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 Vol. 12 No. 3, September 2004
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AAP Grand Rounds 12:30 (2004)
© 2004 American Academy of Pediatrics

NEUROSURGERY

Pediatric Brain Tumors: Provider Volume and Outcomes

Source: Smith ER, Butler WE, Barker FG II. Craniotomy for resection of pediatric brain tumors in the United States, 1988 to 2000: effects of provider caseloads and progressive centralization and specialization of care. Neurosurgery. 2004;54:553–565.[Medline]

The first 20% of the full text of this article appears below.

There has been great interest recently in the relationship between provider volume and surgical outcomes. (With respect to cerebrospinal fluid shunt surgery,1 see also AAP Grand Rounds, August 2003;10:17–18[Free Full Text]). The authors from the Massachusetts General Hospital have been leaders in investigating the effect of volume on outcomes in neurosurgery, having published in the past on hydrocephalus, aneurysmal subarachnoid hemorrhage, trigeminal neuralgia, vestibular neurinoma, and metastatic brain tumors.2–7 In the current report, they turn their attention to pediatric brain tumors.

For data, the authors relied on the Nationwide Inpatient Sample (NIS), a federally maintained database comprised of a random sample of 20% of discharges from acute care hospitals in the United States. The NIS data has been collected since 1988, and includes the ability to track individual hospitals and even, to some degree, individual surgeons. As outcome measures, the . . . [Full Text of this Article]

Joseph H. Piatt, Jr, MD, FAAP
Neurological Surgery and Pediatrics, St. Christopher’s Hospital for Children, Philadelphia, PA