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Eur J Cardiothorac Surg 2004;26:1-2
© 2004 Elsevier Science NL

Editorial

Quality evaluation in congenital heart surgery

Department of Cardio-Thoracic Surgery, Denver Children's Hospital, University of Colorado, 1056 East 19th Avenue, Denver, CO 80262, USA

^* Tel.: +1-303-8616624; fax: +1-303-7648022
e-mail: lacour-gayet.francois@tchden.org

The first 20% of the full text of this article appears below.

Evaluation of quality of care is a duty of the modern medical practice. A reliable method of quality evaluation able to compare fairly institutions and inform a patient and his family of the potential risk of a procedure is clearly needed. Two articles published in this journal present their conclusions based on a similar method.

As stated by D. Boethig et al. in their discussion: "Risk adjustment is difficult and dangerous." Difficult, because congenital heart surgery (CHS) deals with approximately 200 diagnoses and 150 procedures; combining in outcome analyses hundreds of different factors. Dangerous, because the publication of potential unfair or biased outcome evaluations upon the medical community could severely harm the reputation of an institution, when decupled by our global media.

Despite its limitations, the RACHS-1 method deserves the credit of being one of the first attempts at producing risk-adjusted outcomes in congenital heart surgery. Several biases, partially outlined in the two articles, are indeed observed in . . . [Full Text of this Article]

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				W. G. Williams Surgical outcomes in congenital heart disease: expectations and realities Eur. J. Cardiothorac. Surg., June 1, 2005; 27(6): 937 - 944. [Abstract] [Full Text] [PDF]