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J Thorac Cardiovasc Surg 2005;130:234-235
© 2005 The American Association for Thoracic Surgery

Letters to the Editor

Performance of surgery for congenital heart disease: Shall we wait a generation or look for different statistics?

^a Denver Children’s Hospital, University of Colorado, Denver, Colo
^b The Congenital Heart Institute of Florida, University of South Florida, Saint Petersburg, Fla
^c The Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa
^d St Christopher’s Hospital for Children, University College of Medicine, Philadelphia, Pa
^e Institute of Child Health, University College London, London, United Kingdom
^f Great Ormond Street Hospital, University College London, London, United Kingdom
^g The Children’s Memorial Health Institute, Warsaw, Poland
^h Hôpital Necker Enfants Malades, University of Paris, Paris, France
ⁱ Children’s Memorial Hospital, Northwestern University, Chicago, Ill

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

To the Editor:

We read with great interest the reviews on surgical performance in the December 2004 issue of the Journal. ^1-4 These publications made clear that any system that intends to measure surgical performance should include a reliable case-mix/risk-adjustment method. New sophisticated statistical algorithms using risk adjustments are flourishing, such as cumulative risk-adjusted mortality (CRAM), risk-adjusted sequential probability ratio test (SPRT), risk-adjusted cumulative sum (CUSUM), and Funnel plots. A statistical model to adjust for case mix is easier to develop in acquired cardiac surgery than in congenital heart surgery (CHS), which deals with 200 diagnoses and 150 procedures ⁵ with potentially several thousands variations ⁶ and a . . . [Full Text of this Article]

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				F. Lacour-Gayet Editorial comment: The goal is performance evaluation not outcome prediction Eur J Cardiothorac Surg, June 1, 2006; 29(6): 989 - 990. [Full Text] [PDF]