Results
There were 366 surgeons who performed 43,604 isolated CABG that met the
inclusion criteria for our study (Table 1). Of these, 252 surgeons
operated in California and 114 operated in New York. The median number
of years-in-practice was 20 (interquartile range [IQR] 11-28) and
the median O:E ratio for isolated CABG was 0.87 (IQR 0.19-1.4). Years in
practice was roughly normally distributed. The median EMR and case
volume for California surgeons were 2.42 (IQR 1.76, 2.95) and 78.5 (IQR
32.25-129.5) respectively. For New York surgeons median EMR and case
volume were 1.44 (IQR 1.22, 1.68) and 158 (IQR 87.75-243.5).
Linear regression relating normalized EMR to years in practice did not
show a statistically significant relationship, with similar EMR across
the number of years in practice (Table 2). This trend was also visually
summarized using Loess regression (Figure 1). A sensitivity analysis in
which surgeons with <25 cases were excluded to determine if
these surgeons were skewing the data also showed no statistically
significant relationship between years in practice and EMR (Table 3).
Lastly, linear regression relating surgeon isolated CABG O:E ratio to
years in practice, with adjustment for surgeon case volume, also showed
no statistically significant relationship with similar O:E ratios across
the number of years in practice (Table 4). This trend was also visually
summarized using Loess regression (Figure 2).