To the Editor It is with interest that we read the article by Dawes and colleagues1 published in JAMA Surgery. The authors found that, while treating patients with severe traumatic brain injury, the guideline adherence rates ranged from 9.6% to 65.2% for intracranial pressure monitoring and from 6.7% to 76.2% for craniotomy, yet no association between hospital-level compliance rates and risk-adjusted patient outcomes was found. Dawes and colleagues1 suggest that caution should be taken before using compliance with these measures as independent quality metrics.
Ruan X, Kaye AD. Measuring the Quality of Care for Patients With Traumatic Brain Injury. JAMA Surg. 2016;151(3):293-294. doi:10.1001/jamasurg.2015.4224