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Understanding the Graphs

Number of Operations

The number of operations indicates the number of radical prostatectomy procedures undertaken by each surgeon. There is good evidence that better outcomes are obtained by surgeons who perform more procedures (high-volume surgeons), but this does not mean that low-volume surgeons have poorer outcomes. These data include open, endoscopic, laparoscopic and robotic-assisted procedures for cancer of the prostate.

The data are taken from the BAUS Data and Audit System for procedures performed between 1 January 2014 and 31 December 2014.

The number of operations reported may be lower if a surgeon has only worked through part of the relevant time period. This is the first year of publication for these data, so there are currently insufficient data for risk adjustment, but this may be possible with subsequent data sets.

Complication rate

The incidence of complications can vary from very minor (which do not alter the length of stay in hospital) to serious (which may require further intervention).  The data presented here indicate all reported post-operative complications labelled Clavien-Dindo III and above (i.e. any complication requiring surgical, endoscopic or radiological intervention, which would result in a prolonged hospital stay).

These results need to be interpreted with caution because there are many factors that can affect outcome which are not immediately apparent from the raw data. The accuracy of capturing and reporting complications can be variable, and surgeons who appear to have more complications may, in fact, be the ones who are most efficient at recording them.

The red vertical lines displayed on the graphs indicate an acceptable amount of variation (99% and 99.9% alerts). If the figures from your surgeon or unit are shown as lying within these inner boundaries (i.e. the dark blue bar is to the left of the red lines), then that surgeon/unit is graded as "acceptable".

We would look closely at surgeons/units if their figures lie beyond the 99% alert. If the blue bar is to the right of the 99.9% line, the surgeon is termed an “outlier”, and further investigation is essential to determine whether there may be a cause for concern.