RT Journal
A1 Moore FD, Jr
T1 OUtcomes following thyroid and parathyroid surgery in pregnant women—invited critique
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD May 18
VO 144
IS 5
SP 406
OP 406
DO 10.1001/archsurg.2009.61
UL http://dx.doi.org/10.1001/archsurg.2009.61
AB 
These conclusions reinforce the perhaps mistaken notion that the surgeon or the institution controls the outcome. For instance in Table 3, we see nearly identical rates of maternal and fetal morbidity following surgery, suggesting that maternal complications (largely surgeon-controlled) produce fetal complications. Yet when analyzed by region, we see a 7.1% fetal complication rate in the Northeast with a 0% maternal complication rate. This type of study cannot go beyond observation to tell us what key relationships exist nor how to improve practice. This is a general limitation of using databases that were not designed to answer the question at hand; this database is claims-based and designed for administrative purposes.