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Ethical Issues Confronting Outcomes Analysis and Quality Assurance

  • Constantine D. Mavroudis
  • Jeffrey P. Jacobs
  • Allison Siegel
  • Constantine Mavroudis
Chapter

Abstract

The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) has served as the primary, externally validated source for outcomes from its many participating centers. Because participation is voluntary and data are not publically reported, there exists a fundamental conflict with the overwhelming trend toward public reporting in both medicine and cardiac surgery. The ethical issues surrounding this conflict, as well as those involved in public reporting of complex congenital heart disease in general are described herein. The process by which adult cardiac surgery has come to initiate public reporting, while an important model for future directions in outcome reporting, does not adequately address the unique challenges that are faced by the reporting of congenital heart surgical outcomes. If these ethical issues are addressed and public reporting can be done in a responsible manner, then it should be undertaken by the leadership of physician-based groups such as the Society of Thoracic Surgeons.

Keywords

Congenital heart surgery Database Public reporting 

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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  • Constantine D. Mavroudis
    • 1
  • Jeffrey P. Jacobs
    • 2
    • 3
  • Allison Siegel
    • 4
  • Constantine Mavroudis
    • 4
  1. 1.Department of Cardiothoracic SurgeryHospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Division of Cardiac Surgery, Department of SurgeryJohns Hopkins All Children’s Heart Institute, All Children’s Hospital and Florida Hospital for Children, Johns Hopkins UniversityTampa and OrlandoUSA
  3. 3.Division of Cardiac Surgery, Department of SurgeryJohns Hopkins UniversityBaltimoreUSA
  4. 4.Department of SurgeryJohns Hopkins University School of Medicine Florida Hospital for Children, Johns Hopkins Children’s Heart SurgeryOrlandoUSA

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