Their findings are in line with a 2009 study published in the Annals of Surgery that determined ACS NSQIP-participating hospitals each avoided 200-500 complications each year and in doing this, saved typically 12-36 lives per year. With the average cost of medical problems equaling $11,000 per occurrence, the combined potential cost savings of 4,500 hospitals could add up to $13-26 billion each year, amounting to an estimated total savings of $260 billion over a period of 10 years.[i] ‘We are at a critical time when it comes to advocating for the proper sort of quality improvement, especially as CMS techniques toward public reporting based on scientific data and outcome measures in the coming years and ties these steps to value-based purchasing applications,’ said David Hoyt, MD, FACS, executive director of ACS.However, for each one of these loci, the combined analysis provided solid support for a standard association . Thus, the replication studies showed consistent support for an association of generalized vitiligo with SNPs within or close to LPP, the HLA course I and HLA class II genes, GZMB, UBASH3A, and C1QTNF6 and less consistent, although significant, support for an association with SNPs within or near RERE, PTPN22, IL2RA, and TYR. Display of TYR peptide by HLA-A*0201 may mediate the increased loss of partial self-tolerance to tyrosinase also.35 We therefore tested epistasis between HLA-A SNP rs12206499 and TYR SNP rs1393350 with logistic regression analysis, using SNP genotypes from the genomewide association study and replication set 1, thereby detecting evidence of significant epistasis between HLA-A and TYR .