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J Thorac Cardiovasc Surg 2001;121:409-417
© 2001 The American Association for Thoracic Surgery

Presidential Address

Statewide reporting of coronary artery surgery results: A view from California

From Sutter Memorial Hospital, Sacramento, Calif.

Received for publication July 12, 2000. Accepted for publication July 12, 2000. Address for reprints: Bradley J. Harlan, MD, 5301 F St, Sacramento, CA 95819 (E-mail: Bradharlan@aol.com).

	Introduction

 
I have been interested in data collection and analysis for many years. While at the Oregon Health Sciences University in the 1970s I was stimulated in this area. In Sacramento, in the early 1980s, our group began a thorough system of data collection and analysis, hiring a full-time data manager in 1983 and beginning the transition to the Society of Thoracic Surgeons (STS) database in 1991. In the early years we had a crude system of risk prediction. Each surgeon would assign a risk to each of his patients preoperatively at the morning meeting. We then analyzed the observed and predicted results as a method of quality assessment, and we published an article in 1987. ¹

The Western Thoracic Surgical Association has had a long and proud record of supporting outcomes research and reporting. This has been part of several presidential addresses in the past. Members of this Association have served and are serving in important capacities in the STS database project.

When I began planning this address 2 years ago, the plan was for the California Coronary Artery Bypass Graft Mortality Reporting Program (CCMRP) to release results publicly in 1999. For many reasons the release has been repeatedly postponed and has not yet occurred. The impact of the release and the reaction to the release was what I thought would bring maximum timeliness to my address, but that was not to be.

The imminent release of statewide data for California, the experience with projects in New York, Pennsylvania, New Jersey, Northern New England, and Minnesota, and the proliferation of other statewide projects have stimulated me to review the history of these projects, assess where they are now, and look to the future, with both predictions and recommendations.

I have tried to gain access to the information in the statewide reports . . . [Full Text of this Article]

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