Public performance data open to misinterpretation

Anyone with an Internet connection can access them, but they might lead them down the wrong path. Performance data of individual heart surgeons is more readily available on government, health plans and commercial websites, but new research from the Mongan Institute for Health Policy at Boston's Massachusetts General Hospital found that such report cards can be misleading.

Researchers asked respondents about their views on the report cards of fictitious surgeons. They found that people tend to focus on certain measures in judging who is a good or bad physician, but their perceptions might be off, depending on how that data is presented. For instance, they tended to focus on the number of deaths rather than risk-adjusted mortality rates.

The researchers discovered that the ability to correctly interpret which surgeon was best varied widely between 16 percent and 66 percent, depending on the format.

"Some displays were more understandable than others, but the ones the respondents said they preferred were not necessarily the ones they interpreted accurately," Karen Donelan, a senior survey scientist from the Mongan Institute, wrote in the study. "Some people liked numbers in a table. Some liked graphs with colors and bars. Others were better with proportions, rates, and measurements."

Patients also might not fully understand the terminology, such as the phrase "risk-adjusted mortality," particularly information about hospitals that care for complex patients.

"Most tertiary care hospitals care for very sick people who are referred because they may be too complicated for a community hospital to handle. Sicker patients are at higher risk for poor surgical outcomes," Doneland said in a statement yesterday.

Even with the risks in releasing such data to the public, healthcare consumers should have access to that information, Lawrence H. Cohn, a heart surgeon at Brigham and Women's Hospital and a professor of surgery at Harvard Medical School, pointed out.

The researchers said there's no simple answer but encourage patients to do their homework, trust their cardiologist's referral and meet with the surgeon in deciding who is best for them.

For more information:
- see the research announcement
- here's the research

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