Surgical Outcomes Analysis and Research
|Founded||Worcester, MA 2006|
|Founder(s)||Jennifer F. Tseng, MD, MPH|
|Key people||Jennifer F. Tseng, MD, MPH
Mary Beth Curnen
(Computer Science Assistant)
Surgical Outcomes Analysis & Research, SOAR, is a research laboratory of the Department of Surgery at the University of Massachusetts Medical School with expertise in outcomes research. SOAR investigates surgical diseases and perioperative outcomes. The group focuses on pancreatic cancer as well as other gastrointestinal and hepatobiliary malignancies. SOAR's goal is to examine quality, delivery, and financing of care in order to have an immediate impact on patient care and system improvements. The group members utilize national health services and administrative databases, as well as prospective institutional tissue-linked databases, to investigate and to address factors contributing to disease outcomes and healthcare disparities.
The work in SOAR incorporates advanced statistical techniques, including logistic regression, prediction score, and decision analysis modeling. Additionally, SOAR participates in groundbreaking pancreatic cancer biomarker discovery. With rigorous proteomic assessment of blood, bile, and pancreatic fluid, they aspire to utilize biomarkers that will enable early diagnosis of pancreatic cancer and reliably predict patient response to treatment.
About Outcomes Research 
Outcomes Research evaluates the impact of health care on the health outcomes of patients and populations AHRQ. This research may also include the evaluation of economic impacts linked to health outcomes, such as cost effectiveness and cost utility. An emphasis is placed on disease-oriented evaluations of care delivered in general, real-world settings. There are a wide range of outcomes to study including mortality, morbidity, functional status, mental well-being, and other aspects of health-related quality of life. Outcomes research is a multidisciplinary field of inquiry that examines the use, quality, delivery, and financing of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations. Outcomes research provides the data to help solve critical problems that are faced in everyday clinical practice. The information learned can have an immediate impact on patient care and system improvement.
About SOAR 
The mission of SOAR is to decrease perioperative morbidity and mortality, address health care disparities, and increase overall patient survival and quality of life. SOAR members hope, as part of the surgical outcomes research community, to improve overall outcomes for patients with surgical diseases.
SOAR director, Dr. Jennifer F. Tseng, has been supported by the Pancreatic Cancer Alliance through the UMass Cancer Center and the Department of Cancer Biology, and has a mandate to focus substantial effort on improving survival and quality of life for pancreatic cancer patients. She has spearheaded an integrated UMass Pancreas Program, a unique endeavor to Central Massachusetts.
SOAR coinvestigators at UMass include: Dr. Fred Anderson, Director of the Center for Outcomes Research; Dr. Giles Whalen, Vice-Chair of Surgery and Chief of Surgical Oncology and Endocrine Surgery; Dr. Shimul Shah, Transplant Surgery, Dr. Karim Alavi, Colorectal Surgery, and Dr. Heena Santry, MD, Trauma Surgery. The group also collaborates with investigators from other institutions.
Research Goals 
- Pancreatic cancer and pancreatic disease
- Other gastrointestinal and hepatobiliary malignancies
- Investigating factors that affect surgical outcomes for diverse specialties including transplant, colorectal, cardiovascular and minimally invasive surgery
About UMass Medical School 
UMass Medical School, located in Worcester, is one of five University of Massachusetts campuses, and one of about 28 free-standing, university-based academic health science centers in the U.S. Ranked fourth in the nation in primary care education in the 2006 U.S. News & World Report's “America's Best Graduate Schools,” UMMS comprises three schools - the School of Medicine, Graduate School of Biomedical Sciences and the Graduate School of Nursing.
See also: UMass Medical School Website
- Jennifer F. Tseng, MD, MPH - SOAR Director
- Giles Whalen, MD - Surgical Oncology
- Ted McDade, MD - Post-doctoral Research Scientist
- Shimul Shah, MD - Transplant Surgery
- Karim Alavi, MD - Colorectal Surgery
- Heena Santry, MD - "Trauma Surgery"
- Jillian Smith, MD, MPH - Surgical Resident
- Sing Chau Ng, MS - Data Analyst
- (Frank) Zheng Zhou, MD, PhD - Consultant
- Mary Sullivan, NP - Clinical Trials and Database Management
- Mary Beth Curnen - Research Coordinator
- Andreea Bodnari - Computer Science Assistant
- James McPhee, MD - 2005- 2007 Research Fellow
- Joshua Hill, MD - 2006- 2007 Research Fellow
- Melissa Murphy, MD, MPH - 2007- 2009 Evans Pancreatic Cancer Research Fellow
- Jessica Simons, MD - 2007- 2009 Karen Sweeney Polkinghorn Pancreatic Cancer Research Fellow
- James Carroll, MD - 2008- 2010 Linda J. Verville Research Fellow
- Jillian Smith, MD, MPH - 2009- 2011 William D. Maney Research Fellow
- Andrew Burr, DO - 2009- 2011 Research Fellow
- Elizaveta Ragulin Coyne, MD - 2010-2012 Linda J Verville Research Fellow
- Elan Witkowski, MD - 2010-2012 Research Fellow
SOAR Team Members 
- Ed Arous, UMass Medical School Student
- Erin Cooley, UMass Surgical Resident
- Charles Psoinos, UMass Medical Student
- Maia Sharuk, UMass Medical Student
- Josh Shaw, UMass Medical School Student
- Jason Wiseman, UMass Medical School Student
- Stephen Skinner, UMass Medical School Student
Ongoing Research 
SOAR researchers use national health services and administrative databases as well as prospective institutional tissue-linked databases to investigate factors contributing to disease outcomes for pancreatic cancer, hepato biliary disease, vascular disease, colorectal disease and brain tumors. These projects are under development with the use of the following databases:
- SEER Medicare
- UMass/Memorial Cancer Databases:
Publications 2010 
- Singla A, Simons JP, Carroll JE, Li YF, Ng SC, Tseng JF, Shah SA. Hospital Volume as a Surrogate for Laparoscopic-Assisted Colectomy. Surg Endosc. 2010 Mar;24(3):662-9.
- Hill JS, Zhou Z, Simons JP, Ng SC, McDade TP, Whalen GF, Tseng JF. A Simple Risk Score to Predict In-Hospital Mortality after Pancreatic Resection for Cancer. Ann Surg Oncol 2010 Jul; 17:1802–1807.
- Simons JP, Ng SC, Hill JS, Shah SA, Zhou Z, Tseng JF. In-hospital mortality from liver resection for hepatocellular carcinoma: a simple risk score. Cancer 2010 Apr 1;116(7):1733-1738.
- Simons JP, Ng SC, McDade TP, Zhou Z, Shah SA, Earle CC, Tseng JF. Progress for resectable cancer? A population-based assessment of US practices. Cancer 2010 Apr 1; 116(7):1681-1690.
- Murphy MM, Tseng JF, Shah SA. Disparities in Cancer Care: An Operative Perspective. Surgery 2010 May;147(5):733-7.
- Carroll JE, Hurwitz ZM, Simons JP, McPhee JT, Ng SC, Shah SA, Al-Refaie WB, Tseng JF. In-hospital mortality after resection of biliary tract cancer in the United States. HPB (Oxford) 2010 Feb; 12(1): 62-67.
- Carroll JE, Smith JK, Simons JP, Murphy MM, Ng SC, Shah SA, Zhou Z, Tseng JF. Redefining mortality after pancreatic cancer resection. J Gastrointest Surg. 2010 Nov;14(11):1701-8.
- McDade TP, Hill JS, Simons JP, Piperdi B, Ng SC, Zhou Z, Kadish SP, Fitzgerald TJ, Tseng JF. A National Propensity-Adjusted Analysis of adjuvant radiotherapy in the treatment of resected pancreatic adenocarcinoma. Cancer. 2010 Jul1;116(13):3257-66.
- Piperdi M, McDade TP, Shim JK, Piperdi B, Kadish SP, Sullivan ME, Whalen GF, Tseng JF. A neoadjuvant strategy for pancreatic adenocarcinoma increases the likelihood of receiving all components of care: Lessons from a single institution database. HPB (Oxford). 2010 Apr;12(3)204-210.
- Zhou Z, McDade TP, Simons JP, Ng SC, Lambert LA, Whalen GF, Shah SA, Tseng JF. Surgery and radio therapy for retroperitoneal and abdominal sarcoma: both necessary and sufficient? Arch Surg 2010;145(5):426-431.
- Wiseman JT, Sharuk MN, Singla A, Cahan M, Litwin DEM, Tseng JF, Shah SA. Surgical Management of Acute Cholecystitis at a Tertiary Care Center in the Modern Era. Arch Surg. 2010 May;145(5):439-44.
- Murphy MM, Ng SC, Simons JP, Csikesz NG, Shah SA, Tseng JF. Predictors of Major Complications after Laparoscopic Cholecystectomy:Surgeon, Hospital, or Patient? J Am Coll Surg 2010 Jul;211(1): 73-80.
- Smith JK, Ng SC, Hill JS, Simons JP, Arous EJ, Shah SA, Tseng JF, McDade TP. Complications after pancreatectomy for neuroendocrine tumors: A national study. J Surg Res 2010 Sep;163(1):63-8.
- Burr AT, Shah SA. Disparities in Organ Allocation and Access to Liver Transplantation in the United States. In press, Expert Reviews of Gastroenterology and Hepatology, 2010 Apr;4(2):133-40.
- Murphy MM, Witkowski ER, Ng SC, McDade TP, Hill JS, Larkin AC, Whalen GF, Litwin DE, Tseng JF. Trends in adrenalectomy: a recent national review. Surg Endosc (2010) 24:2518-2526.
- Al-Refaie WB, Gay G, Virnig BA, Tseng JF, Stewart A, Vickers SM, Tuttle TM, Feig BW. Variations in gastric cancer care: a trend beyond racial disparities. Cancer 2010 Jan;116(2) 465-75.
- Nath B, Li YF, Carroll JE, Szabo G, Tseng JF, Shah SA. Alcohol exposure as a risk factor for adverse outcomes in elective surgery. J Gastrointest Surg. 210 Nov;14(11)1732-41.
- Smith JK, Hill JS, Ng SC, McDade TP, Shah SA, Tseng JF. Potential benefit of resection for stage IV gastric cancer: A national survey. J Gastrointest Surg. 2010 Nov;14(11):1660-8.
- Colombo B, Singla A, Li Y, Tseng JF, Saidi RF, Bozorgzadeh A, Shah SA. Current trends and short-term outcomes of live donor nephrectomy: a population-based analysis of the nationwide inpatient sample. World J Surg. 2010 Dec;34(12):2985-90.
- Csikesz NG, Singla A, Murphy MM, Tseng JF, Shah SA. Surgeon volume metrics in laparoscopic cholesystectomy. Dig Dis Sci. 2010 Aug;55(8):2398-405.
- Burr AT, Csikesz NG, Gonzales E, Tseng JF, Saidi RF, Bozorgzadeh A, Shah SA. Comparison of Right Lobe Donor Hepatectomy with Elective Right Hepatectomy for Other Casuses in New york. Dig Dis Sci. 2010 Nov 27 [Epub ahead of print].
- Singla A, Hart JL, Li Y, Tseng JF, Shah SA. Hospitalization for Complications of Cirrhosis: Does Volume Matter? J Gastrointest Surg. 2010 Nov 25 [Epub ahead of print].
- Shah SA, Smith JK, Li Y, Ng SC, Carroll JE, Tseng JF. Underutilization of therapy for hepatocellular carcinoma in the medicare population. Cancer. 2010 Oct 13. [Epub ahead of print].
- Manasanch EE, Smith JK, Bodnari A, McKinney J, Gray C, McDade TP, Tseng JF. Tumor registry versus physician medical record review: A head-tohead comparison of pancreatic neuroendocrine tumor cases. In press, Journal of Oncology Practice.
Publications 2009 
- Hill JS, McPhee JT, McDade TP, Zhou Z, Sullivan ME, Whalen GF, Tseng JF. Pancreatic Neuroendocrine tumors: the impact of surgical resection on survival. Cancer. 2009;115(4):741-751.
- McPhee JT, Eslami MH, Arous EJ, Messina LM, Schanzer A. Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms in the United States (2001-2006): A Significant Survival Benefit Over Open Repair is Independently Associated with Increased Institutional Volume. Journal of Vascular Surgery 2009 Apr; 49(4): 817-26.
- Csikesz NG, Nguyen LN, Tseng JF, Shah SA. Nationwide Volume and Mortality After Elective Surgery in Cirrhotic Patients. J Amer Coll Surg 2009 Jan; 208(1):96-103.
- Eppsteiner RW, Csikesz NG, McPhee JT, Tseng JF, Shah SA. Surgeon Volume Impacts Hospital Mortality for Pancreatic Resection. Ann Surg 2009 Apr; 249(4):635-40.
- Cooley EK, McPhee JT, Simons JP, Sweeney WB, Tseng JF, Alavi K. Colorectal neoplasia screening before age 50? Current epidemiologic trends in the United States. Dis Colon Rectum 2009 Feb; 52(2):222-9.
- Murphy MM, Simons JP, Hill JS, McDade TP, Ng SC, Whalen GF, Shah SA, Harrison LH, Tseng JF. Pancreatic Resection: A Key Component to Reducing Racial Disparities in Pancreatic Adenocarcinoma. Cancer 2009 Sept; 115(17):3979-90.
- Murphy MM, Knaus WJ, Ng SC, Hill JS, McPhee JT, Shah SA, Tseng JT. Total Pancreatectomy: A National Study. HPB (Oxford) 2009 Sep;11(6)476-482.
- Murphy MM, Simons JP, Ng SC, McDade TP, Smith JK, Shah SA, Zhou Z, Earle CC, Tseng JF. Racial Differences in Cancer Specialist Consultation, Treatment, and Outcomes for Locoregional Pancreatic Adenocarcinoma. Ann Surg Oncol 2009 Nov; 16(11):2968-77.
- Murphy MM, Shah SA, Simons JP, Csikesz NG, McDade TP, Bodnari A, Ng SC, Zhou Z, Tseng JF. Predicting Major Complications after Laparoscopic Cholecystectomy: A Simple Risk Score. Journal of Gastrointestional Surgery; 2009 Nov:13(11):1929-1936.
- Simons JP, Shah SA, Ng SC, Whalen GF, Tseng JF. National Complication Rates after Pancreatectomy: Beyond Mere Mortality. J Gastrointest Surg 2009 Oct;13(10):1798-805.
- Simons JP, Ng SC, Hill JS, Shah SA, Bodnari A, Zhou Z, Tseng JF. In-hospital mortality for liver resection for metastatic disease: a simple risk score. J Surg Res 2009 Sept; 156(1):21-25.
- Simons JP, Ng SC, Shah SA, McDade TP, Whalen GF, Tseng JF. Malignant Intraductal Papillary Mucinous Neoplasm: Are We Doing the Right Thing? Journal of Surgical Research 2009 June 21 (epub ahead of print).
- Simons JP, Hill JS, Ng SC, Shah SA, Zhou Z, Whalen GF, Tseng JF. Perioperative Mortality for Management of Hepatic Neoplasm: A Simple Risk Score. Ann Surg 2009 Dec; 250(6) 929-934.
- Singla A, Li Y, Ng SC, Csikesz NG, Tseng JF, Shah SA. Is the growth in laparoscipic surgery reproducible with more complex procedures? Surgery 2009;146(2):367-74.
- Singla A, Csikesz NG, Simons JP, Li YF, Ng SC, Tseng JF, Shah SA. National Hospital Volume in Acute Pancreatitis: Analysis of the Nationwide Inpatient Sample 1998-2006. HPB (Oxford) 2009 Aug;11(5):391-7.
- Singla A, Simons JP, Li Y, Csikesz NG, Ng SC, Tseng JF, Shah SA. Admission volume determines outcome for patients with acute pancreatitis: a case-controlled analysis. Gastroenterology 2009 Dec; 137(6):1995-2001.
- Hill JS, McPhee JT, Whalen GF, Sullivan ME, Warshaw AL, Tseng JF. In-Hospital Mortality after Pancreatic Resection for Chronic Pancreatitis: Population Based Estimates from the Nationwide Inpatient Sample. J Am Coll Surg 2009 Oct; 209(4)468-76.
- Csikesz NG, Singla A, Simons JP, Tseng JF, Shah SA. The impact of socioeconomic status on presentation and treatment of diverticular disease. J Gastrointest Surg 2009 Nov; 13(11): 1993-2001.
Publications 2008 
- Hill JS, McPhee JT, Messina LM, Ciocca RG, Eslami MH (July 2008). "Regionalization of abdominal aortic aneurysm repair: evidence of a shift to high-volume centers in the endovascular era". J. Vasc. Surg. 48 (1): 29–36. doi:10.1016/j.jvs.2008.02.048. PMID 18589227.
- Tseng JF (March 2008). "Management of serous cystadenoma of the pancreas". J. Gastrointest. Surg. 12 (3): 408–10. doi:10.1007/s11605-007-0360-310.1007/s11605-007-0360-3. PMID 17963014.
- Tseng JF, Fernández-del Castillo C, Warshaw AL. Survival after medical and surgical treatment of pancreatic adenocarcinoma. In: Beger HG, Matsuno S, Cameron JL, eds. Diseases of the Pancreas: Current Surgical Therapy. Heidelberg: Springer Inc, 2008;61:695-704
- Al-Refaie WB, Tseng JF, Gay G, et al. (August 2008). "The impact of ethnicity on the presentation and prognosis of patients with gastric adenocarcinoma. Results from the National Cancer Data Base". Cancer 113 (3): 461–9. doi:10.1002/cncr.2357210.1002/cncr.23572. PMID 18553367.
- Csikesz NG, Tseng JF, Shah SA (August 2008). "Trends in surgical management for acute cholecystitis". Surgery 144 (2): 283–9. doi:10.1016/j.surg.2008.03.033. PMID 18656637.
- Csikesz NG, Simons JP, Tseng JF, Shah SA (September 2008). "Surgical specialization and operative mortality in hepato-pancreatico-biliary (HPB) surgery". J. Gastrointest. Surg. 12 (9): 1534–9. doi:10.1007/s11605-008-0566-z10.1007/s11605-008-0566-z. PMID 18612710.
- McPhee JT, Schanzer A, Messina LM, Eslami MH (December 2008). "Carotid artery stenting has increased rates of postprocedure stroke, death, and resource utilization than does carotid endarterectomy in the United States, 2005". J. Vasc. Surg. 48 (6): 1442–50, 1450.e1. doi:10.1016/j.jvs.2008.07.017. PMID 18829236.
- Eppsteiner RW, Csikesz NG, Simons JP, Tseng JF, Shah SA (October 2008). "High volume and outcome after liver resection: surgeon or center?". J. Gastrointest. Surg. 12 (10): 1709–16; discussion 1716. doi:10.1007/s11605-008-0627-310.1007/s11605-008-0627-3. PMID 18704600.
- Csikesz N, Ricciardi R, Tseng JF, Shah SA (October 2008). "Current status of surgical management of acute cholecystitis in the United States". World J Surg 32 (10): 2230–6. doi:10.1007/s00268-008-9679-510.1007/s00268-008-9679-5. PMID 18668287.
- Murphy MM, Simons JP, Hill JS, et al. (September 2009). "Pancreatic resection: a key component to reducing racial disparities in pancreatic adenocarcinoma". Cancer 115 (17): 3979–90. doi:10.1002/cncr.2443310.1002/cncr.24433. PMID 19514091.
Publications 2007 
- Tseng JF, Pisters PW, Lee JE, et al. (April 2007). "The learning curve in pancreatic surgery". Surgery 141 (4): 456–63. doi:10.1016/j.surg.2006.09.013. PMID 17383522.
- Tseng JF, Fernández-del Castillo C, Warshaw AL. The cystic tumors of the pancreas. In: Blumgart LH, ed. Surgery of the Liver, Biliary Tract and Pancreas. Philadelphia: Elsevier Inc, 2007
- Hill JS, Shankar S, Evans DB, Tseng JF. Control of bleeding from the portal/superior mesenteric vein. In: Nauta RD, ed. Operative Techniques in General Surgery, 2007 Dec;(9)4:152-159
- McPhee JT, Hill JS, Ciocca RG, Messina LM, Eslami MH (December 2007). "Carotid endarterectomy was performed with lower stroke and death rates than carotid artery stenting in the United States in 2003 and 2004". J. Vasc. Surg. 46 (6): 1112–1118. doi:10.1016/j.jvs.2007.08.030. PMID 18154987.
- McPhee JT, Hill JS, Eslami MH (May 2007). "The impact of gender on presentation, therapy, and mortality of abdominal aortic aneurysm in the United States, 2001–2004". J. Vasc. Surg. 45 (5): 891–9. doi:10.1016/j.jvs.2007.01.043. PMID 17391899.
- McPhee JT, Asham EH, Rohrer MJ, et al. (April 2007). "The midterm results of stent graft treatment of thoracic aortic injuries". J. Surg. Res. 138 (2): 181–8. doi:10.1016/j.jss.2006.09.039. PMID 17292414.
- McPhee JT, Hill JS, Whalen GF, et al. (August 2007). "Perioperative mortality for pancreatectomy: a national perspective". Ann. Surg. 246 (2): 246–53. doi:10.1097/01.sla.0000259993.17350.3a. PMC 1933570. PMID 17667503.
- Smith JK, McPhee JT, Hill JS, et al. (April 2007). "National outcomes after gastric resection for neoplasm". Arch Surg 142 (4): 387–93. PMID 17441293.
For more detailed information refer to SOAR- publications.