University Hospitals Sussex, UK.
Ann R Coll Surg Engl. 2022 Feb;104(2):106-112. doi: 10.1308/rcsann.2021.0106. Epub 2021 Dec 13.
Limited surgeon-specific outcomes data are currently released to the public. Existing schemes generally result from the recommendations of public enquiries, addressing breaches to patient safety and malpractice. We found limited evidence in the literature about patients' or orthopaedic surgeons' wishes regarding the release of such data to the public.
We surveyed 80 joint replacement patients and 41 orthopaedic surgeons regarding their wishes concerning collection and release of individual surgeon data to the public.
Of 80 patients, 30% (24/80) were aware of data on the NHS-My Choices website, 16% (13/80) had reviewed data prior to operation and 95% (76/80) wanted data concerning surgeons' experience, length of stay and complications including revisions. Patients expected more current monitoring of data than occurs. Of 41 surgeons, 20% (8/41) thought national joint registry (NJR) derived data accurately reflected their NHS work. Surgeons did not think this data improved patient outcomes (34%, 14/41), and that it reduced innovation (61%, 25/41) and training (75%, 31/41) and increased risk of adverse behaviour (61%, 25/41). Surgeons wanted a minimal data set accurately presented and risk adjusted.
In the future, it is likely that more individual surgeon data will be released to the public. There needs to be an agreed, accurate minimum dataset collected, reviewed in local clinical governance meetings and published with explanatory notes regarding the interfering variables and what conclusions can be drawn regarding the ability of the surgeon. This process needs to be overseen by an independent body trusted by the public.
目前向公众发布的仅限于外科医生特定的结果数据有限。现有的方案通常是根据公众调查的建议制定的,旨在解决患者安全和医疗事故方面的违规行为。我们发现文献中关于患者或骨科外科医生对向公众发布此类数据的愿望的证据有限。
我们调查了 80 名关节置换患者和 41 名骨科外科医生,了解他们对收集和向公众发布个别外科医生数据的意愿。
在 80 名患者中,有 30%(24/80)知道 NHS-My Choices 网站上的数据,16%(13/80)在手术前查看过数据,95%(76/80)希望获得有关外科医生经验、住院时间和并发症(包括翻修)的数据。患者希望更及时地监测数据。在 41 名外科医生中,有 20%(8/41)认为国家关节登记处(NJR)得出的数据准确反映了他们在 NHS 的工作。外科医生认为这些数据并没有改善患者的结果(34%,14/41),反而减少了创新(61%,25/41)和培训(75%,31/41),并增加了不良行为的风险(61%,25/41)。外科医生希望以最小的数据量准确呈现和风险调整。
在未来,可能会向公众发布更多的个别外科医生数据。需要收集一个经双方同意的、准确的最小数据集,在当地临床治理会议上进行审查,并附有关于干扰变量的说明以及可以从外科医生的能力中得出哪些结论的说明。这个过程需要由公众信任的独立机构监督。