News about the Congenital Heart Surgery Database and Public Reporting

STS President Robert S.D. Higgins, MD, MSHA, and First Vice President Joseph A. Dearani, MD, provided details about the Congenital Heart Surgery Database and STS Public Reporting in an announcement released on November 19. 

Over the last 4 years, we have learned a substantial amount from the medical community and the public about the reporting of data from The Society of Thoracic Surgeons’ Congenital Heart Surgery Database (CHSD). STS leadership values and appreciates receiving feedback from diverse groups of stakeholders within the congenital community regarding public reporting of risk-adjusted outcomes in the CHSD. During a recent STS Board of Directors meeting, the Board deliberated at length on the feedback from STS membership and made the following recommendations, which subsequently were supported by the Congenital Heart Surgeons’ Society at its annual meeting last month in Chicago:  

1.    Update public reporting format: Supplement the STS Public Reporting website to include risk-adjusted outcomes and annual hospital case volumes and complexity for the most commonly performed (i.e., benchmark) congenital heart procedures (ASD, VSD, TOF, etc.).
2.    Report center-level all-patient risk-adjusted mortality: Remove the “star ratings” graphic. Report institutional volumes, observed-to-expected ratios, and confidence intervals. Display procedures stratified by STAT category and benchmark procedures.
3.    Revamp the STS Public Reporting website for the CHSD: Refine, improve, and better explain the text, tables, and graphics on the STS Public Reporting website to better meet the needs of the medical community and the public. 

STS strongly believes that voluntary public reporting should continue. Our patients, families, and programs benefit from accurate, transparent, and reliable quality information, particularly about congenital heart surgery. STS intends to implement the changes noted above by Q1 2020 during the phase 1 rollout of the Next Generation STS National Database. Our objective is to do everything we can to improve the system and incorporate feedback from our stakeholders. 

Comprehensive risk modeling is a significant challenge, especially given the low volumes of individual procedures and numerous variables influencing these procedures. While the current methodologies have been validated with strong statistical evidence, we recognize that no risk model is perfect and that there is always room for improvement. For this reason, we have engaged a group of academic and clinical congenital experts and biostatisticians who have, over the past year, provided input and guidance toward the development of improved risk models. Their work is continuing and will help further inform our efforts.

It is important to emphasize that the Next Generation STS National Database, updates to Public Reporting, and development of new risk models are all iterative processes, and the appropriate changes will be employed with review and input from experts and stakeholders all along the way. We believe that our collective efforts will improve transparency and public awareness, quality outcomes, and patient safety in congenital heart surgery.  

We will keep you updated on our progress. And thanks again for your commitment to our patients and the profession.

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Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,400 cardiothoracic surgeons, researchers, and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society’s mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.