Auditing the vascular surgical audit

The results are presented of vascular surgical audits in Oxford over the 10 years 1975-85. Changes observed include the decreasing use of endarterectomy (other than carotid), the introduction of transluminal angioplasty, and fewer lumbar sympathectomies. The number of major amputations has increased relative to arterial reconstructions. Our audit methods over the 10 years included the use of punch cards, two different computer programs, and a simple weekly audit of cases. The relative merits of these methods are compared. Numbers of procedures performed in Oxford were compared with expected figures calculated from the Hospital In-patient Enquiry, the Lothian audit, and the Vascular Surgical Society survey. In general the calculated and actual numbers are similar. Difficulties in finding comparable operation categories and the totally inadequate classification of nationally collected data highlight the need for improved audit in vascular surgery.