title: Does practice make perfect?
abstract: Extensive literature supports the correlation between surgical volume and improved clinical outcome in the management of various cancers. It is this evidence that has catalysed the creation of centres of excellence. However, on closer inspection, many of these studies are poor quality, low weight and use vastly heterogenous end points in assessment of both volume and outcome. We critically appraise the English language literature published over the last ten years pertaining to the volume outcome relationship in the context of cancer care. Future balanced unbiased studies may enable equipoise in planning international cancer management strategies.
authors.affiliation: Institute of Clinical Outcomes in Research and Education (ICORE), St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: A M
authors.initials: AM
authors.lastname: Hogan
authors.forename: D C
authors.initials: DC
authors.lastname: Winter
mesh_terms: D002173:Cancer Care Facilities / Q000592:standards* / Q000706:statistics & numerical data*; D002986:Clinical Trials as Topic; D006801:Humans; D009369:Neoplasms / Q000401:mortality / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D019984:Quality Indicators, Health Care; D015996:Survival Rate