Variations in mortality rates among Canadian NICUs —and anonymous reporting
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We still don't understand how public health care institutions can be “transparent and accountable” and at the same time anonymous. Our editorial view is that data on publicly funded health care institutions should be available not only to researchers and regulators, but also to the public. We see no inconsistency between our claims that the public may be interested to know the track records of specific institutions and is capable of interpreting such information in a reasonable way. Rarely is the public interest served by the suppression of information, although in our commentary we allow for exceptions to our policy on disclosure where “there is a clear and demonstrable potential for net harm.”

We agree with Shoo Lee and colleagues and with Jonathan Lomas and Morris Barer that studies of the validity of measures used to compare institutions need not reveal the names of the institutions (perhaps ever). The aim of such studies is the measuring stick, not the measured. Further, as Lomas and Barer rightly state, journals must respect existing agreements and “grandfather” such papers. (As we did.) 

But what about the future? If anonymity of our public institutions derives from the patronizing attitudes of some of our health care facilities and professionals, then those attitudes need to change. Lomas and Barer are right that we need some data. But we need this data not just on provider and institutional attitudes, but also on what the public wants.

Lastly, we understand the reluctance of the directors of 2 key institutions “to introduce a new ‘non-anonymity’ condition on funding”: They are near the front lines and want to encourage, not discourage research. But they should also take the lead and publicly promote more public disclosure among our institutions and funding agencies so that non-anonymity becomes the rule rather than the exception. Perhaps their letter is a start.

**John Hoey** **Anne Marie Todkill** **Ken Flegel** *CMAJ*