The Ethics of Transparency: Publication of Cardiothoracic Surgical Outcomes in the Lay Press

Cardiothoracic surgical (CTS) outcomes have been published in the lay press for nearly 2 decades. Pressures to expand such publication come from many different areas and cannot be resisted indefinitely. Evidence exists that contemporary reporting of outcomes data is based on flawed methodologies that potentially mislead and deceive. Such deceptions may harm patients, surgeons, and hospitals in various ways, and could undermine quality of surgical care and patients' access to it. Yet, public reporting of outcomes can also be beneficial to all concerned, but only if relevant data are accurate and the formats in which they are reported are valid and easily understood. In this essay, we review the early history of public reporting of CTS outcomes, discuss potentially negative aspects of public reporting, and suggest solutions to these problems. We then consider the positive aspects of public reporting and provide recommendations for the future. We conclude that CTS data should be collected and analyzed under the direction of professional medical societies and that reports of outcomes based on such data should be published in the lay press.