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J Thorac Cardiovasc Surg 2001;122:1063-1076
© 2001 The American Association for Thoracic Surgery


Statistics for the Rest of Us (STATS)

Clinical-pathologic conference: Use and choice of statistical methods for the clinical study, "Superficial adenocarcinoma of the esophagus"

Eugene H. Blackstone, MDa,b, Thomas W. Rice, MDa

From the Department of Thoracic and Cardiovascular Surgerya and the Department of Biostatistics and Epidemiology,b The Cleveland Clinic Foundation, Cleveland, Ohio.

Received for publication April 6, 2001. Revisions requested May 23, 2001; revisions received Aug 24, 2001. Accepted for publication Aug 30, 2001. Address for reprints: Eugene H. Blackstone, MD, The Cleveland Clinic Foundation, 9500 Euclid Ave, Desk F25, Cleveland, OH 44195 (E-mail: blackse@ccf.org).


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Drs Rice and Blackstone

 
See related article on page 1077.

Recently, the Editor of the Journal telephoned us with a "crazy idea." He read a few phrases from the "Patients and Methods" section of our paper "Superficial Adenocarcinoma of the Esophagus" (which appears in this issueGo 1) and thought most readers would understand the first phrase, perhaps 50% the second, maybe 10% to 25% the third, and but a handful the fourth. His idea was to call a time-out to bring readers up to speed on statistical methodology. He suggested we extract key phrases from our paper and explain them in the format of a Clinical-Pathologic Conference (CPC).

His selection of "Superficial Adenocarcinoma of the Esophagus" is interesting, because the intensity of statistical analysis required to unlock the meaning of the data is high. Further, the article appears in the General Thoracic Surgery section, introducing into that arena data analysis concepts and methods more frequently found in the cardiac surgery sections.

Before proceeding, please read the paper.

Each section of the CPC is introduced by quotations from the paper and followed by dialogue between Drs Rice (TWR) and Blackstone (EHB). Throughout the dialogue, key technical ideas are highlighted for discussion in marginal notes. We recommend two sources of supplemental information: chapter 71 of Thoracic SurgeryGo 2 and chapter 6 of Cardiac Surgery.Go 3

Essence of the article

Surgery is the treatment of choice for superficial adenocarcinoma of the esophagus. The ideal patient has high-grade dysplasia found at surveillance, good pulmonary function, and undergoes a transhiatal esophagectomy. Discovery of N1 disease or development of postoperative pulmonary complications necessitating reintubation reduces the benefits of surgery. (Ultramini-Abstract)

EHB: Dr Rice, for readers unfamiliar with superficial adenocarcinoma of the esophagus, what instigated this study?

TWR: Adenocarcinoma arising in Barrett esophagus is occurring with increasing frequency, resulting in more patients . . . [Full Text of this Article]


Related Article

Superficial adenocarcinoma of the esophagus
Thomas W. Rice, Eugene H. Blackstone, John R. Goldblum, Malcolm M. DeCamp, Sudish C. Murthy, Gary W. Falk, Adrian H. Ormsby, Lisa A. Rybicki, Joel E. Richter, and David J. Adelstein
J. Thorac. Cardiovasc. Surg. 2001 122: 1077-1090. [Abstract] [Full Text] [PDF]



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