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Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery.

Publication ,  Journal Article
O'Brien, SM; Gauvreau, K
Published in: Cardiol Young
December 2008

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.

Duke Scholars

Published In

Cardiol Young

DOI

EISSN

1467-1107

Publication Date

December 2008

Volume

18 Suppl 2

Start / End Page

145 / 151

Location

England

Related Subject Headings

  • United States
  • Quality Assurance, Health Care
  • Humans
  • Heart Defects, Congenital
  • Data Interpretation, Statistical
  • Child
  • Cardiovascular System & Hematology
  • Cardiac Surgical Procedures
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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O’Brien, S. M., & Gauvreau, K. (2008). Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery. Cardiol Young, 18 Suppl 2, 145–151. https://doi.org/10.1017/S1047951108002898
O’Brien, Sean M., and Kimberlee Gauvreau. “Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery.Cardiol Young 18 Suppl 2 (December 2008): 145–51. https://doi.org/10.1017/S1047951108002898.
O’Brien SM, Gauvreau K. Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery. Cardiol Young. 2008 Dec;18 Suppl 2:145–51.
O’Brien, Sean M., and Kimberlee Gauvreau. “Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery.Cardiol Young, vol. 18 Suppl 2, Dec. 2008, pp. 145–51. Pubmed, doi:10.1017/S1047951108002898.
O’Brien SM, Gauvreau K. Statistical issues in the analysis and interpretation of outcomes for congenital cardiac surgery. Cardiol Young. 2008 Dec;18 Suppl 2:145–151.
Journal cover image

Published In

Cardiol Young

DOI

EISSN

1467-1107

Publication Date

December 2008

Volume

18 Suppl 2

Start / End Page

145 / 151

Location

England

Related Subject Headings

  • United States
  • Quality Assurance, Health Care
  • Humans
  • Heart Defects, Congenital
  • Data Interpretation, Statistical
  • Child
  • Cardiovascular System & Hematology
  • Cardiac Surgical Procedures
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology