Hospital risk-adjusted margin positivity rate is quality metric

August 7, 2014
Hospital risk-adjusted margin positivity rate is quality metric

(HealthDay)—Hospital risk-adjusted margin positivity rate (RAMP) can identify performance-based outliers and represents a rectal cancer surgery quality metric, according to a study published online Aug. 4 in the Journal of Clinical Oncology.

Nader N. Massarweh, M.D., from the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues conducted an observational cohort study of 32,354 patients with within the National Cancer Data Base (2003 to 2005), treated at 1,349 hospitals. Using standard observed-to-expected methodology, hospital performance was classified as low outlier (better than expected), high outlier (worse than expected), or non-RAMP outlier.

The researchers observed significant correlations for various structural (academic status and volume), process (pathologic nodal evaluation and neoadjuvant radiation therapy use), and outcome (sphincter preservation, readmission, and 30-day postoperative mortality) measures with outlier status. Low outliers had better five-year overall survival than high outliers and nonoutliers (79.9 versus 64.9 and 68.9 percent, respectively; P < 0.01). The risk of death was lower at low outliers versus high outliers and nonoutliers (hazard ratios, 0.61 and 0.69, respectively). A higher risk of death was seen at high outliers versus nonoutliers (hazard ratio, 1.12).

"Hospital RAMP outlier status is a rectal cancer surgery composite metric that reliably captures hospital quality across all levels of care and could be integrated into existing quality improvement initiatives for ," the authors write.

More information: Abstract
Full Text (subscription or payment may be required)
Editorial

Related Stories

Surgeon volume, prognosis post-esophageal cancer op linked

January 24, 2013

(HealthDay)—For patients with esophageal cancer undergoing resection, surgeon volume, but not hospital volume, is independently associated with prognosis, according to research published online Jan. 7 in the Journal of ...

Pre-op MRI of margins predicts rectal cancer outcomes

December 8, 2013

(HealthDay)—Preoperative high-resolution magnetic resonance imaging (MRI) assessment of circumferential resection margin (CRM) status predicts survival and other disease progression outcomes in patients with rectal cancer, ...

Getting chemo first may help in rectal cancer

May 15, 2014

(Medical Xpress)—A new phase II study to be presented at the annual meeting of the American Society for Clinical Oncology finds that if chemotherapy is offered before radiation and surgery, more patients will be able to ...

Survival up after progression in HPV-positive oropharynx CA

June 26, 2014

(HealthDay)—For patients with oropharynx cancer (OPC), human papillomavirus (HPV) positivity is associated with improved survival after disease progression, according to a study published online June 23 in the Journal of ...

Recommended for you

Strange circular DNA may offer new way to detect cancers

July 30, 2015

Strange rings of DNA that exist outside chromosomes are distinct to the cell types that mistakenly produced them, researchers have discovered. The finding raises the tantalizing possibility that the rings could be used as ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.