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(Circulation. 2007;115:1508-1510.)
© 2007 American Heart Association, Inc.

Editorial

To Understand Cardiac Surgical Report Cards

Look Both Ways

Thomas J. Ryan, MD

From the Section of Cardiology, Boston University School of Medicine, Boston, Mass.

Correspondence to Dr Thomas J. Ryan, Section of Cardiology, Boston University Medical Center, C822, 88 E Newton St, Boston, MA 02118. E-mail thomas.ryan@bmc.org

Key Words: Editorials • bypass • surgery

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The aphorism attributed to Sir Winston Churchill, "the longer back you look, the further forward you can see," would seem quite apt to place in perspective the importance of the article by Shahian and colleagues that is published in this week’s issue of Circulation.¹ These investigators provide a comprehensive side-by-side comparison of risk-adjusted coronary artery bypass graft (CABG) mortality rates ascertained from validated core clinical variables with CABG mortality rates risk-adjusted from administrative data compiled primarily for billing purposes. The importance of this comparison of in-hospital and 30-day mortality for "isolated CABG" springs from its intended use as a report card to grade the quality of individual hospitals in the performance of cardiac surgery. Their report finds the same limitations and inaccuracies in estimates of mortality rates that use administrative data as had been reported in large and careful studies done 15 years earlier by Hannan,² Jollis,³ and others. Unquestionably, this article should serve as a wake-up call for the entire cardiology community to realize just how important an issue lies on the doorstep.

Article p 1518

First, these investigators were responding to a mandate of the Massachusetts legislature that data on all cardiac surgical procedures be collected in the Society of Thoracic Surgeons National Adult Cardiac Database, which commenced in 2002. It was further directed that these data be submitted to the Massachusetts Data Analysis Center (Mass-DAC) based in the Department of Healthcare Policy at Harvard Medical School. There, under the direction of Dr Sharon-Lise T. Normand, the . . . [Full Text of this Article]

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