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Table 2 Assessment of surgeon volume-outcomes relationship

From: Relationship between surgeon volume and outcomes: a systematic review of systematic reviews

Procedure/condition Relationship Study End of search period Reviewers’ conclusions
Colorectal cancer ++ Archampong et al. 2012 [24] 9/2011 Results are significantly better for HVS concerning mortality, overall survival, permanent stoma, and abdominoperineal excision; not significant for disease-specific survival and anastomotic leak
Archampong et al. 2010 [25] 3/2010 Results are significantly better for HVS concerning overall survival, permanent stoma, abdominoperineal excision, and local recurrence; not significant for mortality and anastomotic leak
Van Gijn et al. 2010 [48] 2/2010 Data clearly support a relation between surgeon volume and mortality as well as survival
Salz et al. 2008 [43] 4/2007 No overall conclusions can be made due to heterogeneous study results and flaws in the methodological quality of the systematic review
Iversen et al. 2007 (short-term) [35] 6/2004 Data indicate a relation between volume and short-term mortality for colon cancer but no statistically significant results for colorectal and rectal cancer
Iversen et al. 2007 (long-term) [36] 6/2004 Data indicate a relation between volume and long-term survival for colon cancer but no statistically significant results for colorectal and rectal cancer
Bariatric surgery ++ Zevin et al. 2012 [54] 4/2011 Data clearly support the relationship between HVS and several patient-related outcomes including mortality
Padwal et al. 2011 [41] 1/2011 Data clearly support the relationship between HVS and several patient-related outcomes including mortality
Klarenbach et al. 2010 [37] 2/2009 Data clearly support the relationship between HVS and several patient-related outcomes including mortality
AAA + Young et al. 2007 [53] NR Pooled effect sizes for mortality were significant but findings should be interpreted with caution due to the quality of the data
Wilt et al. 2006 [50] 10/2005 Data clearly support the relationship between HVS and in-hospital mortality
Esophageal cancer + Brusselaers et al. 2014 [26] 9/2013 Data indicate a relationship between volume and long-term survival
Wouters et al. 2012 [52] 7/2010 No significant results for patient-related outcomes albeit data indicate a slight relationship between volume and mortality as well as survival
Radical prostatectomy + Trinh et al. 2013 [47] 12/2011 Data indicate a relation between volume and lots of different patient-related outcomes albeit there are no clear results for mortality
Wilt et al. 2008 [51] 11/2007 Data indicate a relation between volume and different complications albeit the result for mortality is not significant
Total knee arthroplasty + Lau et al. 2012 [38] 12/2011 Data indicate a relation between volume and many different patient-related outcomes but results are significant only for about the half of the outcomes
Stengel et al. 2004 [45] NR Data do not support a significant relationship between surgeon volume and patient-related outcomes albeit most outcomes are better for HVS
Breast cancer ++ Gooiker et al. 2010 [30] 2/2010 Data of this methodologically excellent review clearly support the relationship between HVS and survival
CABG ? Sepehripour et al. 2013 [44] 7/2012 Data do not indicate a clear relation between volume and mortality or other patient-related outcomes and results should be interpreted with caution due to methodological shortcomings
Cystectomy + Goossens-Laan et al. 2011 [32] 9/2010 Data show a significant relation between volume and mortality whereas the result for survival is not significant and the body of evidence is limited
Head and neck cancer + Eskander et al. 2014 [28] 3/2013 Data indicate a relationship for volume and long-term mortality/survival for surgery of the oral cavity but no significant results for in-hospital mortality for larynx or oropharyngeal surgery
Lung cancer + Van Meyenfeldt et al. 2012 [49] 1/2011 Data show a relationship between surgeon volume and postoperative mortality
Norwood procedure ? Pieper et al. 2014 [42] 3/2013 Data might indicate a slight relationship between volume and patient-related outcomes but the results are heterogeneous and predominantly non-significant
Pancreatic surgery + Gooiker et al. 2011 [31] 2/2010 Data indicate a relation between volume and postoperative mortality albeit studies are heterogeneous
PCI ? Strom et al. 2014 [46] 9/2012 Data indicate a relation between volume and major adverse cardiac events but there is no relationship between volume and mortality and pooled results are very heterogeneous
Trauma ? Caputo et al. 2014 [27] 6/2013 The review included only four primary studies which are more than 10 years old and it does not report on statistical significance
  1. Authors’ assessment on the surgeon volume-outcome relationship is based on the body of evidence (taking overlaps of primary studies into account), quality of systematic reviews, consistency of findings and up-to-dateness of the body of evidence: + tendency/trend, ++ moderate, +++ strong, ? unclear, and − no relationship. NR not reported