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Ethical Issues Confronting Outcomes Analysis and Quality Assurance

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Pediatric and Congenital Cardiac Care

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.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, 3400 Spruce St Silverstein Pavilion 6 Floor, Philadelphia, PA, 19104, USA

    Constantine D. Mavroudis MD, MSc

  2. Division of Cardiac Surgery, Department of Surgery, Johns Hopkins All Children’s Heart Institute, All Children’s Hospital and Florida Hospital for Children, Johns Hopkins University, Saint Petersburg, Tampa and Orlando, FL, USA

    Jeffrey P. Jacobs MD, FACS, FACC, FCCP

  3. Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA

    Jeffrey P. Jacobs MD, FACS, FACC, FCCP

  4. Department of Surgery, Johns Hopkins University School of Medicine Florida Hospital for Children, Johns Hopkins Children’s Heart Surgery, 2501 N. Orange Ave Suite 540, Orlando, FL, 32804, USA

    Allison Siegel MSSA & Constantine Mavroudis MD

Authors
  1. Constantine D. Mavroudis MD, MSc
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  2. Jeffrey P. Jacobs MD, FACS, FACC, FCCP
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  3. Allison Siegel MSSA
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  4. Constantine Mavroudis MD
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Corresponding author

Correspondence to Constantine Mavroudis MD .

Editor information

Editors and Affiliations

  1. School of Medicine,, University of Oslo, Oslo, Norway

    Paul R. Barach

  2. Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Division of Cardiac Surgery, Department of Surgery, Johns Hopkins All Children’s Heart Institute, All Children’s Hospital and Florida Hospital for Children, Johns Hopkins University, St. Petersburg, Tampa, Orlando, FL, USA,, Baltimore, Maryland, USA

    Jeffery P. Jacobs

  3. Wayne State University, Detroit, Michigan, USA

    Steven E. Lipshultz

  4. The Hospital for Sick Children, Toronto, Ontario, Canada

    Peter C. Laussen

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Mavroudis, C.D., Jacobs, J.P., Siegel, A., Mavroudis, C. (2015). Ethical Issues Confronting Outcomes Analysis and Quality Assurance. In: Barach, P., Jacobs, J., Lipshultz, S., Laussen, P. (eds) Pediatric and Congenital Cardiac Care. Springer, London. https://doi.org/10.1007/978-1-4471-6587-3_23

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  • DOI: https://doi.org/10.1007/978-1-4471-6587-3_23

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6586-6

  • Online ISBN: 978-1-4471-6587-3

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