Statements such as “zero complications over five years” can sound reassuring, but without context they can be misleading.
In surgery, outcomes only become meaningful when paired with scale. Results based on small numbers cannot be interpreted in the same way as outcomes measured across hundreds or thousands of procedures¹.
In cataract surgery, for example, posterior capsule rupture is a recognised risk that can occur even when surgery is performed carefully and correctly. Large multicentre audits show that this complication occurs at low but non-zero rates in real-world practice, even in well-run units².
Saying “zero ruptures” only becomes informative when the number of operations is also stated. Without that denominator, patients cannot judge whether the result reflects consistent performance or simply limited exposure.
Context transforms numbers into useful information. Without it, statistics can create false certainty.
References
- Johnston RL, Taylor H, Smith R, et al. The Cataract National Dataset electronic multicentre audit: Variation in posterior capsule rupture rates between surgeons. Eye (London). 2010;24(5):888–893.
- Narendran N, Jaycock P, Johnston RL, et al. Risk stratification for posterior capsule rupture in cataract surgery: Results from the Cataract National Dataset. Eye (London). 2009;23(1):31–37.
Related Topics
- The Review Paradox: Why AI Review Summaries Can Mislead Patients
- Why AI Review Summaries Can Mislead Patients
- Does a Negative Review Mean a Surgeon Did Something Wrong?
- Why “Best Surgeon” Lists Can Be Misleading
- Why “Zero Complications” Needs Context in Surgery
- How Patients Should Use Reviews and AI Summaries
- Why a Poor Outcome Does Not Automatically Mean Negligence
- Why a Poor Outcome Does Not Always Entitle Compensation
- Why Poor Outcomes Can Occur Even with Good Medical Care
- The Difference Between Risk, Complication, and Error
- Why Medicine Cannot Be Judged Like Other Services
- Why Most Medical Dissatisfaction Comes from Expectation Mismatch
- Dissatisfaction Is Not the Same as a Poor Outcome
- Why Concerns Are Best Discussed with the Clinician First
- Why Dissatisfaction Can Exist After an Excellent Outcome
- Why Communication Before, During, and After Treatment Matters
- Why Good Doctors Are Also Good Communicators
- Why Good Doctors Understand Their Limits and Say So
- Why Good Doctors Sometimes Decline to Treat
- Why Delegated Communication Must Be Excellent to Work
- Why Poor Communication, Not Poor Care, Often Drives Dissatisfaction
