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A Health Technology Assessment in Maxillofacial Cancer Surgery by Using the Six Sigma Methodology.

Carlo Ricciardi1,2, Giovanni Dell'Aversana Orabona3, Ilaria Picone4

  • 1Department of Electrical Engineering and Information Technology, University of Naples "Federico II", 80125 Naples, Italy.

International Journal of Environmental Research and Public Health
|September 28, 2021
PubMed
Summary

This study compared two antibiotic protocols for oral cancer surgery patients, finding no significant difference in hospital stay length. Health technology assessment using Six Sigma and DMAIC can inform future research on surgical outcomes.

Keywords:
drugshealth technology assessmenthealthcaremaxillofacial surgerysix sigma

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Area of Science:

  • Oncology
  • Surgical Infections
  • Health Technology Assessment

Background:

  • Squamous cell carcinoma is the most common oral cancer.
  • Antibiotic prophylaxis is crucial in oral mucosa cancer surgery.
  • Two distinct antibiotic protocols were used at the University of Naples "Federico II" between 2006 and 2018.

Purpose of the Study:

  • To perform a health technology assessment (HTA) comparing two antibiotic protocols used in oral mucosa cancer surgery.
  • To evaluate the impact of antibiotic protocols on length of hospital stay (LOS) using Six Sigma and DMAIC methodologies.
  • To identify factors influencing LOS in patients undergoing oral cancer surgery.

Main Methods:

  • A retrospective analysis of 136 patients undergoing oral mucosa cancer surgery from 2006 to 2018.
  • Application of the Six Sigma Define, Measure, Analyse, Improve, Control (DMAIC) cycle for HTA.
  • Statistical analysis of 13 variables, including American Society of Anaesthesiologist score, lymphadenectomy, tracheotomy, and infection presence, to determine their influence on LOS.

Main Results:

  • The shift in protocol from 2011 to Cefazolin plus Clindamycin did not result in a statistically significant overall difference in LOS.
  • Factors such as American Society of Anaesthesiologist score, lymphadenectomy, tracheotomy, and infection significantly influenced LOS (p < 0.05) in both groups.
  • While overall LOS was not significantly different, analysis by individual variables provided valuable insights into protocol performance.

Conclusions:

  • The study suggests that the choice between the two evaluated antibiotic protocols did not significantly alter the length of hospital stay for oral cancer surgery patients.
  • The DMAIC cycle and Six Sigma tools are effective for conducting health technology assessments in surgical settings.
  • Future research should consider utilizing these HTA methodologies to further compare surgical outcomes and optimize patient care.