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National survey of UK consultant surgeons’ opinions on surgeon-specific mortality data in cardiothoracic surgery

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Title: National survey of UK consultant surgeons’ opinions on surgeon-specific mortality data in cardiothoracic surgery
Authors: Jarral, OA
Baig, K
Pettengell, C
Darzi, A
Athanasiou, T
Item Type: Journal Article
Abstract: © 2016 American Heart Association, Inc.Background - In the United Kingdom, cardiothoracic surgeons have led the outcome reporting revolution seen over the last 20 years. The objective of this survey was to assess cardiothoracic surgeons opinions on the topic, with the aim of guiding future debate and policy making for all subspecialties. Methods and Results - A questionnaire was developed using interviews with experts in the field. In January 2015, the survey was sent out to all consultant cardiothoracic surgeons in the United Kingdom (n=361). Logistic regression, bivariate correlation, and the χ 2 test were used to assess whether there was a relationship between answers and demographic variables. Free-text responses were analyzed using the grounded theory approach. The response rate was 73% (n=264). The majority of respondents (58.1% oppose, 34.1% favor, and 7.8% neither) oppose the public release of surgeon-specific mortality data and associate it with several adverse consequences. These include risk-averse behavior, gaming of data, and misinterpretation of data by the public. Despite this, the majority overwhelmingly supports publication of team-based measures of outcome. The free-text responses suggest that this is because most believe that quality of care is multifactorial and not represented by an individuals mortality rate. Conclusions - There is evident opposition to surgeon-specific mortality data among UK cardiothoracic surgeons who associate this with several unintended consequences. Policy makers should refine their strategy behind publication of surgeon-specific mortality data and possibly consider shift toward team-based results for which there will be the required support. Stakeholder feedback and inclusive strategy should be completed before introducing major initiatives to avoid unforeseen consequences and disagreements.
Issue Date: 12-Jul-2016
Date of Acceptance: 18-May-2016
URI: http://hdl.handle.net/10044/1/32783
DOI: https://dx.doi.org/10.1161/CIRCOUTCOMES.116.002749
ISSN: 1941-7705
Publisher: American Heart Association
Start Page: 414
End Page: 423
Journal / Book Title: Circulation-Cardiovascular Quality and Outcomes
Volume: 9
Copyright Statement: © 2016 American Heart Association, Inc.
Keywords: consultants
outcomes research
policy making
quality assessment
Cardiovascular System & Hematology
1102 Cardiovascular Medicine And Haematology
1117 Public Health And Health Services
Publication Status: Published
Appears in Collections:Department of Surgery and Cancer
Institute of Global Health Innovation