Closing the loop: Optimizing physicians' operational and strategic behavior

Clinical databases are essential elements in optimizing medical care. They are no finality by themselves, but essential elements in the generation of knowledge. Optimal medical care starts with optimal care based on existing knowledge. This care continues with the registration of the variability in morbidity, comorbidity, and therapy, but also the registration of the early and late outcome. This should then allow the generation of structured infe rences based on this registration and the closure of the loop, by treating patients according to this newly created evidence. (C) 1999 by The Society of Thoracic Surgeons.