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Editorial

The surgeon, the statistics and the data

IRCCS Policlinico San Donato, Divisione di Cardiochirurgia II, San Donato Milanese, 20097 Milano, Italy

^_* Corresponding author. Tel.: +39 0252774514; fax: +39 0252775327. (Email: menicanti@libero.it).

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

Studies which evaluate the outcome of surgical activity are important to increase knowledge, to improve quality of care and of course to organize the planning and economics of health care systems.

Ranking health care providers can contribute to improving the quality of care delivered. Nevertheless, there is debate in the scientific community on whether such a ranking should be openly published or analyzed by peer review in a select professional environment. It has been clearly demonstrated that the publication of an outcome registry with ranking of medical care providers reduces the published mortality rates, but this may be achieved partly by undertreatment of sicker patients in an attempt to achieve a better ranking [1–3].

It goes without saying that when such a registry is published, the quality and reliability of the data collection must be near perfect. Without this, results are inconsistent, misleading and potentially dangerous. Actual mortality results can be stratified by risk and analyzed by comparison to expected mortality (mortality index) but, once again, such an index is only as precise as the database from which it is generated.

This issue of the European Journal of Cardio-thoracic Surgery features an article by D’Errico and co-workers about the correlation between the EuroSCORE model [4] and the results of the Italian CABG outcome study published last year in the same journal [5]. The new article is a different analysis of the same database. In the conclusion of this paper D’Errico and co-workers affirm that ‘the EuroSCORE model can be exported to . . . [Full Text of this Article]