Provision of a surgeon's performance data for people considering elective surgery

Abstract

Background

A consumer model of health supports that people undergoing elective surgery should be informed about the past operative performance of their surgeon before making two important decisions: 1. to consent to the proposed surgery, and 2. to have a particular doctor perform the surgery. This information arguably helps empower patients to participate in their care. While surgeons' performance data are available in some settings, there continues to be controversy over the provision of such data to patients, and the question of whether consumers should, or want to, be provided with this information.

Objectives

To assess the effects of providing a surgeon's performance data to people considering elective surgery on patient‐based and service utilisation outcomes.

Search methods

For the original review, we searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, 2009, Issue 4); MEDLINE (Ovid) (1950 to 28 September 2009); EMBASE (Ovid) (1988 to 28 September 2009); PsycINFO (Ovid) (1806 to 28 September 2009); CINAHL (EBSCO) (1982 to 20 October 2009); Current Contents (Ovid) (1992 to 23 November 2009); and ProQuest Dissertations and Theses (1861 to 20 October 2009).

For this update, we searched: CENTRAL (2009 to 3 March 2014); MEDLINE (Ovid) (2009 to 3 March 2014); EMBASE (Ovid) (2009 to 3 March 2014); PsycINFO (Ovid) (2009 to 9 March 2014); CINAHL (EBSCO) (2009 to 9 March 2014), Current Contents (Web of Science) (November 2009 to 21 March 2014), and ProQuest Dissertations and Theses (2009 to 21 March 2014). We applied no language restrictions.

Selection criteria

Randomised controlled trials (RCTs), cluster RCTs, quasi‐RCTs and controlled before and after studies (CBAs), in which an individual surgeon's performance data were provided to people considering elective surgery. We considered the CBAs for inclusion from 2009 onwards.

Data collection and analysis

Two review authors (AH, SH) independently assessed all titles, abstracts, or both of retrieved citations. We identified no studies for inclusion. Consequently, we conducted no data collection or analysis.

Main results

We found no studies that met the inclusion criteria; therefore, there are no results to report on the effect of the provision of a surgeon's performance data for people considering elective surgery.

Authors' conclusions

We found no studies reporting the impact of the provision of a surgeon's performance data for people considering elective surgery. This is an important finding in itself. While the public reporting of a surgeon's performance is not a new concept, the efficacy of this data for individual patients has not been empirically tested. A review of qualitative studies or new primary qualitative research may be useful to determine what interventions are currently in use and explore the attitudes of consumers and professionals towards such interventions.

Plain language summary

Provision of a surgeon's performance data for people considering elective surgery

Review question

We reviewed the evidence about the effect of providing information about a surgeon's performance to people who are thinking of having elective surgery. Elective surgery is defined as "surgery of a non emergency nature; although recommended, it can be scheduled in advance without affecting the health of the patient or the expected result of the procedure" (Dox 2004, p. 452).

Background

Measuring the performance of surgeons is generally thought to be a good practice that will result in better surgical results. Providing information about the performance of individual surgeons is more controversial and it is not clear what effect giving consumers this information might have. We wanted to discover whether there was any evidence about the effect of making data about a surgeon's performance available to people who are thinking about having elective surgery, compared with people making similar decisions without this information.

Key results

There have been studies on ways of collecting and reporting information about the performance of surgeons, but we did not find any studies published before March 2014 that looked at the effect of this information on consumers.

This lack of evidence may reflect the practical difficulties and ethical issues involved in researching this topic. For example, surgeons might not be willing to take part in such studies. There might also be legal or ethical problems with providing only some patients with information about a surgeon's performance. However, it would be helpful to have more information to inform debate on this topic. Qualitative studies are needed that explore the attitudes of consumers and professionals towards providing this type of information, and their beliefs about potential effects.