Equivalent outcomes after coronary artery bypass graft surgery performed by consultant versus trainee surgeons: A systematic review and meta-analysis

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Presentation transcript:

Equivalent outcomes after coronary artery bypass graft surgery performed by consultant versus trainee surgeons: A systematic review and meta-analysis Sohaib A. Virk, BMed/MD, Sebastian R.A. Bowman, BMedSci, Lionel Chan, PhD, Paul G. Bannon, PhD, Waleed Aty, MD, Bruce G. French, MBBS, Akshat Saxena, MBBS The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 3, Pages 647-654.e1 (March 2016) DOI: 10.1016/j.jtcvs.2015.11.006 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart for literature search and study selection. CABG, Coronary artery bypass grafting. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 647-654.e1DOI: (10.1016/j.jtcvs.2015.11.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Forest plot displaying the mean difference in (A) aortic crossclamp and (B) cardiopulmonary bypass durations between trainee and consultant coronary artery bypass graft cases. The middle of the squares corresponds to the mean difference; horizontal lines show 95% CIs; middle of the filled diamond shows the pooled mean difference. Results of a test of heterogeneity between studies is given below the summary statistics. SD, standard deviation; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 647-654.e1DOI: (10.1016/j.jtcvs.2015.11.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Forest plot displaying ORs of perioperative all-cause mortality for trainee versus consultant coronary artery bypass graft cases. The OR of individual studies corresponds to the middle of the squares, 95% CIs are shown by horizontal lines, and the pooled OR is represented by the middle of the filled diamond. A test of heterogeneity between studies is given below the summary statistics. OR, Odds ratio; SE, standard error; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 647-654.e1DOI: (10.1016/j.jtcvs.2015.11.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Forest plot displaying hazard ratios (HRs) of midterm mortality for trainee versus consultant coronary artery bypass graft cases. The HR of individual studies corresponds to the middle of the squares, 95% CIs are shown by horizontal lines, and the pooled OR is represented by the middle of the filled diamond. A test of heterogeneity between studies is given below the summary statistics. HR, Hazard ratio; SE, standard error; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 647-654.e1DOI: (10.1016/j.jtcvs.2015.11.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Funnel plot of SE by logit odds ratio, for assessment of publication bias. Open circles represent studies included in the present meta-analysis; filled circles represent potential missing studies. The open diamond represents the pooled logit odds ratio for perioperative mortality in included studies; the filled diamond represents the adjusted ratio after accounting for potential missing studies. SE, standard error. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 647-654.e1DOI: (10.1016/j.jtcvs.2015.11.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Forest plot of perioperative mortality for trainee versus consultant coronary artery bypass grafting cases. The Journal of Thoracic and Cardiovascular Surgery 2016 151, 647-654.e1DOI: (10.1016/j.jtcvs.2015.11.006) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions