This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fingerote, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fingerote, R. J.
Related Collections
Right arrow Health services research
Right arrow Statistics & Research Methods
Right arrow Breast Cancer
CMAJ • July 24, 2001; 165 (2)
© 2001 Canadian Medical Association or its licensors

Letters
Correspondance

Do women treated for breast cancer at teaching hospitals really fare better?

Robert J. Fingerote

Gastroenterologist Queensway-Carleton Hospital Ottawa, Ont.

I am concerned by the conclusion reached by Ruhee Chaudhry and colleagues that patients who underwent surgery for breast cancer tumours smaller than 20 mm in diameter experienced better survival if they were initially seen in teaching hospitals rather than community hospitals.1 I could not help but detect a degree of bias in this study against physicians in nonteaching hospitals. Statements such as "teaching status may affect patient outcomes directly because of better knowledge and skills" imply that surgeons in teaching hospitals are superior to those in community hospitals; this has no foundation in fact.

I agree with the authors that differences in patient outcomes between the 2 types of hospital need to be analyzed. If there is a factor that differentiates patient survival in the nonteaching versus teaching centres, it needs to be detected and addressed. If differences in outcome are "artifact[s] of misclassification," this study needs to be expanded to confirm or refute this point. In the meantime, however, let us not fall into the trap of publishing articles such as this that are biased and will have a limited role in improving health care for Canadians.

Reference

  1. Chaudhry R, Goel V, Sawka C. Breast cancer survival by teaching status of the initial treating hospital. CMAJ 2001;164(2):183-8.[Abstract/Free Full Text]




This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fingerote, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fingerote, R. J.
Related Collections
Right arrow Health services research
Right arrow Statistics & Research Methods
Right arrow Breast Cancer