"Kidney transplantation at Bir Hospital is world-class," declared an article in Kantipur. Perhaps elated by this apparent achievement, it even published an editorial praising the success.
Great!
It sounded like something to celebrate. Especially when we are working in such resource-poor setting with several limitations. Such success should be morale-lifting for anyone working in the field.
But the news sounded too good to be true to me. Primarily because of extremely sloppy care my patients had received when I sent few with advanced kidney disease to the same folks that tout these results. My earlier sympathy for a fellow public institution has faded and I have stopped sending them patients.
Are they doing such superb job? Maybe I had misunderstood them. I do not have access to their original data. But going by what data have been given in these newspaper articles, it does not actually look very celebratory.
The only data that I could make sense of was transplant rejection rate. It says Bir's kidney transplant rejection rate is 11% compared to global average of 20%. I assume this is annual graft rejection (the transplant program seems to be just 4 years old to give a longer-term outcome. And 20% global outcome data is for 1 year graft rejection rate based on my non-expert search of web. The range was actually 10-20%).
All these transplants are living donor kidney transplants. So the 1 year graft survival rate is 89% for Bir's program. Corresponding data for whole of the US is 96%. This seems to be a huge difference from a claim of world-class outcomes. Perhaps it could be claimed that Bir's outcomes approach that of global average. But being closer to global average does not mean being a "world-class" in the usual sense of the word. All this hoo-ha appears to be self-congratulatory chest-thumping from statistical white lies.
While it may be very healthy to celebrate success, however small, this propensity to manufacture delusions to feel good might be rather detrimental. From what I see everyday working at a public hospital, humility and self-reflection to rectify and improve our dismal healthcare delivery system is more important than ego quenching from such manufactured successes.
Great!
It sounded like something to celebrate. Especially when we are working in such resource-poor setting with several limitations. Such success should be morale-lifting for anyone working in the field.
But the news sounded too good to be true to me. Primarily because of extremely sloppy care my patients had received when I sent few with advanced kidney disease to the same folks that tout these results. My earlier sympathy for a fellow public institution has faded and I have stopped sending them patients.
Are they doing such superb job? Maybe I had misunderstood them. I do not have access to their original data. But going by what data have been given in these newspaper articles, it does not actually look very celebratory.
The only data that I could make sense of was transplant rejection rate. It says Bir's kidney transplant rejection rate is 11% compared to global average of 20%. I assume this is annual graft rejection (the transplant program seems to be just 4 years old to give a longer-term outcome. And 20% global outcome data is for 1 year graft rejection rate based on my non-expert search of web. The range was actually 10-20%).
All these transplants are living donor kidney transplants. So the 1 year graft survival rate is 89% for Bir's program. Corresponding data for whole of the US is 96%. This seems to be a huge difference from a claim of world-class outcomes. Perhaps it could be claimed that Bir's outcomes approach that of global average. But being closer to global average does not mean being a "world-class" in the usual sense of the word. All this hoo-ha appears to be self-congratulatory chest-thumping from statistical white lies.
While it may be very healthy to celebrate success, however small, this propensity to manufacture delusions to feel good might be rather detrimental. From what I see everyday working at a public hospital, humility and self-reflection to rectify and improve our dismal healthcare delivery system is more important than ego quenching from such manufactured successes.
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