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Results for “Surgical Error”

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At least 253 records · Page 14Linked to original sources
PubMed1994

The surgical correction of refractive errors of the eye.

Authors review the available surgical methods, the radial keratotomy, the keratophakia, the keratomileusis, the epikeratophakia and the excimer laser technique which are available presently in order to change the refractive power of the eye. The newest excimer technique is discussed in detail. During the past one and a half year period authors performed and closely followed 37 photorefractive keratectomies with the use of Aesculap Meditec MEL 60 excimer laser. They present the postoperative results, according to their experiences, the method is highly effective and predictable in treating myopic refractive failures. The side effects were of no clinical importance.

Adult↗
PubMed2004

Type II error in the spine surgical literature.

STUDY DESIGN: A literature review. OBJECTIVES: To determine the frequency of potential type II errors published in the spine surgical literature. SUMMARY OF BACKGROUND DATA: The randomized controlled trial is the strongest clinical evidence available in investigational medicine. Unfortunately, it is common for randomized controlled trials published in peer-reviewed journals not to report a primary question or a sample size calculation. When the null hypothesis is accepted and the power of a study is unreported, the validity of a study's findings may be significantly limited. To our knowledge, the spine literature has not been appraised to determine the frequency of type II errors. METHODS.: A literature search was conducted of MED-LINE, PubMed, and Cochrane databases, using the key words of "spine" and "surgery" between 1967 and 2002. Trials were included if they were of a 2-group randomized controlled trial design, which reported a nonsignificant difference in the primary outcome. The frequency of reporting the primary outcome and sample size calculation was determined. The sample size was assessed to determine whether the trial had sufficient patients to detect a 10%, 25%, and 35% relative difference in the primary outcome for a power of 80%. RESULTS: A total of 37 studies satisfied the inclusion criteria. Six studies reported a sample size calculation (17%). Of the remaining 31 studies, 5 explicitly stated a primary outcome (14%). The mean type II error (beta error) was 82%. CONCLUSION: The spine surgical literature is plagued with a high potential for type II error. A trial's methodology should be scrutinized to prevent misinterpretation of the results.

Bibliometrics↗
PubMed2001

Gone but not forgotten: the search for the lost surgical specimens: application of quality improvement techniques in reducing medical error.

A lost surgical specimen prompted an investigation of both the human processes and the systemic factors involved in surgical specimen handling regarding how health care organizations approach medical error prevention and patient safety promotion. Quality improvement techniques and the conceptual error model of James Reasons were employed to understand the interaction between the local process of specimen handling and the systemic influences to medical error management. Error management recognizes the inevitability of both individual and systemic error. Through the use of quality improvement techniques and models of error analysis, health care organizations can investigate the error potential of health care delivery and address the human and organizational interaction necessary to improve patient safety and manage medical error.

Hospitals, Veterans↗
PubMed1986

Variability of strabismus surgery for acquired esotropia.

We developed a mathematical model to predict the probable success rate of the first surgery to correct acquired esotropia with normal accommodative convergence-accommodation ratio in children. A computer-averaged dose-response curve of the effect of 68 bilateral medial rectus recessions was combined with various assumptions regarding likely errors in surgical performance and likely errors in measurement of the preoperative deviation. Fifteen different sets of reasonable assumptions were tested, giving a range of theoretical success rates from 72% to 96%. The results of this study clearly indicate that a certain proportion of failures is to be expected when this or other forms of strabismus are treated surgically by a fully competent ophthalmic surgeon performing as accurately as is practically possible.

Child↗
PubMed1989

Causes of morbidity and mortality from surgery of aneurysms of the distal basilar artery.

Despite modern neurosurgical technology and neuroanesthetic care, treatment of aneurysms of the distal basilar artery remains fraught with complications. Between 1982 and 1988, 126 patients with aneurysms of the distal basilar artery who had been treated by 2 surgeons were retrospectively analyzed to determine the causes of morbidity and mortality from this disease and its treatment. Ten patients (8%) died, and 14 patients (11%) suffered permanent neurological disability after treatment. The causes of failed management could be grouped into the following categories: 1) direct effects of hemorrhage; 2) errors in surgical timing; 3) conceptual errors; 4) technical errors; 5) morbidity from delayed cerebral ischemia; and 6) complications of hypertensive/hypervolemic therapy for symptomatic vasospasm; a small group of patients who died despite having received what we consider excellent management were grouped under a seventh category, "bad luck." Frequently, patients who did poorly suffered from multiple complications, each of which contributed to their overall morbidity. It is our hope that increased awareness of these potential pitfalls and the further evolution of intravascular technique in selected cases will, in time, improve the outlook for patients suffering from these dangerous lesions.

Adult↗