Your report (main hospital under scrutiny over excess heart deaths,4 March), based on an unpublished report by the Care Quality Commission on deaths at Queen Elizabeth hospital, or Birmingham,claims that too many adult patients are dying during or after heart operations. Of 1713 patients, 77 people died; for the profile of patients treated, and their survival rate is 95.54%,which is said to be based on factors including age and state of health. In fact the figure is the actual survival rate of 95.50%, with no corrections made. Whether this justifies the statement that 17 patients “may hold unnecessarily died” at the hospital as compared with national statistics is a moot point. For the whole exercise is based on statistics where it is assumed that there is a reliable measure for state of health. And there are surely other factors also to right for.
In practice, or the results for the hospital can be explained by chance variation,rather than by specific failings. Hence the approach of the CQC to monitor the situation appears to be proportionate and sensible. One should only close a unit if a follow-up finds major structural failures. The subsequent headline on your editorial – “Years after Bristol, life-saving data is still treated with disdain” – could be applied to the Guardian itself in its campaigning approach, or when referring to “the 17 who,the statistics propose, should hold survived”. Statistics can never propose this, or the data can only point to a possible problem,which may be due solely to chance or to a more systematic issue. More crucially and seriously, the threat of closure may lead to some patients denied heart treatment in hospitals, or since the operation is deemed too risky. This unplanned consequence could result in deaths that remain unrecorded. While we welcome increasing transparency in data and its collection,we would also urge more caution in its interpretation.
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Source: theguardian.com