BMJ  2005;330:44 (1 January), doi:10.1136/bmj.330.7481.44

Letter

Paediatric cardiac surgical mortality after Bristol

Authors' reply

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

EDITOR—Parry et al call for clarity of our methods for risk adjustment. We adjusted by type of operation, by incorporating the 11 open procedure groups as factors into our regression model. The use of procedure groups for risk adjustment is in line with another published method.¹ In contrast, recently published centre comparisons based on the central cardiac audit database were not risk adjusted.²

Gibbs et al and Morris and Archer on bmj.com remain concerned by the lack of accuracy of hospital episode statistics.³ Work commissioned by the Bristol inquiry showed reasonable agreement between these and the UK cardiac surgical register. Hospital episode statistics also recorded 99% of 30 day postoperative deaths in hospital for the procedures of interest.⁴ Morris and Archer confirm that the Oxford centre was approached by the Department of Health in 2001 on the basis of both hospital episode statistics data and cardiac surgical register . . . [Full text of this article]

p.aylin@imperial.ac.uk, Dr Foster Unit at Imperial College London, Department of Epidemiology and Public Health, St Mary's Campus, Imperial College, London W2 1PG

Dr Foster Unit at Imperial College London, Department of Epidemiology and Public Health, St Mary's Campus, Imperial College, London W2 1PG

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