Publicly available performance tables do not make surgeons avoid high risk cases

A new study shows that the introduction of publicly available performance tables in the United Kingdom showing mortality after major cardiac surgery by individual surgeons did not result in fewer procedures being performed on high risk patients, as critics had predicted. The study also shows an association between the introduction of the tables and a decrease in mortality.

The study, published online in Heart (http://heart.bmj.com/cgi/content/abstract/hrt.2006.106393v1), analysed data that were collected prospectively from all NHS centres in northwest England that undertake cardiac surgery. The data covered 25 730 patients undergoing coronary artery bypass grafting for the first time between April 1997 and March 2005. Figures were for 30 different surgeons in four major NHS sites.

The researchers compared surgery carried out before and after individual cardiac surgeons' outcomes became public in 2001, to determine whether some surgeons had become more averse to risk, operating only on patients with a lower …