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BACKGROUND Although numerous studies suggest that there is an inverse relation between hospital volume of surgical procedures and surgical mortality, the relative importance of hospital volume in various surgical procedures is disputed. METHODS Using information from the national Medicare claims data base and the Nationwide Inpatient Sample, we examined(More)
BACKGROUND Although the relation between hospital volume and surgical mortality is well established, for most procedures, the relative importance of the experience of the operating surgeon is uncertain. METHODS Using information from the national Medicare claims data base for 1998 through 1999, we examined mortality among all 474,108 patients who(More)
The Agency for Toxic Substances and Disease Registry (ATSDR) and the United States (US) Environmental Protection Agency (EPA) Office of Solid Waste and Emergency Response (OSWER) list arsenic as a major concern for Superfund sites and the environment at large. Arsenic is clearly linked to skin, bladder, and lung cancer occurrence in populations highly(More)
Arsenic is a known carcinogen specifically linked to skin cancer occurrence in regions with highly contaminated drinking water or in individuals who took arsenic-containing medicines. Presently, it is unknown whether such effects occur at environmental levels found in the United States. To address this question, the authors used data collected on 587 basal(More)
OBJECTIVE To determine normal values for the urinary calcium/creatinine ratio (UCa/Cr) in infants. To assess the impact of short-term supplementation of infant formula with calcium and phosphorus on UCa/Cr in a group of infants. DESIGN We determined UCa/Cr in randomly collected urine samples from a group of children and adults. Short-term supplementation(More)
BACKGROUND & AIMS The most widely quoted complication rates for colonoscopy are from case series performed by expert endoscopists. Our objectives were to evaluate the rates of bleeding, perforation, and death associated with outpatient colonoscopy and their risk factors in a population-based study. METHODS We identified all individuals 50 to 75 years old(More)
BACKGROUND The health implications of regional differences in Medicare spending are unknown. OBJECTIVE To determine whether regions with higher Medicare spending provide better care. DESIGN Cohort study. SETTING National study of Medicare beneficiaries. PATIENTS Patients hospitalized between 1993 and 1995 for hip fracture (n = 614,503), colorectal(More)
PURPOSE We designed this study to evaluate the association of colonoscopy with colorectal cancer (CRC) death in the United States by site of CRC and endoscopist specialty. METHODS We designed a case-control study using Surveillance, Epidemiology, and End Results (SEER)-Medicare data. We identified patients (cases) diagnosed with CRC age 70 to 89 years(More)
OBJECTIVE To determine whether the more intensive screening and treatment for prostate cancer in the Seattle-Puget Sound area in 1987-90 led to lower mortality from prostate cancer than in Connecticut. DESIGN Natural experiment comparing two fixed cohorts from 1987 to 1997. SETTING Seattle-Puget Sound and Connecticut surveillance, epidemiology, and end(More)