If the causative factors could be identified, "then we could take the experience of high-volume centers and translate that to everybody else, so everybody could have good outcomes," he said.
According to Dr. Livingston, of the University of Texas, Dallas, previous studies relied on statistical modeling of the mortality relationship. "Those models are only as good as the model can represent the data," he said, and very few have been rigorously assessed to see how well they describe the phenomenon that they're trying to describe. This paper "should serve as the template for what everyone should do when they're performing volume outcome studies or any kind of regression analysis," he added.
The authors reported that they have no financial disclosures.