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Peer Review of Bariatric Surgical Skill Level Studied

Increased complications, higher mortality, longer operations, more reoperations for lowest skill quartile
THURSDAY, Oct. 10 (HealthDay News) -- For bariatric surgeons, peer review of surgical skill correlates with improved postoperative outcomes, according to a study published in the Oct. 10 issue of the New England Journal of Medicine.
John D. Birkmeyer, M.D., from the University of Michigan in Ann Arbor, and colleagues collected empirical data on technical skill to examine the correlation with postoperative outcomes for 20 bariatric surgeons. Each surgeon submitted a representative videotape of their performance of a laparoscopic gastric bypass, and the videotapes were rated by at least 10 peer surgeons who were unaware of the operating surgeon's identity.
The researchers found that, across the 20 surgeons, the mean summary ratings of technical skill ranged from 2.6 to 4.8 on a 1 to 5 scale. Compared with the top quartile, the bottom quartile of surgical skill correlated with significantly increased complication rates (14.5 versus 5.2 percent) and with significantly increased mortality (0.26 versus 0.05 percent). Significantly longer operations and higher rates of reoperation were seen with the lowest quartile of skill.
"Although these findings are preliminary, they suggest that peer rating of operative skill may be an effective strategy for assessing a surgeon's proficiency," the authors write.
Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMsa1300625?query=featured_home )Editorial (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMe1309785?query=featured_home )
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