathanaël / Willems, Lise / Decroocq, Justine / Deau-Fischer, Bénédicte / Vignon, Marguerite / Birsen, Rudy / Moufle, Frederique / Leclaire, Clément / Balladur, Elisabeth / Deschamps, Paul / Chauchet, Adrien / Batista, Rui / Limat, Samuel / Treluyer, Jean-Marc / Ricard, Laure / Stocker, Nicolas / Hermine, Olivier /

Choquet, Sylvain / Morel, Véronique / Metz, Carole / Bouscary, Didier / Kroemer, Marie / Zerbit, Jérémie

Cancers

2023 Volume 15, Issue 16

Abstract: ... or CAR T (Chimeric antigen receptor T) cells between 2017 and 2022 were included. Analysis ... of CAR T cells such as age, elevated lactate dehydrogenase, and elevated C-Reactive Protein at the time ... demonstrated to be potential predictive factors for progression after CAR T cell therapy. These findings prove ...

Abstract	Immunotherapy (IT) is a major therapeutic strategy for lymphoma, significantly improving patient prognosis. IT remains ineffective for a significant number of patients, however, and exposes them to specific toxicities. The identification predictive factors around efficacy and toxicity would allow better targeting of patients with a higher ratio of benefit to risk. PRONOSTIM is a multicenter and retrospective study using the Clinical Data Warehouse (CDW) of the Greater Paris University Hospitals network. Adult patients with Hodgkin lymphoma or diffuse large-cell B lymphoma treated with immune checkpoint inhibitors or CAR T (Chimeric antigen receptor T) cells between 2017 and 2022 were included. Analysis of covariates influencing progression-free survival (PFS) or the occurrence of grade ≥3 toxicity was performed. In total, 249 patients were included. From this study, already known predictors for response or toxicity of CAR T cells such as age, elevated lactate dehydrogenase, and elevated C-Reactive Protein at the time of infusion were confirmed. In addition, male gender, low hemoglobin, and hypo- or hyperkalemia were demonstrated to be potential predictive factors for progression after CAR T cell therapy. These findings prove the attractiveness of CDW in generating real-world data, and show its essential contribution to identifying new predictors for decision support before starting IT.
Language	English
Publishing date	2023-08-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15164028
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