ISTCs

The Independent Sector Treatment Centres were politically contentious, and the arguments for and against were conducted in a data-free environment. We like our NHS, so there was plenty of support for claims of botched operations at ISTCs were terrible with the NHS left to pick up the pieces: or alternatively a grudging admission that the outcomes of treatment at ISTCs were ok BUT ONLY because they cherry picked the easy cases. Some people managed to make both claims at the same time.

So here are some data, published two years in arrears. No doubt the arguments will continue, not least because of all the things mentioned in the 'limitation' section of the discussion.

This paper is a good example of pragmatic evaluation, which is what you often have to do with political initiatives. When you can't randomise, you have to make do with matching, and since matching is never perfect / never as good as randomising, you are left to wonder if you really did compare like with like.

The scope of the study was ambitious - data collection on all patients treated for a period of 16 months, and patient reported outcomes (hence requiring return of a questionnaire).