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Article ; Online: Viewpoint: rationing and surgical care.

Alderson, Derek

2018 Volume 121, Issue 1, Page(s) 1

MeSH term(s)	Cost Control ; Elective Surgical Procedures/economics ; Health Care Rationing/economics ; Humans ; National Health Programs/economics ; Needs Assessment ; United Kingdom ; Urologic Surgical Procedures/economics
Language	English
Publishing date	2018
Publishing country	England
Document type	Editorial
ZDB-ID	1462191-5
ISSN	1464-410X ; 1464-4096 ; 1358-8672
ISSN (online)	1464-410X
ISSN	1464-4096 ; 1358-8672
DOI	10.1111/bju.14092
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Ui VI Zs.107: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 13: Show issues

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Article ; Online: Improving patient outcomes after surgery.

Marx, Clare / Alderson, Derek

BMJ (Clinical research ed.)

2017 Volume 359, Page(s) j4580

Language	English
Publishing date	2017--10
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.j4580
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Article ; Online: The firm: extended surgical teams improve training and patient care.

Allum, Bill / Eardley, Ian / Alderson, Derek / Mortensen, Neil

BMJ (Clinical research ed.)

2019 Volume 366, Page(s) l5499

Language	English
Publishing date	2019-09-17
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.l5499
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Article ; Online: Neoadjuvant chemotherapy in oesophageal adenocarcinoma - Authors' reply.

Alderson, Derek / Nankivell, Matthew / Langley, Ruth / Cunningham, David

The Lancet. Oncology

2017 Volume 18, Issue 11, Page(s) e641

MeSH term(s)	Adenocarcinoma ; Esophageal Neoplasms ; Humans ; Neoadjuvant Therapy
Language	English
Publishing date	2017-10-31
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2049730-1
ISSN	1474-5488 ; 1470-2045
ISSN (online)	1474-5488
ISSN	1470-2045
DOI	10.1016/S1470-2045(17)30776-3
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Zs.A 5696: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 460: Show issues

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Article ; Online: Impact of sex and age on chemotherapy efficacy, toxicity and survival in localised oesophagogastric cancer: A pooled analysis of 3265 individual patient data from four large randomised trials (OE02, OE05, MAGIC and ST03).

Athauda, Avani / Nankivell, Matthew / Langley, Ruth E / Alderson, Derek / Allum, William / Grabsch, Heike I / Starling, Naureen / Chau, Ian / Cunningham, David

European journal of cancer (Oxford, England : 1990)

2020 Volume 137, Page(s) 45–56

Abstract: Background: There is a lack of large-scale randomised data evaluating the impact of sex and age in patients undergoing chemotherapy followed by potentially curative surgery for oesophagogastric cancer.: Patients and methods: Individual patient data ... ...

Abstract	Background: There is a lack of large-scale randomised data evaluating the impact of sex and age in patients undergoing chemotherapy followed by potentially curative surgery for oesophagogastric cancer. Patients and methods: Individual patient data from four prospective randomised controlled trials were pooled using a two-stage meta-analysis. For survival analysis, hazard ratios (HRs) were calculated for patients aged <70 and ≥ 70 years, as well as between males and females. Mandard tumour regression grade (TRG) and, ≥grade III toxicities were compared using logistic regression models to calculate odds ratios. All analyses were adjusted for the type of chemotherapy received. Results: 3265 patients were included for survival analysis (2668 [82%] male, 597 [18%] female; 2627 (80%) <70 years, 638 (20%) ≥70 years). A significant improvement in overall survival (OS) (HR: 0.78; p < 0.001) and disease-specific survival (DSS) (HR: 0.78; p < 0.001) was observed in females compared with males. No significant differences in OS (HR: 1.11; p = 0.045) or DSS (HR: 1.01; p = 0.821) were observed in older patients compared with younger patients. For patients who underwent resection, older patients (15% vs 10%; p = 0.03) and female patients (14% vs 10%, p = 0.10) were more likely to achieve favourable Mandard TRG scores. Females experienced significantly more ≥grade III nausea (10% vs 5%; p≤0.001), vomiting (10% vs 4%; p≤0.001) and diarrhoea (9% vs 4%; p≤0.001) than males. Conclusions: In this large pooled analysis using prospective randomised trial data, females had significantly improved survival while experiencing more gastrointestinal toxicities. Older patients achieved comparable survival to younger patients and thus, dependent on fitness, should be offered the same treatment paradigm.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/pharmacology ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Esophageal Neoplasms/drug therapy ; Esophageal Neoplasms/epidemiology ; Esophageal Neoplasms/mortality ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Sex Factors ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/mortality ; Survival Rate ; Young Adult
Language	English
Publishing date	2020-07-31
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	82061-1
ISSN	1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0277-5379 ; 0959-8049 ; 0964-1947
DOI	10.1016/j.ejca.2020.06.005
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Zs.A 456: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Surgical Innovation in the Era of Global Surgery: A Network Analysis.

Garas, George / Cingolani, Isabella / Patel, Vanash / Panzarasa, Pietro / Alderson, Derek / Darzi, Ara / Athanasiou, Thanos

Annals of surgery

2018 Volume 271, Issue 5, Page(s) 868–874

Abstract: Objective: To present a novel network-based framework for the study of collaboration in surgery and demonstrate how this can be used in practice to help build and nurture collaborations that foster innovation.: Background: Surgical innovation is a ... ...

Abstract	Objective: To present a novel network-based framework for the study of collaboration in surgery and demonstrate how this can be used in practice to help build and nurture collaborations that foster innovation. Background: Surgical innovation is a social process that originates from complex interactions among diverse participants. This has led to the emergence of numerous surgical collaboration networks. What is still needed is a rigorous investigation of these networks and of the relative benefits of various collaboration structures for research and innovation. Methods: Network analysis of the real-world innovation network in robotic surgery. Hierarchical mixed-effect models were estimated to assess associations between network measures, research impact and innovation, controlling for the geographical diversity of collaborators, institutional categories, and whether collaborators belonged to industry or academia. Results: The network comprised of 1700 organizations and 6000 links. The ability to reach many others along few steps in the network (closeness centrality), forging a geographically diverse international profile (network entropy), and collaboration with industry were all shown to be positively associated with research impact and innovation. Closed structures (clustering coefficient), in which collaborators also collaborate with each other, were found to have a negative association with innovation (P < 0.05 for all associations). Conclusions: In the era of global surgery and increasing complexity of surgical innovation, this study highlights the importance of establishing open networks spanning geographical boundaries. Network analysis offers a valuable framework for assisting surgeons in their efforts to forge and sustain collaborations with the highest potential of maximizing innovation and patient care.
MeSH term(s)	Diffusion of Innovation ; Humans ; Network Meta-Analysis ; Robotic Surgical Procedures/trends
Language	English
Publishing date	2018-12-31
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000003164
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Article ; Online: Haemochromatosis and gastrointestinal cancer.

Lagergren, Katarina / Wahlin, Karl / Mattsson, Fredrik / Alderson, Derek / Lagergren, Jesper

International journal of cancer

2016 Volume 139, Issue 8, Page(s) 1740–1743

Abstract: Iron overload in patients with haemochromatosis is a strong risk factor for liver cancer, but its influence on other gastrointestinal cancer risk is unclear. The aim was to assess the relative risk of luminal gastrointestinal cancer among patients ... ...

Abstract	Iron overload in patients with haemochromatosis is a strong risk factor for liver cancer, but its influence on other gastrointestinal cancer risk is unclear. The aim was to assess the relative risk of luminal gastrointestinal cancer among patients diagnosed with haemochromatosis. This population-based, nationwide Swedish cohort study included patients with haemochromatosis in Sweden in 1965-2013. The incidence of gastrointestinal cancers was assessed through the Swedish Cancer Registry. The measure of relative risk was the standardised incidence ratio (SIR) with 95% confidence interval (CI), that is, the ratio of the observed number of gastrointestinal cancers in the haemochromatosis cohort divided by the expected number of such cancers, calculated from the entire corresponding background population of Sweden. Among 6,849 patients in the haemochromatosis cohort with up to 48 years of follow-up, the SIRs were 3-fold increased for oesophageal squamous cell carcinoma (SIR = 3.2, 95% CI 1.3-6.6; n = 7) and 40% increased for colon adenocarcinoma (SIR = 1.4, 95% CI 1.1-1.9; n = 54). No associations were found between haemochromatosis and the risk of adenocarcinoma of the oesophagus (SIR = 0.5, 95% CI 0.0-2.5; n = 1), stomach (SIR = 0.7, 95% CI 0.3-1.4; n = 8), small bowel (SIR = 1.2, 95% CI 0.0-6.7; n = 1) or rectum (SIR = 1.0, 95% CI 0.6-1.6; n = 21). These findings indicate that haemochromatosis increases the risk of oesophageal squamous cell carcinoma and colon adenocarcinoma, but might not influence the risk of other types of luminal gastrointestinal cancer. These findings should encourage further research examining the role of iron overload in cancer aetiology.
MeSH term(s)	Carcinoma, Squamous Cell/epidemiology ; Carcinoma, Squamous Cell/metabolism ; Cohort Studies ; Esophageal Neoplasms/epidemiology ; Esophageal Neoplasms/metabolism ; Esophageal Squamous Cell Carcinoma ; Female ; Gastrointestinal Neoplasms/epidemiology ; Gastrointestinal Neoplasms/metabolism ; Hemochromatosis/epidemiology ; Hemochromatosis/metabolism ; Humans ; Incidence ; Male ; Middle Aged ; Registries ; Sweden/epidemiology
Language	English
Publishing date	2016-06-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	218257-9
ISSN	1097-0215 ; 0020-7136
ISSN (online)	1097-0215
ISSN	0020-7136
DOI	10.1002/ijc.30229
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Zs.MO 576: Show issues

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Article: Kongress der Schweizerischen Gesellschaft für Chirurgie in Lugano

Schackert, Gabriela / Farges, Olivier / Alderson, Derek

Swiss knife

2016 Volume -, Issue 2, Page(s) 6

Language	German ; French ; English
Document type	Article
ZDB-ID	2270030-4
ISSN	1661-1381
Database	Current Contents Medicine

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Article ; Online: Rising to the challenge of multimorbidity.

Whitty, Christopher J M / MacEwen, Carrie / Goddard, Andrew / Alderson, Derek / Marshall, Martin / Calderwood, Catherine / Atherton, Frank / McBride, Michael / Atherton, John / Stokes-Lampard, Helen / Reid, Wendy / Powis, Stephen / Marx, Clare

BMJ (Clinical research ed.)

2020 Volume 368, Page(s) l6964

MeSH term(s)	Clinical Competence ; Clinical Decision-Making ; Holistic Health ; Humans ; Intersectoral Collaboration ; Multiple Chronic Conditions/epidemiology ; Multiple Chronic Conditions/therapy ; Patient Care Team/standards
Language	English
Publishing date	2020-01-06
Publishing country	England
Document type	Editorial
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.l6964
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Article ; Online: The lifetime cost to English students of borrowing to invest in a medical degree: a gender comparison using data from the Office for National Statistics.

Ercolani, Marco G / Vohra, Ravinder S / Carmichael, Fiona / Mangat, Karanjit / Alderson, Derek

BMJ open

2015 Volume 5, Issue 4, Page(s) e007335

Abstract: Objective: To evaluate this impact on male and female English medical graduates by estimating the total time and amount repaid on loans taken out with the UK's Student Loans Company (SLC).: Setting: UK.: Participants: 4286 respondents with a ... ...

Abstract	Objective: To evaluate this impact on male and female English medical graduates by estimating the total time and amount repaid on loans taken out with the UK's Student Loans Company (SLC). Setting: UK. Participants: 4286 respondents with a medical degree in the Labour Force Surveys administered by the Office for National Statistics (ONS) between 1997 and 2014. Outcomes: Age-salary profiles were generated to estimate the repayment profiles for different levels of initial graduate debt. Results: 2195 female and 2149 male medical graduates were interviewed by the ONS. Those working full-time (73.1% females and 96.1% males) were analysed in greater depth. Following standardisation to 2014 prices, average full-time male graduates earned up to 35% more than females by the age of 55. The initial graduate debt from tuition fees alone amounts to £39,945.69. Owing to interest charges on this debt the average full-time male graduate repays £57,303 over 20 years, while the average female earns less and so repays £61,809 over 26 years. When additional SLC loans are required for maintenance, the initial graduate debt can be as high as £81,916 and, as SLC debt is written off 30 years after graduation, the average female repays £75,786 while the average male repays £110,644. Conclusions: Medical graduates on an average salary are unlikely to repay their SLC debt in full. This is a consequence of higher university fees and as SLC debt is written off 30 years after graduation. This results in the average female graduate repaying more when debt is low, but a lower amount when debt is high compared to male graduates.
MeSH term(s)	Adult ; Costs and Cost Analysis ; Education, Graduate/economics ; Education, Graduate/statistics & numerical data ; Female ; Humans ; Male ; Salaries and Fringe Benefits ; Schools, Medical/economics ; Sex Distribution ; Students, Medical ; United Kingdom/epidemiology ; Universities/economics
Language	English
Publishing date	2015-04-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2747269-3
ISSN	2044-6055 ; 2044-6055 ; 2053-3624
ISSN (online)	2044-6055
ISSN	2044-6055 ; 2053-3624
DOI	10.1136/bmjopen-2014-007335
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