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Extra info for Interpreting the Volume-Outcome Relationship in the Context of Cancer Care

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Harmon JW, Tang DG, Gordon TA, et al. Hospital volume can serve as a surrogate for surgeon volume for achieving excellent outcomes in colorectal resection. Ann Surg. 1999;230(3):404–11; discussion 411–3. Imperato PJ, Nenner RP, Starr HA, Will TO, Rosenberg CR, Dearie MB. The effects of regionalization on clinical outcomes for a high risk surgical procedure: A study of the Whipple procedure in New York State. American Journal of Medical Quality. 1996;11(4):193–7. Lieberman MD, Kilburn H, Lindsey M, Brennan MF.

5. Health outcome(s) must be assessed as the dependent variable(s). Volume must be an independent variable. We limited the review to studies of patients treated from 1980 to the present, because of the rapidity of changes in hospital care, available treatments, and surgical techniques. In our view, data from patient cohorts prior to 1980 would have questionable relevance to today’s policy issues. In a few instances, we included studies if part of their patient sample included patients treated in 1978 or 1979, but most of the sample comprised patients from the 1980s.

Annals of Surgery. 1998;228(3):429–38. Wade TP, Halaby IA, Stapleton DR, Virgo KS, Johnson FE. Population-based analysis of treatment of pancreatic cancer and Whipple resection: Department of Defense hospitals, 1989–1994. Surgery. 1996;120(4):680–5; discussion 686–7.

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