BMJ  2008;336:900-901 (26 April), doi:10.1136/bmj.39545.504792.80 (published 21 April 2008)

Editorials

How to improve surgical outcomes

Data should be monitored and acted on at local and national levels

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

Surgical outcomes are increasingly being scrutinised through national audit and publication of unadjusted league tables.¹ Two accompanying studies report different ways of measuring surgical outcomes and performance—one in groin hernia repair and the other in percutaneous coronary intervention.^{2 3} Public scrutiny of surgical outcomes should be encouraged, but the data and statistical analysis should be robust, meaningful, and accurate. Unadjusted league tables are often misleading because they take insufficient account of the patients’ risk factors. Commercial organisations can also produce in-depth analyses of NHS data, but many clinicians argue that the accuracy of the raw data is questionable and that such analyses are expensive and of unknown utility.

Encouraging clinicians to take responsibility for data analysis at local and national levels could improve our understanding of surgical results and help develop ways to improve outcomes. The outcomes studied should be important and easy to measure—for example, postoperative death or disease specific . . . [Full text of this article]

¹ St George’s Vascular Institute, London SW17 0QT, ² Community Health Sciences, St George’s, University of London, London SW17 0RE

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Cumulative funnel plots for the early detection of interoperator variation: retrospective database analysis of observed versus predicted results of percutaneous coronary intervention

Babu Kunadian, Joel Dunning, Anthony P Roberts, Robert Morley, Darragh Twomey, James A Hall, Andrew G C Sutton, Robert A Wright, Douglas F Muir, and Mark A de Belder
BMJ 2008 336: 931-934. [Abstract] [Full Text] [PDF]

Volume of procedures and risk of recurrence after repair of groin hernia: national register study

Pär Nordin and Willem van der Linden
BMJ 2008 336: 934-937. [Abstract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

Scepticsm regarding claims for low mortality/morbidity for self reported audits

Mohan Adiseshiah
bmj.com, 7 May 2008 [Full text]