Document Detail


Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery.
MedLine Citation:
PMID:  19063785     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It is universally agreed that efforts to improve quality benefit from the analysis of outcomes. Yet, it is challenging to compare results across institutions because factors other than performance also impact outcomes. Two factors that complicate the analysis of outcomes after congenital cardiac surgery are case-mix and random statistical variation. Case-mix refers to differences in the mix of patients and their risk-factors at different institutions that may cause some centres to have more frequent complications and lower survival regardless of their true performance. Random statistical variation refers to fluctuations in outcomes that occur at random and follow the laws of probability. A variety of statistical methods exist to address these issues and make provider comparisons more fair. We explain a few common approaches including stratification, regression analysis, and confidence intervals. Concepts are illustrated using artificial data from two hypothetical hospitals, as well as real data from a multi-institution registry.
Authors:
Sean M O'Brien; Kimberlee Gauvreau
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Cardiology in the young     Volume:  18 Suppl 2     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-09     Completed Date:  2009-04-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  145-51     Citation Subset:  IM    
Affiliation:
Department of Biostatistics and Bioinformatics and Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina 27715, USA. obrie027@mc.duke.edu
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / statistics & numerical data*
Child
Data Interpretation, Statistical*
Heart Defects, Congenital / surgery*
Humans
Quality Assurance, Health Care / statistics & numerical data*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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