Design and statistical methodology of the National Surgical Quality Improvement Program: why is it what it is?

This article reviews the philosophy and principles of the National Surgical Quality Improvement Program (NSQIP) that the founders of the program had in mind when they developed the program; explains how the philosophy and principles led to the design and statistical methods that were chosen for the program: and reviews recently proposed changes to the program and potential problems that these changes may create. (C) 2009 Published by Elsevier Inc.