An article in today's Observer claims that "Britain is shamed by NHS death rate". It reports on a comparative study of surgical death rates after major surgery undertaken, but not yet published, by teams from University College London and Columbia University in New York which purports that that fewer American patients than British died in hospital after major surgery. The Observer journalist Jo Revill is quick to present this as further 'evidence' that the NHS reforms are failing, and harnesses comments from David Bennett of St Georges Hospital, who has been banging on — quite rightly, actually — about Britain's comparative lack of critical care facilities.
A worrying aspect of this report is that the headline 'outcomes' of this study have been accepted uncritically by the journalist concerned, and published without revealing sufficient information to allow readers to draw their own conclusions. The study is apparently to be published in a 'peer-reviewed' journal later in the year, and selective and uncritical leaking such as this prior to full and proper publication is simply unethical. An important aspect of peer-reviewed publication is that (in theory) details of the study method and the raw data are published to allow readers to draw alternative conclusions, and to form an opinion on potential confounders such as observer or publication bias.
In a comparative study such as this there are many potentially-confounding variables which can influence the interpretation of the observations, for example the selection of the patients, their ages and underlying conditions, the indications for surgery, the seniority of the surgeon, the support services available, etc. Without such information, it is impossible to determine whether there is any grain of truth in this story, or whether it is just another example of the British media hell-bent on discrediting the Government.
As it happens, I suspect intuitively and from my own observations that the general conclusions of the study may well be correct — but if they are, understanding the underlying reasons in a way that enables a constructive approach to improving the situation is not helped by cheap sensationalism such as this.