0
ARTICLE |

The Quality of Surgery: Statistical vs Incidental Approaches-Reply

HUNTER H. McGUIRE JR, MD; J. SHELTON HORSLEY III, MD; DAVID R. SALTER, MD; MICHAEL SOBEL, MD
Arch Surg. 1993;128(1):109-110. doi:10.1001/archsurg.1993.01420130121020.
Text Size: A A A
Published online

ABSTRACT

In Reply.—Our study was conducted, not with a preexisting bias against data management, but with such high hopes that we filed almost 28 000 facts and each year calculated 552 complication rates for 52 classes of procedures. We did not report these details because in 14 years only one difference was significant, and no calculation revealed a problem that we had not already recognized and remedied by a prompt, incidental approach to every complication.

Between statistical and incidental approaches to quality there should be no conflict. The facts in our computer file and in our morbidity discussions are identical. Neither are underreported or subjective. Their differences are in what they achieve. The continuous incidental approach easily and economically optimizes outcomes by minimizing errors. The statistical approach tediously and retrospectively validates claims of acceptable outcomes. The rare need to validate claims justifies continuous filing of data but, except for infection

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();