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辩论：我们是否应该使用可变调整生命显示器（VLAD）来识别普通外科手术中的表现差异？

Debate: should we use variable adjusted life displays (VLAD) to identify variations in performance in general surgery?

作者信息

O Neill Stephen, Wigmore Stephen J, Harrison Ewen M

机构信息

Department of Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK.

出版信息

BMC Surg. 2015 Aug 28;15:102. doi: 10.1186/s12893-015-0087-0.

DOI:10.1186/s12893-015-0087-0
PMID:26314294
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4551379/
Abstract

BACKGROUND

The recent push for the publication of individual surgeon outcomes underpins public interest in safer surgery. Conventional, retrospective assessment of surgical performance without continuous monitoring may lead to delays in identifying poor performance or recognition of practices that lead to be better than expected performance.

DISCUSSION

The variable life adjusted display (VLAD) is not new, yet is not widely utilised in General Surgery. Its construction is simple and if caveats are appreciated the interpretation is straightforward, allowing for continuous surveillance of surgical performance.

SUMMARY

While limitations in the detection of variations in performance are appreciated, the VLAD could represent a more useful tool for monitoring performance.

摘要

背景

近期推动公布个体外科医生的手术结果，这体现了公众对更安全手术的关注。对手术表现进行常规的回顾性评估而不进行持续监测，可能会导致识别手术表现不佳情况或认识到那些带来优于预期表现的做法出现延迟。

讨论

可变寿命调整显示（VLAD）并非新事物，但在普通外科中并未得到广泛应用。它的构建简单，并且如果了解其注意事项，解释起来很直接，能够对手术表现进行持续监测。

总结

虽然认识到在检测表现差异方面存在局限性，但VLAD可能是一种更有用的表现监测工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc8c/4551379/52c9eb558acb/12893_2015_87_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc8c/4551379/52c9eb558acb/12893_2015_87_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc8c/4551379/52c9eb558acb/12893_2015_87_Fig1_HTML.jpg

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BMJ Open. 2016 Oct 31;6(10):e012471. doi: 10.1136/bmjopen-2016-012471.
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