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Regionalization and Outcomes of Lung Cancer Surgery in Ontario, Canada

Overview of attention for article published in Journal of Clinical Oncology, August 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

news
1 news outlet
twitter
17 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
7 Dimensions

Readers on

mendeley
23 Mendeley
Title
Regionalization and Outcomes of Lung Cancer Surgery in Ontario, Canada
Published in
Journal of Clinical Oncology, August 2017
DOI 10.1200/jco.2016.69.8076
Pubmed ID
Authors

Anna M. Bendzsak, Nancy N. Baxter, Gail E. Darling, Peter C. Austin, David R. Urbach

Abstract

Purpose Regionalization of complex surgery to high-volume hospitals has been advocated based on cross-sectional volume-outcome studies. In April 2007, the agency overseeing cancer care in Ontario, Canada, implemented a policy to regionalize lung cancer surgery at 14 designated hospitals, enforced by economic incentives and penalties. We studied the effects of implementation of this policy. Methods Using administrative health data, we used interrupted time series models to analyze the immediate and delayed effects of implementation of the policy on the distribution of lung cancer surgery among hospitals, surgical outcomes, and health services use. Results From 2004 to 2012, 16,641 patients underwent surgery for lung cancer. The proportion of operations performed in designated hospitals increased from 71% to 89% after the policy was implemented. Although operative mortality decreased from 4.1% to 2.9% (adjusted odds ratio, 0.68; 95% CI, 0.58 to 0.81; P < .001), the reduction was due to a preexisting declining trend in mortality. In contrast, in the years after implementation of the policy, length of hospital stay decreased more than expected from the baseline trend by 7% per year (95% CI, 5% to 9%; P < .001), and the distance traveled by all patients to the hospital for surgery increased by 4% per year (95% CI, 0% to 8%; P = .03), neither of which were explained by preexisting trends. Analyses limited to patients ≥ 70 years of age demonstrated a reduction in operative mortality (odds ratio, 0.80 per year after regionalization; 95% CI, 0.67 to 0.95; P = .01). Conclusion A policy to regionalize lung cancer surgery in Ontario led to increased centralization of surgery services but was not independently associated with improvements in operative mortality. Improvements in length of stay and in operative mortality among elderly patients suggest areas where regionalization may be beneficial.

Twitter Demographics

The data shown below were collected from the profiles of 17 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 23 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 26%
Unspecified 4 17%
Student > Doctoral Student 3 13%
Student > Master 3 13%
Student > Bachelor 2 9%
Other 5 22%
Readers by discipline Count As %
Medicine and Dentistry 13 57%
Unspecified 7 30%
Agricultural and Biological Sciences 1 4%
Sports and Recreations 1 4%
Economics, Econometrics and Finance 1 4%
Other 0 0%

Attention Score in Context

This research output has an Altmetric Attention Score of 19. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 February 2019.
All research outputs
#827,177
of 13,396,110 outputs
Outputs from Journal of Clinical Oncology
#2,302
of 13,417 outputs
Outputs of similar age
#28,527
of 262,092 outputs
Outputs of similar age from Journal of Clinical Oncology
#103
of 187 outputs
Altmetric has tracked 13,396,110 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 13,417 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.1. This one has done well, scoring higher than 82% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 262,092 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 187 others from the same source and published within six weeks on either side of this one. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.