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The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis

In oral cancer surgery, the decision to perform a tracheotomy is often determined by the surgeon. In this study, we investigated the competency of clinical scoring systems in identifying patients who require tracheotomy and examined the degree of agreement between the surgeon's decision and the...

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Autores principales: Abe, Atsushi, Ito, Yu, Hayashi, Hiroki, Furuta, Hiroshi, Ishihama, Takanori, Adachi, Moriyasu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322477/
https://www.ncbi.nlm.nih.gov/pubmed/34397703
http://dx.doi.org/10.1097/MD.0000000000026712
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author Abe, Atsushi
Ito, Yu
Hayashi, Hiroki
Furuta, Hiroshi
Ishihama, Takanori
Adachi, Moriyasu
author_facet Abe, Atsushi
Ito, Yu
Hayashi, Hiroki
Furuta, Hiroshi
Ishihama, Takanori
Adachi, Moriyasu
author_sort Abe, Atsushi
collection PubMed
description In oral cancer surgery, the decision to perform a tracheotomy is often determined by the surgeon. In this study, we investigated the competency of clinical scoring systems in identifying patients who require tracheotomy and examined the degree of agreement between the surgeon's decision and the indications of various scoring systems. We identified 110 patients who were surgically treated for oral cancer. Of these, 67 patients (44 men and 23 women) who underwent resection and reconstruction were retrospectively analyzed. To derive the score, we evaluated the endpoint of the airway management score using clinical records and images. We divided the patients into two groups based on the Cameron and Gupta scores (tracheotomy and no-tracheotomy groups) and evaluated the degree of agreement with the surgeon's decision by calculating the κ coefficient. The κ coefficients of the Gupta and Cameron scores were 0.61 (95% confidence interval [CI]: 0.40–0.82) and 0.60 (95% CI: 0.38–0.82), respectively. The clinical evaluation of the κ coefficient indicated that the Cameron and Gupta scores agreed fairly with the surgeon's decision. In this study, the Cameron and Gupta scores fairly agreed with the decision of experienced surgeons and were confirmed as acceptable guides for making clinical judgments.
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spelling pubmed-83224772021-08-02 The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis Abe, Atsushi Ito, Yu Hayashi, Hiroki Furuta, Hiroshi Ishihama, Takanori Adachi, Moriyasu Medicine (Baltimore) 3900 In oral cancer surgery, the decision to perform a tracheotomy is often determined by the surgeon. In this study, we investigated the competency of clinical scoring systems in identifying patients who require tracheotomy and examined the degree of agreement between the surgeon's decision and the indications of various scoring systems. We identified 110 patients who were surgically treated for oral cancer. Of these, 67 patients (44 men and 23 women) who underwent resection and reconstruction were retrospectively analyzed. To derive the score, we evaluated the endpoint of the airway management score using clinical records and images. We divided the patients into two groups based on the Cameron and Gupta scores (tracheotomy and no-tracheotomy groups) and evaluated the degree of agreement with the surgeon's decision by calculating the κ coefficient. The κ coefficients of the Gupta and Cameron scores were 0.61 (95% confidence interval [CI]: 0.40–0.82) and 0.60 (95% CI: 0.38–0.82), respectively. The clinical evaluation of the κ coefficient indicated that the Cameron and Gupta scores agreed fairly with the surgeon's decision. In this study, the Cameron and Gupta scores fairly agreed with the decision of experienced surgeons and were confirmed as acceptable guides for making clinical judgments. Lippincott Williams & Wilkins 2021-07-30 /pmc/articles/PMC8322477/ /pubmed/34397703 http://dx.doi.org/10.1097/MD.0000000000026712 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 3900
Abe, Atsushi
Ito, Yu
Hayashi, Hiroki
Furuta, Hiroshi
Ishihama, Takanori
Adachi, Moriyasu
The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis
title The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis
title_full The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis
title_fullStr The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis
title_full_unstemmed The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis
title_short The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis
title_sort degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: a retrospective analysis
topic 3900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322477/
https://www.ncbi.nlm.nih.gov/pubmed/34397703
http://dx.doi.org/10.1097/MD.0000000000026712
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