NICOR statement regarding National Adult Cardiac Surgery Audit data validation
NICOR’s mission is to provide accurate data on cardiovascular outcomes for the public, healthcare providers and the medical profession. NICOR manages the National Adult Cardiac Surgery Audit, which has been reporting risk adjusted* outcomes since 2005. The most recent hospital and consultant procedure numbers, risk-adjusted in-hospital mortality and risk factor incidence were published for NHS hospitals and individual consultants in April 2014.
Since this publication, it has become clear that there may be some data irregularities, which raises concerns about the data validation processes for the Audit. NICOR leads a rigorous validation process for data submitted to the audit for the risk-adjusted outcomes reporting, consisting of three rounds of data analysis being sent to hospitals for local validation. At each of these three stages hospitals are required to acknowledge receipt of the analysis, and amend data to rectify any data completeness or accuracy issues.
Accurate data for indicating hospital and surgeon performance is a complex process between NICOR and local hospitals. While NICOR provides data quality assessment and data validation reports, the process is dependent on surgeons and their local teams using these reports effectively to verify data and undertake local data validation. NICOR is currently reviewing how they can work with surgeons and hospitals to facilitate this process further in the future.
As concerns have been raised about data quality NICOR will now repeat the data validation process, supporting units to re-check all data and submit revisions if inaccuracies are identified. Once this process is complete the analysis will be re-done and published on the SCTS website.
NICOR continues to be committed in all its registries to provide appropriately analysed, accurate outcome data in a timely manner which is understandable by the public, health care providers and the medical profession.
A statement from the Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) on the National Adult Cardiac Surgery Audit and Mr Ian Wilson has been published on its website.
*’Risk adjustment’ is a sophisticated statistical process that takes into account the riskiness of a medical intervention when calculating clinical outcomes, like mortality. Risk adjustment is based on the presence of certain patient risk factors, like high blood pressure and diabetes. Whether risk factors are present in each patient is reported by hospitals along with other national clinical audit data.