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Atul Gawande

Sujay Kakarmath, Howard T Heller, Caroline A Alexander, Edmund S Cibas, Jeffrey F Krane, Justine A Barletta, Neal I Lindeman, Mary C Frates, Carol B Benson, Atul A Gawande, Nancy L Cho, Matthew Nehs, Francis D Moore, Ellen Marqusee, Mathew I Kim, P Reed Larsen, Norra Kwong, Trevor E Angell, Erik K Alexander
CONTEXT: Mutations in the BRAF and RAS oncogenes are responsible for most well-differentiated thyroid cancer. Yet, our clinical understanding of how BRAF-positive and RAS-positive thyroid cancers differ is incomplete. OBJECTIVE: We correlated clinical, radiographic, and pathologic findings from patients with thyroid cancer harboring a BRAF or RAS mutation. DESIGN: Prospective cohort study Setting: Academic, tertiary care hospital Patients: 101 consecutive patients with well-differentiated thyroid cancer Main Outcome Measure: We compared the clinical, sonographic, and pathologic characteristics of patients with BRAF-positive cancer to those with RAS-positive cancer...
September 30, 2016: Journal of Clinical Endocrinology and Metabolism
George Molina, Bridget A Neville, Stuart R Lipsitz, Lorri Gibbons, Ashley Kay Childers, Atul A Gawande, William R Berry, Alex B Haynes
BACKGROUND: Surgical procedures in the United States are increasingly performed in the ambulatory setting, including freestanding ambulatory surgery centers (ASCs). However, there is a lack of research and tracking of surgical outcomes in this setting. MATERIALS AND METHODS: We analyzed data from a state all-payer claims database to produce a retrospective cohort study on the rate of acute care use (emergency department [ED] visits and inpatient admissions) within 7 d after operations performed in freestanding ASCs in South Carolina...
October 2016: Journal of Surgical Research
Barry Rosenberg, Bennett Lane, Atul Gawande
No abstract text is available yet for this article.
August 31, 2016: JAMA Surgery
Erica Borgstrom
No abstract text is available yet for this article.
December 2015: Anthropology & Medicine
Judith M Wong, William R G Perry, Yelena Greenberg, Allen L Ho, Stuart R Lipsitz, Liliana C Goumnerova, Edward R Laws, William R Berry, Atul A Gawande, Angela M Bader
BACKGROUND: Despite efforts for improvement, cerebrospinal fluid (CSF) shunt failure rates remain high. Recent studies have shown promising reductions in failure rates and infection rates with the routine use of perioperative checklists. This study was conducted to pilot test the feasibility and efficacy of integrating specific CSF shunt surgery quality checks into the World Health Organization (WHO) Surgical Safety Checklist. METHODS: We designed CSF shunt checklist quality items according to a previously established methodology, including solicitation of best practices by a national multidisciplinary expert panel...
August 2016: World Neurosurgery
(no author information available yet)
No abstract text is available yet for this article.
2016: BMJ: British Medical Journal
George Molina, Wei Jiang, Lizabeth Edmondson, Lorri Gibbons, Lyen C Huang, Mathew V Kiang, Alex B Haynes, Atul A Gawande, William R Berry, Sara J Singer
BACKGROUND: Previous research suggests that surgical safety checklists (SSCs) are associated with reductions in postoperative morbidity and mortality as well as improvement in teamwork and communication. These findings stem from evaluations of individual or small groups of hospitals. Studies with more hospitals have assessed the relationship of checklists with teamwork at a single point in time. The objective of this study was to evaluate the impact of a large-scale implementation of SSCs on staff perceptions of perioperative safety in the operating room...
May 2016: Journal of the American College of Surgeons
Iwona Stolarek
No abstract text is available yet for this article.
March 2016: Australasian Journal on Ageing
Susan C Pitt, Roland A Hernandez, Matthew A Nehs, Atul A Gawande, Francis D Moore, Daniel T Ruan, Nancy L Cho
BACKGROUND: Thyroid cancer patients frequently have favorable outcomes. However, a small subset develops aggressive disease refractory to traditional treatments. Therefore, we sought to characterize oncogenic mutations in thyroid cancers to identify novel therapeutic targets that may benefit patients with advanced, refractory disease. STUDY DESIGN: Data on 239 thyroid cancer specimens collected between January 2009 and September 2014 were obtained from the Dana Farber/Brigham and Women's Cancer Center...
June 2016: Journal of the American College of Surgeons
Thomas G Weiser, Alex B Haynes, George Molina, Stuart R Lipsitz, Micaela M Esquivel, Tarsicio Uribe-Leitz, Rui Fu, Tej Azad, Tiffany E Chao, William R Berry, Atul A Gawande
OBJECTIVE: To estimate global surgical volume in 2012 and compare it with estimates from 2004. METHODS: For the 194 Member States of the World Health Organization, we searched PubMed for studies and contacted key informants for reports on surgical volumes between 2005 and 2012. We obtained data on population and total health expenditure per capita for 2012 and categorized Member States as very-low, low, middle and high expenditure. Data on caesarean delivery were obtained from validated statistical reports...
March 1, 2016: Bulletin of the World Health Organization
Tarsicio Uribe-Leitz, Joshua Jaramillo, Lydia Maurer, Rui Fu, Micaela M Esquivel, Atul A Gawande, Alex B Haynes, Thomas G Weiser
BACKGROUND: Surgical interventions occur at lower rates in resource-poor settings, and complication and death rates following surgery are probably substantial but have not been well quantified. A deeper understanding of outcomes is a crucial step to ensure that high quality accompanies increased global access to surgical care. We aimed to assess surgical mortality following three common surgical procedures--caesarean delivery, appendectomy, and groin (inguinal and femoral) hernia repair--to quantify the potential risks of expanding access without simultaneously addressing issues of quality and safety...
March 2016: Lancet Global Health
Curt Tribble
No abstract text is available yet for this article.
2016: Heart Surgery Forum
Atul Gawande
No abstract text is available yet for this article.
January 19, 2016: JAMA: the Journal of the American Medical Association
Olivia Nelson, Timothy D Quinn, Alexander F Arriaga, David L Hepner, Stuart R Lipsitz, Zara Cooper, Atul A Gawande, Angela M Bader
Previous literature on preoperative evaluation focuses on the impact on the day of surgery cancellations and delays; however, the framework of cancellations and delays at the time of the elective outpatient preoperative anesthesia visit has not been categorized. We describe the current model in the preoperative clinic at Brigham and Women's Hospital, examining the pattern of cancellations at the time of this preoperative visit and the framework used for categorizing the issues involved. Looking at this broader framework is important in an era of patient-centered care; we seek to identify targets to modify the preoperative assessment and adequately assess and capture the spectrum of issues involved...
April 15, 2016: A & A Case Reports
Zara Cooper, Luca A Koritsanszky, Christy E Cauley, Julia L Frydman, Rachelle E Bernacki, Anne C Mosenthal, Atul A Gawande, Susan D Block
OBJECTIVE: To address the need for improved communication practices to facilitate goal-concordant care in seriously ill, older patients with surgical emergencies. SUMMARY BACKGROUND DATA: Improved communication is increasingly recognized as a central element in providing goal-concordant care and reducing health care utilization and costs among seriously ill older patients. Given high rates of surgery in the last weeks of life, high risk of poor outcomes after emergency operations in these patients, and barriers to quality communication in the acute setting, we sought to create a framework to support surgeons in communicating with seriously ill, older patients with surgical emergencies...
January 2016: Annals of Surgery
George Molina, Thomas G Weiser, Stuart R Lipsitz, Micaela M Esquivel, Tarsicio Uribe-Leitz, Tej Azad, Neel Shah, Katherine Semrau, William R Berry, Atul A Gawande, Alex B Haynes
IMPORTANCE: Based on older analyses, the World Health Organization (WHO) recommends that cesarean delivery rates should not exceed 10 to 15 per 100 live births to optimize maternal and neonatal outcomes. OBJECTIVES: To estimate the contemporary relationship between national levels of cesarean delivery and maternal and neonatal mortality. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional, ecological study estimating annual cesarean delivery rates from data collected during 2005 to 2012 for all 194 WHO member states...
December 1, 2015: JAMA: the Journal of the American Medical Association
Richard Summers
No abstract text is available yet for this article.
December 1, 2015: American Journal of Psychiatry
John G Meara, Andrew J M Leather, Lars Hagander, Blake C Alkire, Nivaldo Alonso, Emmanuel A Ameh, Stephen W Bickler, Lesong Conteh, Anna J Dare, Justine Davies, Eunice Dérivois Mérisier, Shenaaz El-Halabi, Paul E Farmer, Atul Gawande, Rowan Gillies, Sarah L M Greenberg, Caris E Grimes, Russell L Gruen, Edna Adan Ismail, Thaim Buya Kamara, Chris Lavy, Ganbold Lundeg, Nyengo C Mkandawire, Nakul P Raykar, Johanna N Riesel, Edgar Rodas, John Rose, Nobhojit Roy, Mark G Shrime, Richard Sullivan, Stéphane Verguet, David Watters, Thomas G Weiser, Iain H Wilson, Gavin Yamey, Winnie Yip
No abstract text is available yet for this article.
February 2016: International Journal of Obstetric Anesthesia
Taylor E Hurst, Katherine Semrau, Manasa Patna, Atul Gawande, Lisa R Hirschhorn
BACKGROUND: Reducing maternal and neonatal mortality is essential to improving population health. Demand-side interventions are designed to increase uptake of critical maternal health services, but associated change in service uptake and outcomes is varied. We undertook a literature review to understand current evidence of demand-side intervention impact on improving utilization and outcomes for mothers and newborn children. METHODS: We completed a rapid review of literature in PubMed...
2015: BMC Pregnancy and Childbirth
Xiaoyun Liu, Marco Medici, Norra Kwong, Trevor E Angell, Ellen Marqusee, Matthew I Kim, P Reed Larsen, Nancy L Cho, Matthew A Nehs, Daniel T Ruan, Atul Gawande, Francis Moore, Justine Barletta, Jeffrey F Krane, Edmund S Cibas, Tao Yang, Erik K Alexander
BACKGROUND: Since its inception, the Bethesda System for Reporting Thyroid Cytopathology (TBS) has been widely adopted. Each category conveys a risk of malignancy and recommended next steps, though it is unclear if each category also predicts the type and extent of malignancy. If so, this would greatly expand the utility of the TBS by providing prognostic information in addition to baseline cancer risk. METHODS: All patients prospectively enrolled into the authors' thyroid nodule database from 1995 to 2013 with histologically proven malignancy were analyzed...
February 2016: Thyroid: Official Journal of the American Thyroid Association
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