Ward and Illif ask whether there have been too many papers on the 7th UK National Audit Project (NAP7) and whether the “primary purpose” of the project has been lost [1]. NAP7 was a massive project during a pandemic. It is unsurprising that peri-operative cardiac arrest and its contributing factors have generated a large amount of information given this is the final common pathway for serious complications of anaesthesia and surgery [2]. These include those studied in previous NAPs (e.g. airway complications, anaphylaxis) [2]. Of note, NAP7 reported on more cases than NAPs 3–6 combined [3].

We have a duty to share our findings as widely as possible; for our patients, their families, our stakeholders and the thousands of anaesthetists in the UK and Ireland who contributed data to NAP7. In addition to providing new information about complications and for different patients or subspecialties (e.g. children [4], obstetrics [5]), secondary outputs have been driven by our stakeholders. NAP7 has provided novel and up-to-date information in several areas that are important or contentious for anaesthetists and our patients (e.g. impact of COVID-19 [6], use of monitoring [7], the independent sector [8], anaesthesia associates [9] and wellbeing [3]).

At all stages, we made efforts to minimise the number of chapters and the length of these to improve accessibility. An illustration of this is the NAP7 ‘airway and breathing’ chapter and paper [10] that reports on 113 cases and runs to 12 pages compared with NAP4 which included 133 anaesthesia airway cases and runs to 216 pages. The division of the report into discrete short chapters specifically enables and encourages readers to focus on areas most relevant to their areas of practice.

Many of the report chapters have been subsequently published as papers in Anaesthesia, often with additional data and discussion. No project is complete until it is disseminated, and it was, therefore, an intentional strategy to improve visibility of the project by publishing key topic chapters as papers, after full peer review. This further enabled dissemination through podcasts and social media. We judge this a success and thank Anaesthesia and its editors.

The prime purpose of the NAPs is “through national effort to provide detailed numerical and case-based analysis of risk and complications of anaesthesia and surgery, to make these data available to patients and clinicians and in so doing so facilitate better communication and decision making and drive changes that improve safety”. We believe all the findings and recommendations of NAP7 will help make anaesthesia safer and are important for anaesthetists and their patients – we have no regrets about sharing them as widely as possible.

Finally, we thank Ward and Illif for applauding the thoroughness and dissemination of the NAP7 project and the infographic [1]. In answer to what they and colleagues should read given the large number of outputs, we encourage every anaesthetist to read the main papers published in Anaesthesia in November 2023. We also recommend reading the summary chapters in the report [3], which include key findings and 20 main recommendations aimed at making anaesthesia care safer. While few will read the whole report, we encourage anaesthetists to read those papers and chapters that focus on their interests. We hope this stimulates a deeper dive into the report which includes other key chapters on risk, cardiac arrest in low-risk patients, good practice and many others.

Ward 和 Illif 询问关于第 7 届英国国家审计项目 （NAP7） 的论文是否太多，以及该项目的“主要目的”是否已经丢失 [1]。NAP7 在大流行期间是一个庞大的项目。鉴于这是麻醉和手术严重并发症的最终常见途径，围手术期心脏骤停及其影响因素产生了大量信息，这并不奇怪 [2]。这些包括在既往 NAP 中研究的那些（例如气道并发症、全身性过敏反应）[2]。值得注意的是，NAP7 报告的病例比 NAP 3-6 的总和还要多 [3]。

我们有责任尽可能广泛地分享我们的发现;对于我们的患者、他们的家人、我们的利益相关者以及为 NAP7 提供数据的英国和爱尔兰的数千名麻醉师。除了提供有关并发症和不同患者或亚专科（例如儿童 [4]、产科 [5]）的新信息外，我们的利益相关者还推动了次要产出。NAP7 在对麻醉师和我们的患者来说很重要或有争议的几个领域提供了新颖和最新的信息（例如 COVID-19 的影响 [6]、监测的使用[7]、独立部门 [8]、麻醉助理 [9] 和健康状况 [3]）。

在所有阶段，我们都努力减少章节的数量和长度，以提高可访问性。NAP7 的“气道和呼吸”章节和论文 [10] 就是一个例子，它报告了 113 个病例，长达 12 页，而 NAP4 包括 133 个麻醉气道病例，长达 216 页。将报告划分为独立的短章，特别是使读者能够并鼓励读者关注与其实践领域最相关的领域。

许多报告章节随后作为论文发表在 Anaesthesia 上，通常带有额外的数据和讨论。任何项目在传播之前都是不完整的，因此，在经过全面的同行评审后，通过将关键主题章节作为论文发布来提高项目的知名度是一种有意的策略。这进一步使播客和社交媒体的传播成为可能。我们认为这是成功的，并感谢 Anaesthesia 及其编辑。

NAP 的主要目的是“通过全国努力提供对麻醉和手术的风险和并发症的详细数字和基于病例的分析，将这些数据提供给患者和临床医生，从而促进更好的沟通和决策，并推动提高安全性的变革”.我们相信 NAP7 的所有发现和建议都有助于提高麻醉的安全性，并且对麻醉师及其患者很重要——我们不遗憾地尽可能广泛地分享它们。

最后，我们感谢 Ward 和 Illif 对 NAP7 项目和信息图 [1] 的彻底性和传播表示赞赏。鉴于大量产出，为了回答他们和同事应该阅读的内容，我们鼓励每位麻醉师阅读 2023 年 11 月发表在《麻醉》上的主要论文。我们还建议阅读报告中的总结章节 [3]，其中包括主要发现和 20 条旨在提高麻醉护理安全性的主要建议。虽然很少有人会阅读整个报告，但我们鼓励麻醉师阅读那些关注他们兴趣的论文和章节。我们希望这能激发对报告的更深入研究，其中包括有关风险、低风险患者心脏骤停、良好实践等的其他关键章节。