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[What is outcome quality?].

Modern scientific surgery is outcome-oriented, i.e., the success of surgical therapy is quantified and assessed, generally in clinical studies, according to certain criteria such as survival time or complication rates. The public and health policy makers have recently started demanding not only greater transparency in outcome quality assessment, but also that the results obtained be made available for comparisons about medical performance as a whole. Outcome quality would thus cease to be concerned with a limited range of therapy options and to interest merely doctors and surgeons and a small number of selected patients; it would then affect a number of very different hospitals with heterogeneous patient populations and attract the attention of various lobbies in the health sector. What is problematical, however, is that there is no single interpretation of what outcome quality in medicine is supposed to be. Consequently, assessments and comparisons of quality and performance are difficult and often erroneous. Comparisons of performance in surgery should only be done with selected and evaluated parameters of outcome quality and with a critical examination of how they can be implemented and published.