APPENDIXES - AHRQ Effective Health Care Program

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Table C31. Association between hospital volumes (radical prostatectomy) and surgery related mortality (continued) C79 Reference Period Design Yao, 1999 123 19911994 Retrospective cohort Evidence: II2C Quality: 0.677 Wennberg, 1987 124 19741977 Retrospective cohort Evidence: II2C Quality: 0.655 Population 101,604 Medicare beneficiaries after radical prostatectomy 4,570 Medicare beneficiaries after prostatectomy Data Source Volume Definition Medicare claims data Number of procedures/time of the study Medicare claims data: 16 hospitals Number of procedures/ time of the study Outcome Postoperative death within 3090 days after radical prostatectomy Postoperative death within 90 days after prostatectomy Analysis/Units Logistic regression Unit: Patient Goodnessoffit: Not reported Discrimination: Not reported Logistic regression Unit: Patient Goodnessoffit: Not reported Discrimination: Not reported Risk Adjustment Patient age, race, comorbidities; surgeon specialty, hospital teaching status Patient age, comorbidities Hospital size and teaching status Volume Categories Hospital Volume 141 (36/year) Annual Hospital Volume 91 Outcome Rate (%) 0.63 0.59 0.56 0.39 Adjusted Volume Effect 1.51 (1.25; 1.77) 1.43 (1.17; 1.69) 1.42 (1.16; 1.68) 1 (reference) 1 (reference) 1.26 (0.69; 2.32) 1.66 (0.95; 2.89)
Table C32. Association between hospital volumes (radical prostatectomy) and complications (cardiac, respiratory or vascular events, the need for reoperation, bleeding, renal failure, and shock) C80 Reference Period Design Yao, 1999 123 19911994 Retrospective cohort Evidence: II2C Quality: 0.677 Hu, 2003 118 19971998 Retrospective cohort Evidence: II2C Population 101,604 Medicare beneficiaries after radical prostatectomy 2,292 Medicare beneficiaries after radical prostatectomy Data Source Volume Definition Medicare claims data Number of procedures/time of the study Medicare claims data. Number of procedures/time of the study Outcome Inhospital complications Inhospital complications Analysis/Units Logistic regression Unit: Patient Goodnessoffit: Not reported Discrimination: Not reported Multiple regression Unit: Patient Goodnessoffit: Not reported Risk Adjustment Patient age, race, comorbidities; surgeon specialty, hospital teaching status Patient age, race, comorbidities, hospital type, region Volume Categories Hospital Volume 141 (36/year) 141 (36/year) Hospital volume (% of procedures) Low (85.2) (60 /year) Outcome Rate (%) Any complications 31.3(30.8 31.9) 28.7(28.2 29.3) 27.8(27.2 28.3) 26.3(25.8 26.9) Postoperative complications 21.6 16.8 Adjusted Volume Effect Serious complications 1.4 3(1.37; 1.48) 1.25 (1.19; 1.31) 1.09 (1.03; 1.15) 1(reference) 1.28 (1.24; 1.32) 1.13 (1.08; 1.17) 1.08 (1.04; 1.12) 1 (reference) 1 (reference) 0.84(0.59; 1.19) Quality: 0.86 Begg, 2002 122 19921996 Retrospective cohort Evidence: II2C Quality: 0.63 11,522 Medicare beneficiaries (Parts A and B) after radical prostatectomy, 6,421 with localized PC; 403 hospitals SEER data base linked to Medicare claims Average number of procedures/year Postoperative complications during 30 days after surgery Discrimination: Yes GEElogistic regression Unit: Patient Goodnessoffit: Not reported Discrimination: Not reported Patient age, race, stage of cancer, co morbidities; hospital surgeon correlations Annual Hospital Volume (% hospitals)
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APPENDIXES
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Appendix A: Search Strategy (contin
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Appendix C: Evidence Tables and Fig
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Table C1. Disease specific mortalit
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Table C2. Biochemical progression/r
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Table C2. Biochemical progression/r
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Table C4. Incidence of distant meta
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Figure C2. Diseasespecific surviv
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Table C8. Outcomes after cryosurgic
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Table C10. Comparative effectivenes
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Table C13. Perioperative and pathol
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Figure C4. Comparative studies of t
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Page 44 and 45: Table C19. Late toxicity outcomes a
Page 46 and 47: Table C20. Patient outcomes after h
Page 48 and 49: Table C21. Proton radiation for loc
Page 50 and 51: Table C23. Adjusted percentage dist
Page 52 and 53: Table C25. QOL studies of treatment
Page 60 and 61: Figure C6. Search strategy Database
Page 62 and 63: Table C27. Quality (% of maximum po
Page 64 and 65: Table C29. Geographic variations in
Page 86 and 87: Table C33. Association between hosp
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Page 104 and 105: Table C41. Sampling sources of stud
Page 106 and 107: Table C43. Association between phys
Page 114 and 115: Figure C8. Percentage of responses
Page 120 and 121: Table C44. Variability in managemen
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Page 124 and 125: Table C45. Association between prov
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Table C49. Significant geographic d
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Figure C14. Distribution of radiati
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Figure C16. Ratio* of radiation onc
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Figure C19. Geographic variations i
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Figure C20. Incidence of prostate c
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Table C55. Incidence of localized p
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Figure C21. Percentage of patients
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Table C62. Significant variations i
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Table C66. Geographic variations in
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Figure C29. Length of stay in hospi
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Figure C30. Hospital charges for ra
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Table C73. Geographic differences i
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Figure C31. Mortality from prostate
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Figure C33. Difference in surgery
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Figure C35. Relative risk of surger
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Figure C37. Difference in surgery r
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Figure C39. Difference in surgery r
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Figure C41. Difference in length of
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Figure C43. Difference in rates of
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Table C76. Odds ratio and attributa
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Table C78. Odds ratio of outcomes,
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Appendix D: List of Excluded Studie
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Appendix E: Sample Abstraction Form
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APPENDIXES - AHRQ Effective Health Care Program

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