Provision of a surgeon's performance data for people considering elective surgery

Henderson A, Henderson S

Published Online:

November 10, 2010

While measuring surgical outcomes is considered good practice and is also associated with numerous quality improvement programs, the disclosure of an individual surgeon's own performance record remains controversial, and the potential benefits for consumers remain unclear. While various methods of collecting, collating and reporting a surgeon's performance have been documented, little is known about the effects of providing this information to people considering elective surgery, compared with people making similar decisions without this information. We found no studies that met the inclusion criteria for this review. However, the following challenges emerged from our review of the background literature: public reporting of data on performance for organisations, units and surgeons; issues with the published data's accuracy, relevance, and usability; ethical issues associated with publishing comparative data for surgeons; and the potential use of a surgeon's data in the consent process.

Further research is required to inform the debate in this area. This lack of evidence may reflect the numerous methodological and ethical issues confronting such research. A research agenda should be established to support exploratory qualitative studies investigating the issues surrounding the provision of a surgeon's performance data for people considering elective surgery.

Abstract (click to read)

Background:

A consumer model of health supports that elective surgery patients should be informed about the past operative performance of their surgeon before making two important decisions: 1) to consent to the proposed surgery, and 2) to have a particular doctor perform the surgery. This information arguably helps empower patients to participate in their care. While surgeons' performance data are available in some settings there continues to be controversy over the provision of such data to patients, and the question of whether consumers should, or want to, be provided with this information.

Objectives:

To assess the effects of providing a surgeon's performance data to people considering elective surgery.

Search strategy:

We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 20 Oct 2009); MEDLINE (Ovid) (28 Sep 2009); EMBASE (Ovid) (28 Sep 2009); PsycINFO (Ovid) (28 Sep 2009); CINAHL (Ebsco) (20 Oct 2009), Current Contents (Ovid) (23 Nov 2009), and Proquest Dissertations and Theses (20 October 2009). We searched all databases from their start dates.

Selection criteria:

Randomised and cluster randomised controlled trials (RCTs), quasi-RCTs and controlled before and after studies, in which an individual surgeon's performance data were provided to patients considering elective surgery.

Data collection and analysis:

Two review authors independently assessed the titles and abstracts of retrieved citations. No studies were identified for inclusion. Consequently, no data collection or analysis was conducted.

Main results:

We found no studies that met the inclusion criteria, therefore there are no results to report on the effect of the provision of a surgeon's performance data for people considering elective surgery.

Authors' conclusions:

We found no studies reporting the impact of the provision of a surgeon's performance data for people considering elective surgery. This is an important finding in itself. While the public reporting of a surgeon's performance is not a new concept, the efficacy of this data for individual patients has not been empirically tested. We recommend that a review of qualitative studies or new primary qualitative research be conducted to determine what interventions are currently in use and explore the attitudes of consumers and professionals towards such interventions.

This record should be cited as:

Henderson A, Henderson S. Provision of a surgeon's performance data for people considering elective surgery. Cochrane Database of Systematic Reviews 2010, Issue 11. Art. No.: CD006327. DOI: 10.1002/14651858.CD006327.pub2

Assessed as up to date:

February 13, 2010

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Primary Review Group:

Consumers and Communication Group

Health topics:

Consumer & communication strategies > Enabling consumers to know about their health & treatment

Consumer & communication strategies > Involving individual consumers in decision-making or communication about their health or treatment

Consumer & communication strategies > Supporting health, treatment, or management behaviours

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Provision of a surgeon's performance data for people considering elective surgery

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