Trends in Funding and Acquisition of Surgical Practices by Private Equity Firms in the US From 2000 to 2020

OR, 0.38; 95% CI, 0.35-0.41; P < .001). Similarly, surgery performed by a surgeon who used high-dose mannitol prepublication was also associated with a smaller decrease in the odds of mannitol administration (OR, 0.43; 95% CI, 0.39-0.47;P < .001)vs surgeons who used low-dose mannitol (OR, 0.29; 95% CI, 0.26-0.33;P < .001).No temporal changes were observed in the overall use of minimally invasive surgery, rate of partial vs radical nephrectomy, and use of intraoperative ultrasonography.Discussion | Following RCT publication, there was a rapid decrease in mannitol use for partial nephrectomy.This suggests an eagerness (particularly among academic, highvolume surgeons) to practice evidence-based medicine.Surgeons whose practice did not align with study protocols were less likely to change, perhaps reflecting the generalizability of the trial's design.Whether the publication was associated with use of mannitol in kidney transplant or cardiac surgery, where therapeutic benefits may differ, is an area of interest.As a limitation, distinction cannot be made between surgeons who were not aware of the RCT vs those who disagreed with its conclusions.Given absence of detailed information on kidney function, assessment of the trial's association with individual patient outcomes is limited.That considered, surgical RCTs are rare, and few studies have estimated their association with nationwide practice.Here we show the broad, rapid real-world surgical practice response to a prominent surgical RCT.