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NICOR, the Society for Cardiothoracic Surgery (SCTS), and the University of Manchester, has released the SCTS Governance Tool. This new online rescource enables cardiac surgery consultants to access information about their clinical activity and outcomes, which facilitates effective monitoring of data quality and clinical practice. The tool allows selection of time periods and operative groups to generate downloadable reports ‘on demand’, which show analysis based on up-to-date, and 'cleaned', National Adult Cardiac Surgery Audit (NACSA) data. More...
Published: Feb 7, 2014 3:28:12 PM
The 2012 annual report on devices from the Cardiac Rhythm Management National Audit has now been published. It is available to view and download from: More...
Published: Feb 5, 2014 1:48:26 PM
NICOR (The National Institute for Cardiovascular Outcomes Research) collects patient information from hospitals across the UK to try and improve the quality of care and outcomes for patients that have heart problems and treatments. These include adult heart surgery, heart attack, heart procedures, heart devices (for example pacemakers), heart failure and congenital heart surgery. More...
Published: Feb 4, 2014 2:11:08 PM
Report National Audit of Percutaneous Coronary Interventional (PCI) procedures 2012
published January 30th 2014.
Expansion in the use of Percutaneous Coronary Intervention (PCI) is seeing more patients with acute coronary syndromes treated more quickly, according to the latest National Audit of PCI (covering 2012). Key findings from the report include: More...
Published: Jan 30, 2014 8:09:31 AM
Acute myocardial infarction: a comparison of short-term survival in national outcome registries in Sweden and the UK
The Myocardial Ischaemia National Audit Project (MINAP), from which the data for the Lancet paper was obtained, continues to collect detailed information about the care provided to patients with heart attack. This demonstrates the commitment of participating clinicians, Trusts and governments to improvements in quality of care. While important improvements have been made since 2010, the end of the period studied by the researchers, there is no room for complacency. We need to continue emphasising both the provision of the best modern care, and the recording of that care. We also need to shift from publishing details of the process of care to the outcomes of care. It is our intention to produce a preliminary report of outcomes for each hospital this year. More...
Published: Jan 23, 2014 10:33:12 AM
Congenital Heart Disease
Congenital heart disease refers to any defect of the heart present from birth. It includes structural defects, congenital arrhythmias, and cardiomyopathies. At least eight in every 1,000 babies are born with a heart or circulatory condition and only a quarter of these are detected by ultrasound scans.
Interpretation, analysis and presentation of clinical outcomes from cardiac surgery is complex. To ensure that patients and the public are not given misleading analyses and to ensure that the performance of organisations and individuals are not misrepresented, the following factors need to be taken into account:
- Some surgeons and some hospitals operate on patients who are at greater risk of dying. For example, an experienced surgeon who operates on more difficult cases (such as small babies with very complex heart disease) would reasonably be expected to have a higher mortality rate than the national average.
- Without taking such factors into account, it is quite possible that a surgeon classed as having a higher mortality rate may well be 'better' than a surgeon classed as having a lower mortality rate. A league table based on data that is not risk adjusted is likely to mislead patients and the public and misrepresent the performance of individuals and institutions. Taking all relevant factors into account is very complex. There is not yet a proven method for doing this for congenital heart disease treatment. For this reason the results on CCAD's website are based upon individual centres and not individual surgeons' survival rates.
- Mortality rates depend on factors other than just the skill of the individual surgeon. For children or adults with congenital heart disease, outcomes depend on the skills of the whole team involved (including the post-operative care staff) and the hospital environment. This is not taken into account when associating named surgeons with mortality rates.
- There is a natural variation in mortality rates from year to year. It is to be expected that mortality rates of individual surgeons vary from year to year. Therefore a high (or low) mortality rate in one particular year is not necessarily an accurate guide to the performance of a particular surgeon.
- The statistical uncertainty in the mortality rate of a surgeon depends on how many operations they have performed. The more operations a surgeon performs, the more confident we can be that the mortality rate they are operating at is their 'true' mortality rate. Judging a surgeon on a small number of operations may lead to incorrect conclusions.
- All congenital heart disease centres in the UK are working together to ensure provision of accurate audit data to the CCAD to enable provision of analyses which properly inform patients and the public and fairly represent clinical performance. In addition to these measures, each congenital heart disease centre holds regular multidisciplinary meetings to discuss mortality and morbidity with the aim of continuously assessing ways to improve treatment.
More information about the Congenital Heart Disease audit, and its findings, can be found on the Congenital Heart Disease Website.
Page last modified on 31 jul 13 09:32