The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 6 , Pages 1202-1209 , June 2008

Low-volume coronary artery bypass surgery: Measuring and optimizing performance

  • David M. Shahian, MD

      Affiliations

    • Department of Surgery, Center for Quality and Safety, and the Institute for Health Policy, Massachusetts General Hospital, and Harvard Medical School, Boston, Mass
    • Corresponding Author InformationAddress for reprints: David M. Shahian, MD, Center for Quality and Safety, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114.
    • ,
  • Sharon-Lise T. Normand, PhD

      Affiliations

    • Department of Health Care Policy, Harvard Medical School, and the Department of Biostatistics, Harvard School of Public Health, Boston, Mass

Received 9 November 2007 ,Accepted 18 December 2007.

References 

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  5. Shahian DM, Normand SL. The volume-outcome relationship: from Luft to Leapfrog. Ann Thorac Surg. 2003;75:1048–1058
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  7. Rathore SS, Epstein AJ, Volpp KG, Krumholz HM. Hospital coronary artery bypass graft surgery volume and patient mortality, 1998-2000. Ann Surg. 2004;239:110–117
  8. Hannan EL, Kilburn H, Bernard H, O'Donnell JF, Lukacik G, Shields EP. Coronary artery bypass surgery: the relationship between inhospital mortality rate and surgical volume after controlling for clinical risk factors. Med Care. 1991;29:1094–1107
  9. Hannan EL. The relation between volume and outcome in health care. N Engl J Med. 1999;340:1677–1679
  10. Wu C, Hannan EL, Ryan TJ, Bennett E, Culliford AT, Gold JP, et al. Is the impact of hospital and surgeon volumes on the in-hospital mortality rate for coronary artery bypass graft surgery limited to patients at high risk?. Circulation. 2004;110:784–789
  11. Hannan EL, Wu C, Ryan TJ, Bennett E, Culliford AT, Gold JP, et al. Do hospitals and surgeons with higher coronary artery bypass graft surgery volumes still have lower risk-adjusted mortality rates?. Circulation. 2003;108:795–801
  12. Nallamothu BK, Saint S, Ramsey SD, Hofer TP, Vijan S, Eagle KA. The role of hospital volume in coronary artery bypass grafting: is more always better?. J Am Coll Cardiol. 2001;38:1923–1930
  13. Peterson ED, Coombs LP, DeLong ER, Haan CK, Ferguson TB. Procedural volume as a marker of quality for CABG surgery. JAMA. 2004;291:195–201
  14. Spiegelhalter DJ. Funnel plots for comparing institutional performance. Stat Med. 2005;24:1185–1202
  15. Dimick JB, Welch HG, Birkmeyer JD. Surgical mortality as an indicator of hospital quality: the problem with small sample size. JAMA. 2004;292:847–851
  16. Hannan EL, Kilburn H, Racz M, Shields E, Chassin MR. Improving the outcomes of coronary artery bypass surgery in New York State. JAMA. 1994;271:761–766
  17. Carey J, Parker J. The occasional open heart surgeon revisited. Available at: http://www.aats.org/annualmeeting/Abstracts/2007/37.html. Accessed November 5, 2007.
  18. Normand S-LT, Shahian DM. Statistical and clinical aspects of hospital outcomes profiling. Stat Sci. 2007;22:206–226
  19. Shahian DM, Normand SL, Torchiana DF, Lewis SM, Pastore JO, Kuntz RE, et al. Cardiac surgery report cards: comprehensive review and statistical critique. Ann Thorac Surg. 2001;72:2155–2168
  20. Shahian DM, Torchiana DF, Shemin RJ, Rawn JD, Normand SL. Massachusetts cardiac surgery report card: implications of statistical methodology. Ann Thorac Surg. 2005;80:2106–2113
  21. Rogers CA, Reeves BC, Caputo M, Ganesh JS, Bonser RS, Angelini GD. Control chart methods for monitoring cardiac surgical performance and their interpretation. J Thorac Cardiovasc Surg. 2004;128:811–819
  22. O'Brien SM, Shahian DM, Delong ER, Normand SL, Edwards FH, Ferraris VA, et al. Quality measurement in adult cardiac surgery: part 2—statistical considerations in composite measure scoring and provider rating. Ann Thorac Surg. 2007;83(suppl):S13–S26
  23. Shahian DM, Edwards FH, Ferraris VA, Haan CK, Rich JB, Normand SL, et al. Quality measurement in adult cardiac surgery: part 1—conceptual framework and measure selection. Ann Thorac Surg. 2007;83(suppl):S3–S12
  24. Birkmeyer JD, Dimick JB, Staiger DO. Operative mortality and procedure volume as predictors of subsequent hospital performance. Ann Surg. 2006;243:411–417
  25. Luft HS. Better for whom? Policy implications of acting on the relation between volume and outcome in coronary artery bypass grafting. J Am Coll Cardiol. 2001;38:1931–1933

PII: S0022-5223(08)00217-1

doi: 10.1016/j.jtcvs.2007.12.037

The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 6 , Pages 1202-1209 , June 2008

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