Public confidence and cardiac surgical outcome

BMJ 1998;316:1759-1760 ( 13 June )

Editorials

Public confidence and cardiac surgical outcome

Cardiac surgery: the fall guy in medical quality assurance

The first 150 words of the full text of this article appear below.

The General Medical Council has recently been grappling with the problem of measuring and comparing surgical outcomes aftercomplex surgery in a heterogeneous patient population with differingseverities of illness.¹ Cardiothoracic surgery, with its immediate,and sometimes catastrophic outcomes, is the first surgical specialtyto come under such scrutiny. Inevitably the media coverage hasdented public confidence in the ability of the medical professionto police itself, and in particular this has been focused on cardiothoracicsurgery.¹ Yet, the irony is that in the United Kingdom cardiothoracicsurgery has better data and is more subject to internal scrutinythan perhaps any other specialty.

The Society of Cardiothoracic Surgeons has a long history of audit. In 1977 Sir Terence English established the United Kingdomcardiac surgical register,² which collects activity and mortality data on all cardiac surgical procedures performed in each NHScardiac surgical unit, amounting to 35 000 procedures a year.Although . . . [Full text of this article]

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