Vascular surgeon data ‘misrepresented’ by media

The National Vascular Registry’s publication included a list of consultants’ raw mortality rates, which do not take into account the how sick the patient is and the complexity of the procedure.

Risk-adjusted data, which does take these factors into account, was only included in the report in a chart which did not specify which score related to which consultant.  

A spokeswoman told HSJ that, when the risk adjustment was applied, all of the nearly 500 surgeons covered by the data fell “within the expected ranges”, with there being no outliers or underperformers.

She added:  “We have purposely not included the risk adjusted mortality in the tables as we were adamant that they shouldn’t be ranked.”

The Daily Mail used the crude rates in a story headlined “The surgeons whose patients were up to 30 times likelier to die”, which highlighted those with the highest unadjusted rates.

A senior source involved in the broader drive to publish consultants’ performance data told HSJ the project and vascular surgeons’ reputation had been damaged by the Mail’s story. The source questioned the NVR’s decision to present crude mortality data in a way which could be ranked while making it impossible to rank surgeons on their risk-adjusted rates.

Ben Bridgewater, who is leading the project at Healthcare Quality Improvement Partnership, said the NVR should be praised not criticised for enhancing transparency.

But he admitted the group, alongside others, would “take some time to reflect on how it has gone this time and learn the lessons so improvements can be made next time”. 

He added: “The Daily Mail extracted the crude mortality out of the table and did not observe the professional advice about interpretation. Doing this leads to a serious danger of misinterpretation.”

One organisation that did not appear in the list provided by the National Vascular Registry’s on Friday was Mid Staffordshire Foundation Trust, despite both abdominal aortic aneurysm andcarotid endarterectomy being carried out at the trust between 2008 and 2012.

The service moved to University Hospital of North Staffordshire where its two surgeons continue to operate.

Mid Staffordshire said it provided 10 years of data to the society and it was up to them how it was presented.

A spokesman for the Vascular Society, said the society had decided it would be “inappropriate” to include Mid Staffordshire as patients might be given the impression they could still choose AAA and CEA procedures at the trust.

Outcome data from operations carried out at Mid Staffordshire were included in the numbers carried out at North Staffordshire under both surgeons.

The news comes after three more specialties, endocrine and thyroid interventional cardiology and orthopaedics, publishing data on Monday. Others specialties are to follow in the coming days.