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Surveillance Bias in Outcomes Reporting

Surveillance Bias in Outcomes Reporting COMMENTARY DVT, some clinicians use duplex ultrasound to screen high- Elliott R. Haut, MD risk asymptomatic trauma patients for DVT. Other clini- Peter J. Pronovost, MD, PhD cians argue this approach is neither clinically necessary nor cost-effective and therefore do not routinely screen for DVT HE PREVALENCE AND EXTENT OF PUBLIC REPORTING in trauma patients. This clinical uncertainly leads to vari- of adverse medical outcomes are increasing. Many ability in the use of screening duplex ultrasound, creating private, public, and government Web sites rank hos- variability in rates of DVT identified and reported—a typi- Tpitals and report scores on selected quality mea- cal example of surveillance bias. sures. Health care consumers, including referring physi- Evidence for surveillance bias in DVT reporting after cians, individual patients, and insurers, can use these data trauma is well documented. For instance, after implemen- to inform decision making by selecting hospitals with bet- tation of a DVT screening guideline at one trauma center, ter outcomes. However, the science of outcome reporting duplex ultrasound rates increased 4-fold and DVT rates in- is young and lags behind the desires of the public in this creased 10-fold. Within the National Trauma Data Bank, information age. Reporting quality http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Surveillance Bias in Outcomes Reporting

JAMA , Volume 305 (23) – Jun 15, 2011

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Publisher
American Medical Association
Copyright
Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2011.822
pmid
21673300
Publisher site
See Article on Publisher Site

Abstract

COMMENTARY DVT, some clinicians use duplex ultrasound to screen high- Elliott R. Haut, MD risk asymptomatic trauma patients for DVT. Other clini- Peter J. Pronovost, MD, PhD cians argue this approach is neither clinically necessary nor cost-effective and therefore do not routinely screen for DVT HE PREVALENCE AND EXTENT OF PUBLIC REPORTING in trauma patients. This clinical uncertainly leads to vari- of adverse medical outcomes are increasing. Many ability in the use of screening duplex ultrasound, creating private, public, and government Web sites rank hos- variability in rates of DVT identified and reported—a typi- Tpitals and report scores on selected quality mea- cal example of surveillance bias. sures. Health care consumers, including referring physi- Evidence for surveillance bias in DVT reporting after cians, individual patients, and insurers, can use these data trauma is well documented. For instance, after implemen- to inform decision making by selecting hospitals with bet- tation of a DVT screening guideline at one trauma center, ter outcomes. However, the science of outcome reporting duplex ultrasound rates increased 4-fold and DVT rates in- is young and lags behind the desires of the public in this creased 10-fold. Within the National Trauma Data Bank, information age. Reporting quality

Journal

JAMAAmerican Medical Association

Published: Jun 15, 2011

References