Author's reply: Assessment of abdominoperineal resection rate as a surrogate marker of hospital quality in rectal cancer surgery (Br J Surg 2013; 100: 1655-1663)

摘要

This paper by Jorgensen and colleagues highlights the utility of existing data sets in exploring quality indicators in surgery. However, the conclusion that abdominoperineal resection (APR) rates do not represent a useful quality indicator for rectal cancer surgery requires closer scrutiny. APR rate was assessed as a quality indicator using correlation with outcomes for 34 hospitals and process measures for 18 units. Sample size will have limited the study's power to detect important associations. For outcomes, all correlation coefficients were negative, interestingly associating higher APR rates with lower rates of adverse outcomes. Furthermore, coefficients as low as 0-3 may be considered quite high for associations with relatively insensitive quality indicators such as mortality rates.