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BMJ. 2007 October 27; 335(7625): 839.
PMCID: PMC2043427
Surgical Mortality

Media attack

Stephen Westaby, consultant cardiac surgeon,1 Nicholas Archer, consultant paediatric cardiologist,2 and Neil Wilson, consultant paediatric cardiologist2

We are concerned that publishing non-risk stratified cardiac surgical mortality statistics may have adverse effects on surgical teams, bereaved parents, and people with children to be treated at targeted centres.1 We support data collection to maintain clinical standards, but hospital episode statistics are unreliable for measuring mortality and unsuitable for comparison between centres.

Half of units will be below the mean in rankings for surgical mortality. The lay press often interprets “below average” as inadequate or incompetent. Non-risk stratified death rates collected by the UK congenital cardiac audit database (CCAD) were recently published. These are difficult to understand for the lay reader. The Scottish press castigated the centre in Glasgow, whose overall survival rate was 95.9% (UK average 96.7%).2 Comments included:

  • •“Death rates for children's heart operations are significantly higher than the rest of the UK” (untrue)
  • •“This is totally unacceptable and I am very concerned . . . The hospital might be happy with its figures but I am not.” (Quote from chairperson of Scottish Patients' Association.)

Local television covered the attack, and confidence in a thoroughly reputable unit was lost. The CCAD and Society for Cardiothoracic Surgery criticised the media's actions, but the damage was done. The press interpret data to present a sensational headline.

What was achieved by public reporting? Talented, hard working, and dedicated healthcare professionals were inappropriately forced to defend their practice. Prospective patients and relatives were filled with unnecessary anxiety. Cardiac surgery is the only specialty under such intense public scrutiny in the UK, and the risk of unjust condemnation constitutes a third and unwelcome party in the consulting room.

Notes

Competing interests: None declared.

References

1. Westaby S, Archer N, Manning N, Adwani S, Grebenik C, Ormerod O, et al. Comparison of hospital episode statistics and central cardiac audit database in public reporting of congenital heart surgery mortality. BMJ 2007;335:759 (13 October.) [PMC free article] [PubMed]
2. Foster K. Fears over child surgery deaths. Scotland on Sunday 2007. June 10. http://scotlandonsunday.scotsman.com/index.cfm?id=906872007.

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