Annals of surgery
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To review the literature evaluating the effect of practice guidelines and decision aids on use of surgery and regional variation. ⋯ Both practice guidelines and decision aids have been proven effective in many clinical contexts. Expanding the clinical scope of these tools and eliminating barriers to implementation will be essential to further efforts directed toward reducing regional variation in the use of surgery.
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To review the literature evaluating the effect of practice guidelines and decision aids on use of surgery and regional variation. ⋯ Both practice guidelines and decision aids have been proven effective in many clinical contexts. Expanding the clinical scope of these tools and eliminating barriers to implementation will be essential to further efforts directed toward reducing regional variation in the use of surgery.
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To perform a systematic review of interventions used to reduce adverse events in surgery. ⋯ Only a small cohort of medium- to high-quality interventions effectively reduce surgical harm and are feasible to implement. It is important that future research remains focused on demonstrating a measurable reduction in adverse events from patient safety initiatives.
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Review Comparative Study
A systematic review of economic evaluations of enhanced recovery pathways for colorectal surgery.
To perform a systematic review of economic evaluations of enhanced recovery pathways (ERP) for colorectal surgery. ⋯ The quality of the current evidence is limited but tends to support the cost-effectiveness of ERP. There is need for well-designed trials to determine the cost-effectiveness of ERP from both the institutional and societal perspectives.
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Evolution has molded metabolic thrift within humans, a genetic heritage that, when thrust into our modern "obesogenic" environment, creates the current obesity crisis. Modern genetic analysis has identified genetic and epigenetic contributors to obesity, an understanding of which will guide the development of environmental, pharmacologic, and genetic therapeutic interventions.