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Challenges Noted in Identifying Poor Surgeon Performance

Challenges Noted in Identifying Poor Surgeon Performance

Low likelihood of identifying surgeon with poor performance for those who do few procedures

MONDAY, July 8 (HealthDay News) -- For some surgical specialties, the number of procedures that a surgeon performs each year is low, and consequently the chance of identifying poor performance is also low, according to research published online July 5 in The Lancet.

Noting that in June 2013 the National Health Service published outcome information for individual surgeons, Kate Walker, Ph.D., from the London School of Hygiene and Tropical Medicine, and colleagues examined whether individual surgeons perform enough procedures to be able to reliably identify poor performance.

The researchers note that, in some specialties, surgeons only perform a low number of procedures each year, and consequently the likelihood of identifying surgeons with increased mortality rates is low. The number of adult cardiac surgeries done is fairly high, but other procedures, including bowel cancer surgery and esophagectomy or gastrectomy procedures, are done less frequently and, as a result, poorly performing surgeons are unlikely to be correctly identified.

"We recommend use of outcomes that are fairly frequent, considering the hospital as the unit of reporting when numbers are low, and avoiding interpretation of no evidence of poor performance as evidence of acceptable performance," the authors write.

Abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61491-9/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61491-9/fulltext )