The importance of data in improving practice: effective clinical use of outcomes data

We are in a transition stage from the widespread use of clinical judgment to the use of risk-adjusted outcomes data for clinical decision-making and quality assessment and improvement. The ultimate long-term goal for the use of predicted outcomes is to be able to inform patients at the earliest state of their symptoms as to the anticipated course of their disease and the results of alternative therapies. For outcomes analyses to be routinely used in clinical practice, they must be formulated succinctly. Because a small number of adverse outcomes may make a big difference in outcome statistics over a short period such as a year, it is important that purchasers of health services take a longer-term view. The demand for public disclosure of every aspect of medical therapy is on the increase, and it is likely that each physician, hospital, specialty group, and so on, is likely to receive some type of report card in the near future. However, I believe it will be very difficult to educate the public, given the enthusiasm we currently see in the press for producing headlines that are not always supported by the facts in the article. Although the importance of outcomes data is unquestioned, it is important to remember that our methods for utilizing the data are still somewhat infantile. Therefore, it is important for us as a profession to question the accuracy and the interpretations of outcomes data.