公开报告外科医生结果:手术数量少导致虚假自满
Kate Walker1, Jenny Neuburger, Oliver Groene
1Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Lancet (London, England)
|July 9, 2013
概括
关于外科医生的表现的公开报告可能会误导. 低的手术数量可能会造成虚假的自满,即使在没有的情况下也表明可接受的表现. 报告应侧重于频繁的结果,并考虑罕见程序的医院级数据.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 手术结果分析手术结果分析
- 患者安全 患者安全
背景情况:
- 英格兰国家卫生服务局 (NHS) 在2013年发布了10个外科专业的个人外科医生结果数据.
- 根据结果数据来评估外科医生的表现,需要足够多的程序来进行可靠的统计分析.
研究的目的:
- 评估个体外科医生每年是否进行足够的手术,以可靠地从公布的结果数据中识别不良表现.
- 确定手术数量较少对识别患有死亡率较高的外科医生准确性的影响.
主要方法:
- 对英格兰NHS十个专业的个人外科医生的手术量数据的分析.
- 统计评估手术量与可靠检测手术表现不佳的能力之间的关系.
主要成果:
- 对于几个外科专业,单个外科医生每年进行的手术数量很少.
- 低的手术量限制了可靠识别明显增加死亡率的外科医生的统计能力.
- 公开报告个人外科医生在低体积专业的结果可能会导致一种虚假的安全感或自满感.
结论:
- 公开报告个别外科医生的结果需要仔细考虑手术量.
- 建议包括专注于频繁的结果,使用医院级报告用于低体积的专业,并避免将没有表现不佳的证据解释为可接受表现的证据.
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