Codman's 1924 address proposes the 'end-result idea': every hospital must follow every patient long enough to determine whether treatment succeeded, and if not, why not. Using the Registry of Bone Sarcoma as a working model, he argues for systematic multi-institutional outcomes collection as the foundation of scientific surgical practice. The paper is both a manifesto for outcomes accountability and a firsthand account of the institutional resistance that nearly killed the idea before it started.
Codman's 1924 address proposes the 'end-result idea': every hospital must follow every patient long enough to determine whether treatment succeeded, and if not, why not. Using the Registry of Bone Sarcoma as a working model, he argues for systematic multi-institutional outcomes collection as the foundation of scientific surgical practice. The paper is both a manifesto for outcomes accountability and a firsthand account of the institutional resistance that nearly killed the idea before it started.