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Society of Cardiothoracic Surgeons 'Blue Book' »
The Society of Cardiothoracic Surgeons of Great Britain and Ireland regularly updates and publishes detailed results of Cardiac Surgey in the UK. The publication is referred to as the 'Blue Book'. The most recent update was featured on the BBC News at 10 and highlights the increasing safety of cardiac surgery in the UK.
BBC Reports on Cardiac Surgical Database Results »
The BBC links provide a summary of the positive messages from the most recent audit of cardiac surgical outcomes in UK units.
Personal Results on the Cardiac Surgical Public Portal »
The Society of Cardiothoracic Surgeons of Great Britain and Ireland and the Healthcare Commission have recently jointly launched the 'Public Portal' to enable access to individual surgeon and unit results. My own results are appended in this link and demonstrate 'better than expected' outcomes for all operations. For the statisticians amongst you this means the results are three standard deviations better than the EuroScore risk model predicts.
National Press Reports (1645 k)
My latest NHS outcome data, presented on the 'public portal', was favourably reported.
Local Guy's and St Thomas' Press (692 k)
The favourable outcomes have also been reported in the in-house Guy's and St Thomas' press.
360-Degree Appraisal (243 k)
As part of the on-going review of medical practice the NHS now uses a 360-degree appraisal of clinicians seeking views of colleagues from all disciplines and from patients. The recent results of my own appraisal are appended. Colleagues appraisal comments are at the end of the review
 Operative Results
The cardiac surgical portal detailed above on this page gives the most up to date audited outcomes from my NHS practice. The data below relates to earlier results published nationally in the Guardian Newspaper with results from my private surgical practice in the same time frame for comparison.
Guardian Audit March 2005
Sequential CUSUM or VLAD plots
The cumulative number of deaths after a surgical procedure can be plotted against the total number of operations and the cumulative sum CUSUM statistical technique applied to provide an alarm if the mortality exceeds an acceptable level.
CUSUM allows trend analysis looking at sequential results. For this analysis the sequential operation is plotted on the horizontal axis and patient outcome on the vertical axis. For each occurrence of a pre-defined adverse patient outcome, typically death, the plot moves incrementally one unit higher on the vertical axis. This allows a graphic representation of outcome against time.
The data can be modified and adjusted to take into account the patient's operative relative risk. In plotting the data a patient death is proportionally offset by the pre-operative risk score using an appropriate risk algorithm such as Parsonnet or Euroscore. Similarly a credit is earned for the survival of a patient, again with the amount being proportional to the patient risk. Such plots have been termed Vertical Life Adjusted Displays VLAD or Cumulative Risk Adjusted Mortality CRAM Plots.
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