Learning the hard way: the importance of accurate data

Area of Science:

• Colorectal cancer surgery outcomes
• Health services research
• Surgical audit

Background:

• The National Bowel Cancer Audit Project (NBOCAP) collects UK colorectal cancer surgery outcomes.
• A specific unit's 30-day postoperative mortality was near the national average but adjusted rates indicated an outlier status.

Purpose of the Study:

• To investigate the reasons behind a colorectal cancer surgery unit appearing as a statistical outlier in national audit data.
• To identify data discrepancies affecting adjusted mortality rates.

Main Methods:

• Comparison of actual patient data with data submitted to the NBOCAP for colorectal cancer surgeries over two years.
• Analysis of specific data points including American Society of Anesthesiology grades and surgical timing.

Main Results:

• Significant discordances were found between submitted and actual data for American Society of Anesthesiology grades.
• Discrepancies in the timing of surgery also contributed to the unit's outlier appearance.
• These data inaccuracies explained the unit's unexpected adjusted mortality rate.

Conclusions:

• Accurate data submission is vital for valid comparisons of healthcare service delivery between surgical units.
• Emphasis on health service outcomes necessitates reliable data for informed decision-making.
• Ensuring data integrity in national audits is essential for objective performance evaluation.