Impact of adherence to board-certified surgeon systems and clinical practice guidelines on colon cancer surgical outcomes in Japan: A questionnaire survey of the National Clinical Database

Hirotoshi Kobayashi, Hiroyuki Yamamoto, Hiroaki Miyata, Mitsukazu Gotoh, Kenjiro Kotake, Kenichi Sugihara, Yasushi Toh, Yoshihiro Kakeji, Yasuyuki Seto

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aim: To investigate the effectiveness of the institutional medical structure and of the implemented clinical practice guidelines for improving colon cancer surgical outcomes. Methods: We conducted a web-based questionnaire survey among departments registered at the National Clinical Database in Japan from October 2014 to January 2015 to assess the association between quality indicators (QIs), including structure and process indicators (clinical practice guideline adherence), and the risk-adjusted odds ratio for operative mortality (AOR) after right hemicolectomy for colorectal cancer during the study period. Results: Among the 2064 departments registering at least one colorectal surgery during the study period, we obtained responses from 814 departments (39.4%). Our analysis on data from 22 816 patients with right hemicolectomy demonstrated that three structural QIs (certification of training hospitals by the Japanese Society of Gastroenterological Surgery and the presences of board-certified gastroenterological and colorectal surgeons) were associated with significantly lower AOR (P <.001, P =.02, and P =.05, respectively). The “performed at the doctor's discretion” answer was associated with poorer short-term outcomes in six process QIs than other answers. Conclusion: The board certification system for gastroenterological and colorectal surgeons and the adherence to the clinical guidelines improve the operative mortality after right hemicolectomy. It is desired to clarify the most suitable QIs to reduce the operative mortality after colorectal surgery.

Original languageEnglish
Pages (from-to)283-293
Number of pages11
JournalAnnals of Gastroenterological Surgery
Volume4
Issue number3
DOIs
Publication statusPublished - 2020 May 1

Keywords

  • board-certified surgeon
  • colon cancer
  • quality indicator
  • questionnaire survey
  • right hemicolectomy

ASJC Scopus subject areas

  • Gastroenterology
  • Surgery

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