| From: Soljak Michael
Michael.Soljak@mail.ehh-ha.nthames.nhs.uk
Date: Wed, 17 Apr 2002 13:11:58 +0100 To: "'Bandolier@pru.ox.ac.uk'" Subject:
CABG Mortality Your article in
Bandolier 98
on CABG mortality quotes US data. However Bandolier and its readers may be
interested to know that the Society of Cardiothoracic Surgeons of Great Britain
& Ireland (address c/o RCS) publishes Annual Reports from the National Adult
Cardiac Surgical Database (the latest Report I have is for 1999-00, published May
2001). This is available from
publishing@e-dendrite.com
at a hefty cost of £80 (I do not know of an on-line edition). The cardiac
surgeons have been running their Patient Analysis & Tracking System (PATS)
for some years now and have a goldmine of data. The Report not only covers
casemix and outcome data, and comparisons with the USA, but also provides
excellent explanations and results of statistical risk stratification techniques.
These include simple and complex Bayesian models and Cumulative Sum ((CUSUM)
analyses, and how they can be applied to performance monitoring. As the
publication of league tables (or hopefully control charts or plots) become more
widespread we will need to become more familiar with these techniques. As usual,
there is no simple answer to problems of risk stratification, but we certainly
need to exert pressure so that more clinical information sytems like
PATS,incorporating these features, are developed. PATS also provides through
these "feedback loops" the facility to predict outcomes for individual patients
so that patients can be more involved in decisionmaking. Dr Michael Soljak FRACP
FAFPHM FFPHM Previous Post (still contactable via this address): Director of
Public Health & Health Strategy Ealing Hammersmith & Hounslow Health
Authority 1 Armstrong Way Southall Middlesex UB2 4SA Tel 020-8893-0115 Fax
020-8893-0398 Mobile 07774-174-658 email
michael.soljak@mail.ehh-ha.nthames.nhs.uk
New Post: Strategic Intelligence Unit NW London Strategic Health Authority 170
Tottenham Court Road LONDON W1P 0HA email:
michael.soljak@nwlondon-stha.nhs.uk
(from 22/4/02) |