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Letters
Surgeon-related variance: how much longer for its recognition?
  1. L Peter Fielding1,
  2. Roger Grace2,
  3. Rosemary Hittinger3
  1. 1Department of Surgery, York Hospital, York, Pennsylvania, USA
  2. 2Springfield Lodge, Oaken, Wolverhampton, UK
  3. 3Group Director of Clinical Performance & Governance, HCA International, London, UK
  1. Correspondence to Professor L Peter Fielding, Department of Surgery, York Hospital, 1001 S. George Street, York, PA 17405, USA; lpfielding{at}wellspan.org

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We read with interest the paper by Morris et al, which looked at 30-day postoperative mortality after colorectal cancer surgery in England.1 In 1978, using the data from the large bowel cancer (LBC) project2 we made the case for looking at ‘surgeon’ as a highly significant variable in the context of randomised control trials. Each surgeon was given a random number independent of their institution to protect their confidentiality The results in the LBC project showed a wide variance in 30-day mortality between 0% and 5% up to 21% and for clinical anastomotic leak, the …

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