Background: The recent push for the publication of individual surgeon outcomes underpins public interest in safer\nsurgery. Conventional, retrospective assessment of surgical performance without continuous monitoring may lead\nto delays in identifying poor performance or recognition of practices that lead to be better than expected\nperformance.\nDiscussion: The variable life adjusted display (VLAD) is not new, yet is not widely utilised in General Surgery. Its\nconstruction is simple and if caveats are appreciated the interpretation is straightforward, allowing for continuous\nsurveillance of surgical performance.\nSummary: While limitations in the detection of variations in performance are appreciated, the VLAD could\nrepresent a more useful tool for monitoring performance.
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