Surgeons are increasingly under pressure to measure and improve their quality. While there is broad consensus that we ought to track surgical quality, there is far less agreement about which metrics matter most. This article reviews the important statistical concepts of case mix and chance as they apply to understanding the observed wide variation in surgical quality. We then discuss the benefits and drawbacks of current measurement strategies through the framework of structure, process, and outcomes approaches. Finally, we describe emerging new metrics, such as video evaluation and network optimization, that are likely to take on an increasingly important role in the future of measuring surgical quality.

中文翻译：

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哪些指标可以准确反映手术质量？

外科医生越来越承受测量和改善其质量的压力。尽管人们普遍认为我们应该追踪手术质量，但对于哪个指标最重要的共识却很少。本文回顾了病例组合和机会的重要统计概念，因为它们适用于了解观察到的手术质量的广泛差异。然后，我们通过结构，过程和结果方法的框架讨论当前衡量策略的利弊。最后，我们描述了新兴的新指标，例如视频评估和网络优化，它们可能在将来衡量手术质量方面扮演越来越重要的角色。