← Back to Search
From Trees To Wood And Back: Perspective On Clinical Data Analysis In Thoracic Surgery.
E. Blackstone, T. Rice
Published 2007 · Medicine
Download PDFAnalyze on Scholarcy
General thoracic surgery has been slow to embrace advanced statistical techniques to assess outcome and direct future therapy to individual patients (the "trees") based on aggregating data and discovering informative patterns in them (the "wood"). This is due in part to the nature and complexity of the practice. However, methods exist that deal with problems of small numbers, variable case volume, and heterogeneity of patients, diseases, and therapies. For effective analysis of these multiple variables, modern strategies must be used and pitfalls avoided. For generating new knowledge about appropriateness of therapy, the focus of analyses must include long-term outcome. Quality improvement efforts may be assisted by in-depth analysis of short-term outcome from a select number of centers to inform future universal efforts. Ultimately, these results need to feed back to improved management of the individual patient.
This paper references
Photodynamic therapy with porfimer sodium for ablation of high-grade dysplasia in Barrett's esophagus: international, partially blinded, randomized phase III trial.
B. Overholt (2005)
Confidence Limits for Recurrence Data—Applied to Cost or Number of Product Repairs
W. Nelson (1995)
Caveat emptor: the treachery of work-up bias.
E. Blackstone (2004)
Evaluation of the complication rate as a measure of quality of care in coronary artery bypass graft surgery.
J. H. Silber (1995)
Use of the Logical Analysis of Data Method for Assessing Long-Term Mortality Risk After Exercise Electrocardiography
M. Lauer (2002)
Improvements on Cross-Validation: The 632+ Bootstrap Method
B. Efron (1997)
Development of an EORTC questionnaire module to be used in quality of life assessment for patients with oesophageal cancer. The EORTC Quality of Life Study Group.
J. Blazeby (1996)
Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial.
J. Douillard (2006)
Improving outcomes after esophagectomy: The impact of operative volume
A. Casson (2005)
National sources of vital status information: extent of coverage and possible selectivity in reporting.
C. Boyle (1990)
Effect of verification bias on screening for prostate cancer by measurement of prostate-specific antigen.
R. Punglia (2003)
Analysis of Longitudinal Data.
P. Diggle (1997)
Sensitivity and specificity of a single diagnostic test in the presence of work-up bias.
Byung Cheol Choi (1992)
Bipolar radiofrequency to ablate atrial fibrillation in patients undergoing mitral valve surgery.
A. Gillinov (2004)
Regression modelling strategies for improved prognostic prediction.
F. Harrell (1984)
Prosthetic heart valves: Objective Performance Criteria versus randomized clinical trial.
G. Grunkemeier (2006)
Hierarchical modeling: its time has come.
E. DeLong (2003)
The influence of hospital and surgeon volume on in-hospital mortality for colectomy, gastrectomy, and lung lobectomy in patients with cancer.
E. Hannan (2002)
Presenting multivariable analyses.
J. Kirklin (1994)
Problems of spectrum and bias in evaluating the efficacy of diagnostic tests.
D. Ransohoff (1978)
Lymph Node Recovery from Colorectal Tumor Specimens:Recommendation for a Minimum Number of Lymph Nodes to be Examined
F. Cianchi (2002)
Statistical methods and scientific inference.
R. A. Fisher (1956)
Games, Gods and Gambling: A History of Probability and Statistical Ideas
F. N. David (1998)
Report cards on cardiac surgeons. Assessing New York State's approach.
J. Green (1995)
Sample size requirements for evaluating heart valves with constant risk events.
Grunkemeier Gl (1994)
The Emergence of Probability
T. Fine (1975)
Comparing hierarchical modeling with traditional logistic regression analysis among patients hospitalized with acute myocardial infarction: should we be analyzing cardiovascular outcomes data differently?
Peter C. Austi (2003)
Recursive partitioning in the health sciences
H. Chang (1999)
Association between performance measures and clinical outcomes for patients hospitalized with heart failure.
G. Fonarow (2007)
The analysis of failure times in the presence of competing risks.
R. Prentice (1978)
Relative Risk Forests for Exercise Heart Rate Recovery as a Predictor of Mortality
H. Ishwaran (2004)
Dictionary of the History of Ideas: Studies of Selected Pivotal Ideas.
P. Wiener (1973)
Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer.
T. Winton (2005)
Superficial adenocarcinoma of the esophagus.
T. Rice (2001)
Stratification of morbidity and mortality outcome by preoperative risk factors in coronary artery bypass patients. A clinical severity score.
T. Higgins (1992)
Theory and applications of hazard plotting for censored failure data
W. Nelson (2000)
Spike and Slab Gene Selection for Multigroup Microarray Data
H. Ishwaran (2005)
Black death, smallpox, and continuity in nature: philosophies in generating new knowledge from clinical experiences.
E. Blackstone (1999)
Improving cardiac surgery quality--volume, outcome, process?
D. Shahian (2004)
The Electrocardiographic Exercise Test in a Population with Reduced Workup Bias: Diagnostic Performance, Computerized Interpretation, and Multivariable Prediction
V. Froelicher (1998)
An Administrative Claims Model Suitable for Profiling Hospital Performance Based on 30-Day Mortality Rates Among Patients With an Acute Myocardial Infarction
H. Krumholz (2006)
The MOS 36‐Item Short‐Form Health Survey (SF‐36): II. Psychometric and Clinical Tests of Validity in Measuring Physical and Mental Health Constructs
C. Mchorney (1993)
Internal validation of risk models in lung resection surgery: bootstrap versus training-and-test sampling.
A. Brunelli (2006)
Human Error in Medicine
M. Bogner (1994)
The declining specificity of exercise radionuclide ventriculography.
A. Rozanski (1983)
BAMarray™: Java software for Bayesian analysis of variance for microarray data
H. Ishwaran (2005)
Statistical modeling: The two cultures
L. Breiman (2001)
Determinants of mortality and type of repair in neonates with pulmonary atresia and intact ventricular septum.
D. Ashburn (2004)
L. Breiman (2005)
Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients.
F. Roques (1999)
Predicting Risk-Adjusted Mortality for CABG Surgery: Logistic Versus Hierarchical Logistic Models
E. Hannan (2005)
Sex and test verification bias. Impact on the diagnostic value of exercise echocardiography.
V. Roger (1997)
Why I Prefer Logits to Probits
J. Berkson (1951)
Statistical Modeling: The Two Cultures (with comments and a rejoinder by the author)
L. Breiman (2001)
Impact of anastomotic airway complications after lung transplantation.
S. Murthy (2007)
Hospital and Patient Characteristics Associated With Death After Surgery: A Study of Adverse Occurrence and Failure to Rescue
J. Silber (1992)
The beneficial effects of specialist thoracic surgery on the resection rate for non-small-cell lung cancer.
A. Martin-Ucar (2004)
Assessing the influence of reversible disease indicators on survival.
P. Andersen (1991)
Breaking down barriers: helpful breakthrough statistical methods you need to understand better.
E. Blackstone (2001)
Microarrays : managing the data deluge.
J. S. Rao (2001)
The relationship between choice of outcome measure and hospital rank in general surgical procedures: implications for quality assessment.
J. Silber (1997)
The Need for Accurate Risk‐Adjusted Measures of Outcome in Surgery: Lessons Learned Through Coronary Artery Bypass
B. Griffith (1995)
Quality of life in patients with various Barrett's esophagus associated health states
C. Hur (2006)
Cardiac surgery report cards: comprehensive review and statistical critique.
D. Shahian (2001)
Coronary Risk Prediction by Logical Analysis of Data
S. Alexe (2003)
The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma.
J. Edwards (2006)
Accounting for nonignorable verification bias in assessment of diagnostic tests.
A. Kosinski (2003)
More Extensive Nodal Dissection Improves Survival for Stages I to III of Colon Cancer: A Population-Based Study
S. Chen (2006)
A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease.
V. Parsonnet (1989)
Influence of hospital characteristics on operative death and survival of patients after major cancer surgery in Ontario.
M. Simunovic (2006)
Atrial fibrillation: current surgical options and their assessment.
A. Gillinov (2002)
Massachusetts cardiac surgery report card: implications of statistical methodology.
D. Shahian (2005)
The unit of analysis error in studies about physicians’ patient care behavior
G. Divine (2007)
Long-term survival after non-small cell lung cancer surgery: development and validation of a prognostic model with a preoperative and postoperative mode.
O. Birim (2006)
AJCC Cancer Staging Manual
M. B. Amin (2002)
The magnitude and the degree of uncertainty of differences.
J. Kirklin (1994)
Effects of hospital volume on life expectancy after selected cancer operations in older adults: a decision analysis.
E. Finlayson (2003)
Graphical Analysis of System Repair Data
W. Nelson (1988)
Can the outcome of coronary bypass grafting be predicted reliably?
P. Sergeant (1997)
Can pulmonary conduit dysfunction and failure be reduced in infants and children less than age 2 years at initial implantation?
T. Karamlou (2006)
Lung cancer in octogenarians: factors affecting morbidity and mortality after pulmonary resection.
Alberto Dominguez-Ventura (2006)
The volume-outcome relationship: from Luft to Leapfrog.
D. Shahian (2003)
Fluorine 18-tagged fluorodeoxyglucose positron emission tomographic scanning to predict lymph node metastasis, invasiveness, or both, in clinical T1 N0 M0 lung adenocarcinoma.
H. Nomori (2004)
Aspirin use and all-cause mortality among patients being evaluated for known or suspected coronary artery disease: A propensity analysis.
P. Gum (2001)
Postoperative survival and the number of lymph nodes sampled during resection of node-negative non-small cell lung cancer.
M. Ludwig (2005)
Designing trials for testing prosthetic cardiac valves: a Food and Drug Administration perspective.
W. Sapirstein (2001)
Improving the Statistical Approach to Health Care Provider Profiling
C. Christiansen (1997)
Esophageal carcinoma: depth of tumor invasion is predictive of regional lymph node status.
T. Rice (1998)
The Thoracic Surgery Scoring System (Thoracoscore): risk model for in-hospital death in 15,183 patients requiring thoracic surgery.
P. Falcoz (2007)
Disparities in the utilization of high-volume hospitals for complex surgery.
J. Liu (2006)
Issues concerning the clinical evaluation of new prosthetic valves.
B. Gersh (1986)
The analysis of survival data from a central cancer registry with passive follow-up.
G. M. Tallis (1988)
The Statistical Analysis of Failure Time Data
J. D. Kalbfleisch (1980)
Coronary artery bypass grafting: the Society of Thoracic Surgeons National Database experience.
F. Edwards (1994)
Do Cardiac Surgery Report Cards Reduce Mortality? Assessing the Evidence
A. Epstein (2006)
Long-term results after carinal resection for carcinoma: does the benefit warrant the risk?
M. D. de Perrot (2006)
Surgeon Specialty and Operative Mortality With Lung Resection
P. Goodney (2005)
Esophagectomy and staged reconstruction.
F. DiPierro (2000)
Matching procedure to morphology improves outcomes in neonates with tricuspid atresia.
T. Karamlou (2005)
Specialists achieve better outcomes than generalists for lung cancer surgery.
G. Silvestri (1998)
Clinical-pathologic conference: use and choice of statistical methods for the clinical study, "superficial adenocarcinoma of the esophagus".
E. Blackstone (2001)
New York State's Cardiac Surgery Reporting System: four years later.
E. Hannan (1994)
Predictions and causal estimations are not supported by the same associative structure
Miguel A. Vadillo (2007)
Will randomized trials detect random valve failure? Reflections on a recent FDA workshop.
G. Gl (1993)
An Administrative Claims Model Suitable for Profiling Hospital Performance Based on 30-Day Mortality Rates Among Patients With Heart Failure
H. Krumholz (2006)
Ventilatory dependency after cardiovascular surgery.
S. Murthy (2007)
Refining esophageal cancer staging.
T. Rice (2003)
Ageism in the management of lung cancer.
M. Peake (2003)
Classification and Regression Trees
L. Breiman (1983)
Paper standard gamble: a paper-based measure of standard gamble utility for current health.
P. Ross (2003)
Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer.
R. Arriagada (2004)
Lurking Variables: Some Examples
B. Joiner (1981)
Early-stage carcinosarcoma of the uterus: the significance of lymph node count
S. Temkin (2006)
Implementation Brief: Use of Commercial Record Linkage Software and Vital Statistics to Identify Patient Deaths
T. Newman (1997)
[18F]Fluorodeoxyglucose uptake by positron emission tomography for diagnosis of suspected lung cancer: impact of verification bias.
M. Lauer (2007)
Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett's esophagus.
C. Ell (2000)
FDA's requirements for in-vitro performance data for prosthetic heart valves.
Johnson Dm (1994)
The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
J. Ware (1992)
Adult open heart surgery in New York State. An analysis of risk factors and hospital mortality rates.
E. Hannan (1990)
This paper is referenced by
Aphorisms and Short Phrases as Pieces of Knowledge in the Pedagogical Framework of the Andalusian School of Public Health
Lorena González-García (2012)
Clinical registries: a quantum of knowledge.
Alessandro Brunelli (2011)
Generating new knowledge in cardiac interventions.
E. Blackstone (2013)