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Invited Critique
July 2011

The Golden State of Healthcare ReformComment on “Predictors of Surgical Intervention for Hepatocellular Carcinoma: Race, Socioeconomic Status, and Hospital Type”

Author Affiliations

Author Affiliation: Institute for Clinical Outcomes Research and Education (iCORE), St Vincent's University Hospital, Elm Park, Dublin, Ireland.

Arch Surg. 2011;146(7):784-785. doi:10.1001/archsurg.2011.39

The tragedy of population-based registry studies is they are defined by their limitations. The tools are cumbersome, the numbers are immense, and it is easy to get lost in leviathan logistics, misattributing significance and underinterpreting covariable confounders. By avoiding microdissection, Zak and colleagues have elegantly displayed the snapshot, landscape overview that underpins the strengths of database analysis. This unique perspective suggests socioeconomic and ethnic inequity in HCC treatment in California. Surprised?

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