{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:53:30Z","timestamp":1791298410525,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale, Aims and Objectives<\/jats:title>\n                    <jats:p>Special treatment of very important persons (VIPs) is widely believed to cause deviation from standard care and worse outcomes, but has rarely been tested objectively, especially in surgery. We examined whether VIP status is associated with worse outcomes after robot\u2010assisted radical prostatectomy and the burden surgeons report when operating on such patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>In a single\u2010centre retrospective study, 75 patients flagged as VIP among 571 men undergoing robot\u2010assisted radical prostatectomy for non\u2010metastatic prostate cancer were matched 1:4 to 300 controls by a propensity score from eight covariates, with exact matching on surgeon (analytic cohort, 375). Perioperative outcomes, complications, and readmission were compared, and six surgeons completed an exploratory eight\u2010item burden survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, covariates were well balanced (all standardised mean differences below 0.10 except operative year, 0.130). Surgical and complication outcomes showed no difference (complications: risk difference +8.0 points, 95% confidence interval \u22122.0 to +18.0). The exception was inpatient antibiotic days, longer in VIPs by 0.87 days (95% confidence interval +0.17 to +1.57), though concentrated in one surgeon and non\u2010significant once that surgeon was excluded (interaction\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Surgeons reported higher cognitive strain and a greater defensive\u2010prescribing impulse, yet their reported intent and actual prescribing correlated only weakly and non\u2010significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VIP status was not associated with worse objective outcomes, but a few surgeons prolonged antibiotics defensively without clear benefit, while their reported burden stayed high, dissociating perception from outcome. Maintaining standard, protocol\u2010based care and antimicrobial stewardship for every patient is the safe and equitable response; the small sample limits precision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70655","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:32:57Z","timestamp":1791297177000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Very Important Person (VIP) Syndrome: Psychological Illusion or Real Surgical Risk? A Propensity Score\u2010Matched Cohort Study of Robot\u2010Assisted Radical Prostatectomy With a Surgeon Survey"],"prefix":"10.1111","volume":"32","author":[{"given":"Taeyoung","family":"Park","sequence":"first","affiliation":[{"name":"Department of Urology Gachon University Gil Medical Center Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyemi","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology Gachon University Gil Medical Center Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5079-5823","authenticated-orcid":false,"given":"Tae Beom","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Urology Gachon University Gil Medical Center Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0153-7814","authenticated-orcid":false,"given":"Kyung Jin","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Urology Gachon University Gil Medical Center Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Urology Gachon University Gil Medical Center Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3495-369X","authenticated-orcid":false,"given":"Kwang Taek","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Urology Gachon University Gil Medical Center Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7351-3995","authenticated-orcid":false,"given":"Il Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Urology Gachon University Gil Medical Center Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-196402000-00012"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.78a.10113"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.2701"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.104.4.989b"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198811243192119"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(96)90137-0"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.4088\/pcc.v04n0602"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2009.01497.x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.185.4157.1124"},{"key":"e_1_2_11_11_1","volume-title":"Thinking, Fast and Slow","author":"Kahneman D.","year":"2011"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.21.2609"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17193122"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.944561"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_11_18_1","first-page":"139","volume-title":"Human Mental Workload","author":"Hart S. G.","year":"1988"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1141-4"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-026-08936-y"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2026.1907872"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70655","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jep.70655","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70655","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:32:58Z","timestamp":1791297178000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.70655"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jep.70655"],"URL":"https:\/\/doi.org\/10.1111\/jep.70655","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70655"}}