The effect of consultant outcome publication on surgeon behaviour: a systematic review and narrative synthesis

Marc P. Williams*, V. Modgil, M. J. Drake, Francis X Keeley

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)
153 Downloads (Pure)

Abstract

INTRODUCTION Surgeon-specific outcome data, or consultant outcome publication, refers to public access to named surgeon procedural outcomes. Consultant outcome publication originates from cardiothoracic surgery, having been introduced to US and UK surgery in 1991 and 2005, respectively. It has been associated with an improvement in patient outcomes. However, there is concern that it may also have led to changes in surgeon behaviour. This review assesses the literature for evidence of riskaverse behaviour, upgrading of patient risk factors and cessation of low-volume or poorly performing surgeons.

MATERIALS AND METHODS A systematic literature review of Embase and Medline databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Original studies including data on consultant outcome publication and its potential effect on surgeon behaviour were included.

RESULTS Twenty-five studies were identified from the literature search. Studies suggesting the presence of risk-averse behaviour and upgrading of risk factors tended to be survey based, with studies contrary to these findings using recognised regional and national databases.

DISCUSSION AND CONCLUSION Our review includes instances of consultant outcome publication leading to risk-averse behaviour, upgrading of risk factors and cessation of low-volume or poorly performing surgeons. As UK data on consultant outcome publication matures, further research is essential to ensure that high-risk patients are not inappropriately turned down for surgery.

Original languageEnglish
Pages (from-to)428-435
Number of pages8
JournalAnnals of the Royal College of Surgeons of England
Volume100
Issue number6
Early online date30 Jun 2018
DOIs
Publication statusPublished - 1 Jul 2018

Structured keywords

  • Centre for Surgical Research

Keywords

  • Behaviours
  • Consultants
  • Publications
  • Treatment outcomes

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