Surgical Outcomes Analysis and Research

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Surgical Outcomes Analysis & Research, SOAR, is a research laboratory of the Department of Surgery at Boston University School of Medicine and Boston Medical Center with expertise in outcomes research. SOAR investigates surgical diseases and perioperative outcomes. The group focuses on pancreatic cancer, other gastrointestinal and hepatobiliary malignancies, vascular disease, and transplant surgery. SOAR's goal is to examine quality, delivery, and financing of care in order to have an immediate impact on patient care and system improvements. The group members utilize national health services and administrative databases, as well as institutional databases, to investigate and to address factors contributing to disease outcomes and healthcare disparities.

The work in SOAR incorporates advanced statistical techniques, including logistic regression, prediction score, and decision analysis modeling.

Outcomes Research evaluates the impact of health care on the health outcomes of patients and populations. This research may also include the evaluation of economic impacts linked to health outcomes, such as cost effectiveness and cost utility. An emphasis is placed on disease-oriented evaluations of care delivered in general, real-world settings. There are a wide range of outcomes to study including mortality, morbidity, functional status, mental well-being, and other aspects of health-related quality of life. Outcomes research is a multidisciplinary field of inquiry that examines the use, quality, delivery, and financing of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations. Outcomes research provides the data to help solve critical problems that are faced in everyday clinical practice. The information learned can have an immediate impact on patient care and system improvement.

SOAR was founded in 2007 at UMass Medical School and relocated to Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, in 2012.

The mission of SOAR is to decrease perioperative morbidity and mortality, address health care disparities, and increase overall patient survival and quality of life. SOAR members hope, as part of the surgical outcomes research community, to improve overall outcomes for patients with surgical diseases.

• Pancreatic cancer and pancreatic disease
• Other gastrointestinal and hepatobiliary malignancies
• Vascular disease
• Transplant surgery and transplant psychology
• Investigating factors that affect surgical outcomes for diverse specialties including colorectal, cardiovascular, transplant, plastic and reconstructive, and minimally invasive surgery

Boston Medical Center (BMC) in Boston, Massachusetts is a teaching hospital of Boston University School of Medicine. Situated in Boston's South End neighborhood, BMC is the largest safety-net hospital in New England and caters to a diverse patient population from around the world.

SOAR researchers use national health services and administrative databases as well as prospective institutional tissue-linked databases to investigate factors contributing to disease outcomes for pancreatic cancer, hepato biliary disease, vascular disease, colorectal disease, plastic and reconstructive surgery, and transplant medicine. These projects are under development with the use of the following databases:

• AHRQ Nationwide Inpatient Sample (NIS)
• National Surgical Quality Improvement Program (NSQIP)
• Surveillance, Epidemiology, and End Results (SEER)
• SEER Medicare
• National Cancer Database

Additionally, individual research groups have access to and have expertise in disease- and specialty-specific databases. These include:

• Vascular Study Group of New England (VSGNE), a regional vascular surgery database.
• Vascular Quality Initiative (VQI), a national vascular surgery database.
• American Society of Thoracic Surgery (ASTS) database
• National Trauma Data Bank (NTDB)
• Scientific Registry of Transplant Recipients

Also, SOAR researchers are conducting patient-centered outcomes research designed to:

• Measure health-related, functional, and other outcomes from the perspective of patients and their families
• Develop decision aid tools and strategies to assist patients in making complex choices about their healthcare
• Compare the effectiveness of surgical interventions on patient-reported outcomes

• Jennifer F. Tseng, MD, MPH - SOAR Founder and Co-Director; Surgeon-in-Chief, Boston Medical Center; James Utley Professor and Chair of Surgery, Boston University School of Medicine
• James R. Rodrigue, PhD - SOAR Co-Director; Director, Behavioral Health Services and Research, The Transplant Center, Beth Israel Deaconess Medical Center; Professor, Psychiatry, Harvard Medical School
• Marc L. Schermerhorn, MD - SOAR Co-Director; Chief, Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center; Associate Professor, Harvard Medical School

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• Fokkema M, de Borst GJ, Nolan BW, Indes J, Buck DB, Lo RC, Moll FL, Schermerhorn ML (Jan 2014). "Clinical relevance of cranial nerve injury following carotid endarterectomy". Eur J Vasc Endovasc Surg. 47 (1): 2–7. doi:10.1016/j.ejvs.2013.09.022. PMC 4096657. PMID 24157257.
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• Fokkema M, Hurks R, Curran T, Bensley RP, Hamdan AD, Wyers MC, Moll FL, Schermerhorn ML (Jan 2014). "The impact of the present on admission indicator on the accuracy of administrative data for carotid endarterectomy and stenting". J Vasc Surg. 59 (1): 32–8. doi:10.1016/j.jvs.2013.07.006. PMC 3874266. PMID 23993438.
• Fokkema Margriet; et al. (2014). "Carotid stenting versus endarterectomy in patients undergoing reintervention after prior carotid endarterectomy". Journal of Vascular Surgery. 59 (1): 8–15. doi:10.1016/j.jvs.2013.06.070. PMC 3852203. PMID 23972527.
• Fokkema Margriet; et al. (2014). "The impact of the present on admission indicator on the accuracy of administrative data for carotid endarterectomy and stenting". Journal of Vascular Surgery. 59 (1): 32–38. doi:10.1016/j.jvs.2013.07.006. PMC 3874266. PMID 23993438.
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• Lo RC, Bensley RP, Dahlberg SE, Matyal R, Hamdan AD, Wyers M, Chaikof EL, Schermerhorn ML (Feb 2014). "Presentation, treatment, and outcome differences between men and women undergoing revascularization or amputation for lower extremity peripheral arterial disease". J Vasc Surg. 59 (2): 409–418. doi:10.1016/j.jvs.2013.07.114. PMC 3946884. PMID 24080134.
• Lo RC, Lu B, Fokkema MT, Conrad M, Patel VI, Fillinger M, Matyal R, Schermerhorn ML (May 2014). "Relative importance of aneurysm diameter and body size for predicting abdominal aortic aneurysm rupture in men and women". J Vasc Surg. 59 (5): 1209–16. doi:10.1016/j.jvs.2013.10.104. PMC 4004688. PMID 24388278.
• Ragulin-Coyne E, Witkowski ER, Chau Z, Wemple D, Ng SC, Santry HP, Shah SA, Tseng JF (Mar 2014). "National trends in pancreaticoduodenal trauma: interventions and outcomes". HPB (Oxford). 16 (3): 275–81. doi:10.1111/hpb.12125. PMC 3945854. PMID 23869407.
• Rodrigue JR, Fleishman A, Vishnevsky T, Whiting J, Vella J, Garrison K, Moore D, Kayler L, Baliga P, Chavin K, Karp S, Mandelbrot DA (2014). "Development and validation of a questionnaire to assess fear of kidney failure following living donation". Transpl. Int. 27 (6): 570–5. doi:10.1111/tri.12299. PMC 4028402. PMID 24606048.
• Rodrigue JR, Paek M, Whiting J, Vella J, Garrison K, Pavlakis M, Mandelbrot DA (2014). "Trajectories of perceived benefits in living kidney donors: Association with donor characteristics and recipient outcomes". Transplantation. 97 (7): 762–8. doi:10.1097/01.tp.0000437560.23588.ef. PMID 24342981. S2CID 12873097.
• Rodrigue JR, Paek M, Egbuna O, Waterman AD, Schold JD, Pavlakis M, Mandelbrot DA (2014). "Readiness of wait-listed black patients to pursue live donor kidney transplantation". Prog Transplant. 24 (4): 355–361. doi:10.7182/pit2014337. PMC 4516085. PMID 25488559.
• Rodrigue JR, Fleishman A, Vishnevsky T, Fitzpatrick S, Boger M (2014). "Organ donation video messaging: Differential appeal, emotional valence, and behavioral intention". Clinical Transplantation. 28 (10): 1184–92. doi:10.1111/ctr.12449. PMID 25125237. S2CID 21256294.
• Rodrigue JR, Fleishman A, Fitzpatrick S, Boger M (2014). "Organ donation knowledge, willingness, and beliefs of motor vehicle clerks". Transplantation. 98 (10): 1025–28. doi:10.1097/tp.0000000000000424. PMID 25222015. S2CID 22705741.
• Rodrigue JR, Paek M, Egbuna O, Waterman AD, Schold JD, Pavlakis M, Mandelbrot DA (2014). "Making house calls increases living donor inquiries and evaluations for blacks on the kidney transplant waiting list". Transplantation. 98 (9): 979–86. doi:10.1097/tp.0000000000000165. PMC 4218873. PMID 24825528.
• Rodrigue JR, Leishman R, Vishnevsky T, Evenson AR, Mandelbrot DA. "Concerns of ABO incompatible and crossmatch-positive potential donors and recipients about participating in kidney exchanges." Clin Transplant. In Press.
• Rodrigue JR, Schold JD, Morrissey J, Whiting J, Vella J, Kayler L, Katz D, Jones J, Kaplan B, Fleishman A, Pavlakis M, Mandelbrot DA. "Pre-donation direct and indirect costs incurred by adults who donated a kidney: Findings from the KDOC study." Am J Transplant. In Press.
• Schold JD, Goldfarb DA, Buccini LD, Rodrigue JR, Mandelbrot DA, Heaphy EL, Fatica R, Poggio ED (2014). "Hospitalizations following living donor nephrectomy in the United States". Clin J Am Soc Nephrol. 9 (2): 355–65. doi:10.2215/CJN.03820413. PMC 3913232. PMID 24458071.
• Schold JD, Buccini LB, Rodrigue JR, Mandelbrot D, Goldfarb DA, Flechner SM, Kayler LK, Poggio ED. "Critical factors associated with missing follow-up data for living kidney donors in the United States." Am J Transplant. In Press.
• Yang CJ, Bliss LA, Schapira EF, Freedman SD, Ng SC, Windsor JA, Tseng JF. "Systematic Review of Early Surgery for Chronic Pancreatitis: Impact on Pain, Pancreatic Function, and Re-intervention. J Gastrointest Surg. 2014 Jun 19.
• Zhang JQ, Curran T, McCallum JC, Wang L, Wyers MC, Hamdan AD, Guzman RJ, Schermerhorn ML (May 2014). "Risk factors for readmission after lower extremity bypass in the American College of Surgeons National Surgery Quality Improvement Program". J Vasc Surg. 59 (5): 1331–9. doi:10.1016/j.jvs.2013.12.032. PMC 4004644. PMID 24491239.

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• Rodrigue JR, Hanto DW, Curry MP (2013). "The Alcohol Relapse Risk Assessment: a scoring system to predict the risk of relapse to any alcohol use after liver transplant". Progress in Transplantation. 23 (4): 310–318. doi:10.7182/pit2013604. PMID 24311394. S2CID 207535298.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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• Burr AT, Shah SA (Apr 2010). "Disparities in Organ Allocation and Access to Liver Transplantation in the United States". Expert Review of Gastroenterology & Hepatology. 4 (2): 133–40. doi:10.1586/egh.10.10. PMID 20350260. S2CID 38576124.
• Carroll JE, Hurwitz ZM, Simons JP, McPhee JT, Ng SC, Shah SA, Al-Refaie WB, Tseng JF (Feb 2010). "In-hospital mortality after resection of biliary tract cancer in the United States". HPB (Oxford). 12 (1): 62–67. doi:10.1111/j.1477-2574.2009.00129.x. PMC 2814406. PMID 20495647.
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• Colombo B, Singla A, Li Y, Tseng JF, Saidi RF, Bozorgzadeh A, Shah SA (Dec 2010). "Current trends and short-term outcomes of live donor nephrectomy: a population-based analysis of the nationwide inpatient sample". World J. Surg. 34 (12): 2985–90. doi:10.1007/s00268-010-0770-3. PMID 20811748. S2CID 9958285.
• Csikesz NG, Singla A, Murphy MM, Tseng JF, Shah SA (Aug 2010). "Surgeon volume metrics in laparoscopic cholesystectomy". Dig Dis Sci. 55 (8): 2398–405. doi:10.1007/s10620-009-1035-6. PMID 19911275. S2CID 12785952.
• Giles Kristina A, et al. (2010). "Stroke and death after carotid endarterectomy and carotid artery stenting with and without high risk criteria". Journal of Vascular Surgery. 52 (6): 1497–1504. doi:10.1016/j.jvs.2010.06.174. PMC 3005797. PMID 20864299.
• Hill JS, Zhou Z, Simons JP, Ng SC, McDade TP, Whalen GF, Tseng JF (Jul 2010). "A Simple Risk Score to Predict In-Hospital Mortality after Pancreatic Resection for Cancer". Ann Surg Oncol. 17 (7): 1802–1807. doi:10.1245/s10434-010-0947-x. PMID 20155401. S2CID 12857618.
• Manasanch EE, Smith JK, Bodnari A, McKinney J, Gray C, McDade TP, Tseng JF. "Tumor registry versus physician medical record review: A head-tohead comparison of pancreatic neuroendocrine tumor cases. In press, Journal of Oncology Practice.
• McDade TP, Hill JS, Simons JP, Piperdi B, Ng SC, Zhou Z, Kadish SP, Fitzgerald TJ, Tseng JF (Jul 2010). "A National Propensity-Adjusted Analysis of adjuvant radiotherapy in the treatment of resected pancreatic adenocarcinoma". Cancer. 116 (13): 3257–66. doi:10.1002/cncr.25069. PMID 20564625.
• Murphy MM, Ng SC, Simons JP, Csikesz NG, Shah SA, Tseng JF (Jul 2010). "Predictors of Major Complications after Laparoscopic Cholecystectomy:Surgeon, Hospital, or Patient?". J Am Coll Surg. 211 (1): 73–80. doi:10.1016/j.jamcollsurg.2010.02.050. PMID 20610252.
• Murphy MM, Tseng JF, Shah SA (May 2010). "Disparities in Cancer Care: An Operative Perspective". Surgery. 147 (5): 733–7. doi:10.1016/j.surg.2009.10.050. PMID 19962161.
• Murphy MM, Witkowski ER, Ng SC, McDade TP, Hill JS, Larkin AC, Whalen GF, Litwin DE, Tseng JF (2010). "Trends in adrenalectomy: a recent national review". Surg Endosc. 24 (10): 2518–2526. doi:10.1007/s00464-010-0996-z. PMID 20336320. S2CID 2979551.
• Nath B, Li YF, Carroll JE, Szabo G, Tseng JF, Shah SA. "Alcohol exposure as a risk factor for adverse outcomes in elective surgery. J Gastrointest Surg. 210 Nov;14(11)1732-41.
• Piperdi M, McDade TP, Shim JK, Piperdi B, Kadish SP, Sullivan ME, Whalen GF, Tseng JF (Apr 2010). "A neoadjuvant strategy for pancreatic adenocarcinoma increases the likelihood of receiving all components of care: Lessons from a single institution database". HPB (Oxford). 12 (3): 204–210. doi:10.1111/j.1477-2574.2009.00150.x. PMC 2889273. PMID 20590888.
• Schermerhorn ML (Dec 2010). "Current management of selected vascular emergencies". Semin Vasc Surg. 23 (4): 199. doi:10.1053/j.semvascsurg.2010.11.002. PMID 21194635.
• Shah SA, Smith JK, Li Y, Ng SC, Carroll JE, Tseng JF (Oct 2010). "Underutilization of therapy for hepatocellular carcinoma in the medicare population". Cancer. 117 (5): 1019–1026. doi:10.1002/cncr.25683. PMID 20945363. S2CID 9127917.
• Simons JP, Ng SC, Hill JS, Shah SA, Zhou Z, Tseng JF (Apr 2010). "In-hospital mortality from liver resection for hepatocellular carcinoma: a simple risk score". Cancer. 116 (7): 1733–1738. doi:10.1002/cncr.24904. PMID 20143433.
• Simons JP, Ng SC, McDade TP, Zhou Z, Shah SA, Earle CC, Tseng JF (Apr 2010). "Progress for resectable cancer? A population-based assessment of US practices". Cancer. 116 (7): 1681–1690. doi:10.1002/cncr.24918. PMID 20143432.
• Singla A, Hart JL, Li Y, Tseng JF, Shah SA (2010). "Hospitalization for Complications of Cirrhosis: Does Volume Matter?". J Gastrointest Surg. 15 (2): 330–335. doi:10.1007/s11605-010-1398-1. PMID 21108014. S2CID 21450789.
• Singla A, Simons JP, Carroll JE, Li YF, Ng SC, Tseng JF, Shah SA (Mar 2010). "Hospital Volume as a Surrogate for Laparoscopic-Assisted Colectomy". Surg Endosc. 24 (3): 662–9. doi:10.1007/s00464-009-0665-2. PMID 19688386. S2CID 34810373.
• Smith JK, Hill JS, Ng SC, McDade TP, Shah SA, Tseng JF (Nov 2010). "Potential benefit of resection for stage IV gastric cancer: A national survey". J Gastrointest Surg. 14 (11): 1660–8. doi:10.1007/s11605-010-1351-3. PMID 20827576. S2CID 1291778.
• Smith JK, Ng SC, Hill JS, Simons JP, Arous EJ, Shah SA, Tseng JF, McDade TP (Sep 2010). "Complications after pancreatectomy for neuroendocrine tumors: A national study". J Surg Res. 163 (1): 63–8. doi:10.1016/j.jss.2010.04.017. PMID 20599224.
• Wiseman JT, Sharuk MN, Singla A, Cahan M, Litwin DE, Tseng JF, Shah SA (May 2010). "Surgical Management of Acute Cholecystitis at a Tertiary Care Center in the Modern Era". Arch. Surg. 145 (5): 439–44. doi:10.1001/archsurg.2010.54. PMID 20479341.
• Zhou Z, McDade TP, Simons JP, Ng SC, Lambert LA, Whalen GF, Shah SA, Tseng JF (2010). "Surgery and radio therapy for retroperitoneal and abdominal sarcoma: both necessary and sufficient?". Arch Surg. 145 (5): 426–431. doi:10.1001/archsurg.2010.70. PMID 20479339.

• Cooley EK, McPhee JT, Simons JP, Sweeney WB, Tseng JF, Alavi K. Colorectal neoplasia screening before age 50? "Current epidemiologic trends in the United States. Dis Colon Rectum 2009 Feb; 52(2):222-9.
• Csikesz NG, Nguyen LN, Tseng JF, Shah SA (Jan 2009). "Nationwide Volume and Mortality After Elective Surgery in Cirrhotic Patients". J Am Coll Surg. 208 (1): 96–103. doi:10.1016/j.jamcollsurg.2008.09.006. PMID 19228510.
• Csikesz NG, Singla A, Simons JP, Tseng JF, Shah SA (Nov 2009). "The impact of socioeconomic status on presentation and treatment of diverticular disease". J Gastrointest Surg. 13 (11): 1993–2001. doi:10.1007/s11605-009-1031-3. PMID 19760302. S2CID 38073393.
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• Hill JS, McPhee JT, Whalen GF, Sullivan ME, Warshaw AL, Tseng JF (Oct 2009). "In-Hospital Mortality after Pancreatic Resection for Chronic Pancreatitis: Population Based Estimates from the Nationwide Inpatient Sample". J Am Coll Surg. 209 (4): 468–76. doi:10.1016/j.jamcollsurg.2009.05.030. PMID 19801320.
• McPhee JT, Eslami MH, Arous EJ, Messina LM, Schanzer A (Apr 2009). "Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms in the United States (2001-2006) A Significant Survival Benefit Over Open Repair is Independently Associated with Increased Institutional Volume". Journal of Vascular Surgery. 49 (4): 817–26. doi:10.1016/j.jvs.2008.11.002. PMID 19147323.
• Murphy MM, Knaus WJ, Ng SC, Hill JS, McPhee JT, Shah SA, Tseng JT (Sep 2009). "Total Pancreatectomy: A National Study". HPB (Oxford). 11 (6): 476–482. doi:10.1111/j.1477-2574.2009.00076.x. PMC 2756634. PMID 19816611.
• Murphy MM, Shah SA, Simons JP, Csikesz NG, McDade TP, Bodnari A, Ng SC, Zhou Z, Tseng JF (Nov 2009). "Predicting Major Complications after Laparoscopic Cholecystectomy: A Simple Risk Score". Journal of Gastrointestinal Surgery. 13 (11): 1929–1936. doi:10.1007/s11605-009-0979-3. PMID 19672665. S2CID 19466099.
• Murphy MM, Simons JP, Hill JS, McDade TP, Ng SC, Whalen GF, Shah SA, Harrison LH, Tseng JF (Sep 2009). "Pancreatic Resection: A Key Component to Reducing Racial Disparities in Pancreatic Adenocarcinoma". Cancer. 115 (17): 3979–90. doi:10.1002/cncr.24433. PMID 19514091.
• Murphy MM, Simons JP, Ng SC, McDade TP, Smith JK, Shah SA, Zhou Z, Earle CC, Tseng JF (Nov 2009). "Racial Differences in Cancer Specialist Consultation, Treatment, and Outcomes for Locoregional Pancreatic Adenocarcinoma". Ann Surg Oncol. 16 (11): 2968–77. doi:10.1245/s10434-009-0656-5. PMID 19669839. S2CID 35362706.
• Simons JP, Hill JS, Ng SC, Shah SA, Zhou Z, Whalen GF, Tseng JF (Dec 2009). "Perioperative Mortality for Management of Hepatic Neoplasm: A Simple Risk Score". Ann Surg. 250 (6): 929–934. doi:10.1097/sla.0b013e3181bc9c2f. PMID 19855257. S2CID 28334621.
• Simons JP, Ng SC, Hill JS, Shah SA, Bodnari A, Zhou Z, Tseng JF (Sep 2009). "In-hospital mortality for liver resection for metastatic disease: a simple risk score". J Surg Res. 156 (1): 21–25. doi:10.1016/j.jss.2009.03.073. PMID 19577250.
• Simons JP, Ng SC, Shah SA, McDade TP, Whalen GF, Tseng JF (2009). "Malignant Intraductal Papillary Mucinous Neoplasm: Are We Doing the Right Thing?". Journal of Surgical Research. 167 (2): 251–257. doi:10.1016/j.jss.2009.05.035. PMID 19765732.
• Simons JP, Shah SA, Ng SC, Whalen GF, Tseng JF (Oct 2009). "National Complication Rates after Pancreatectomy: Beyond Mere Mortality". J Gastrointest Surg. 13 (10): 1798–805. doi:10.1007/s11605-009-0936-1. PMID 19506975. S2CID 31779087.
• Singla A, Csikesz NG, Simons JP, Li YF, Ng SC, Tseng JF, Shah SA (Aug 2009). "National Hospital Volume in Acute Pancreatitis: Analysis of the Nationwide Inpatient Sample 1998-2006". HPB (Oxford). 11 (5): 391–7. doi:10.1111/j.1477-2574.2009.00072.x. PMC 2742608. PMID 19768143.
• Singla A, Li Y, Ng SC, Csikesz NG, Tseng JF, Shah SA (2009). "Is the growth in laparoscipic surgery reproducible with more complex procedures?". Surgery. 146 (2): 367–74. doi:10.1016/j.surg.2009.06.006. PMID 19628097.
• Singla A, Simons JP, Li Y, Csikesz NG, Ng SC, Tseng JF, Shah SA (Dec 2009). "Admission volume determines outcome for patients with acute pancreatitis: a case-controlled analysis". Gastroenterology. 137 (6): 1995–2001. doi:10.1053/j.gastro.2009.08.056. PMID 19733570.

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• Hill JS, McPhee JT, Messina LM, Ciocca RG, Eslami MH (July 2008). "Regionalization of abdominal aortic aneurysm repair: evidence of a shift to high-volume centers in the endovascular era". J. Vasc. Surg. 48 (1): 29–36. doi:10.1016/j.jvs.2008.02.048. PMID 18589227.
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• Csikesz NG, Simons JP, Tseng JF, Shah SA (September 2008). "Surgical specialization and operative mortality in hepato-pancreatico-biliary (HPB) surgery". J. Gastrointest. Surg. 12 (9): 1534–9. doi:10.1007/s11605-008-0566-z. PMID 18612710. S2CID 557379.
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• Hill JS, Shankar S, Evans DB, Tseng JF. "Control of bleeding from the portal/superior mesenteric vein. Operative Techniques in General Surgery 2007 Dec;(9)4:152-159
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