JohnAlanTucker

Wouldn't a more relevant number be the number of avoidable adverse events? If you perform coronary bypass surgery on 1000 patients, some fraction will not be healthy enough to survive the procedure. But usually such procedures are performed only on those at high risk of death from MI. Its not like a decision to have a botox injection.

Any reponse to Dr. Davie's column, in which he states that complication rate is a relatively minor aspect of surgical quality in prostatectomy? I am not a surgeon myself, but easy to imagine that the more aggressively the tumor margins are pursued, the greater risk of impotence, incontinence, etc.

What studies show that increasing transperancy leads to improved patient outcomes? Many have suggested that the primary effect is to dodge risky patients.

Still, it would seem more informative and fair to avoid data presentations that imply greater confidence in these classifications that the stats support. For example, hospitals having a "high adjusted complication rate" surgeon are flagged with an exclamation mark, but many of the surgeons leading to this flag have up to 50% of probability interval lying in "medium" or "low". THe presentation implies greater confidence in your classifications than the data supports

I don't know if I"m allowed to make comments as well as ask questions, but my concern is that people don't necessarily use the data in the way you intend unless you tailor your message taking the echo chamber into account. I've seen several newspaper articles calling out MDs whose rating was at the cusp of "medium" and "high" and based on < 25 procedures. I suspect that the average user of your database may simply pick the surgeon with the lowest ACR in their city and make an appointment.