Are APERs included in the estimate of 18-month stoma rate?

APERs are included in the estimate. The clinical interest is in the proportion of all rectal cancer patients undergoing a major resection who have a stoma at 18 months, not just those who have a “temporary” stoma. This reflects both the use of sphincter preserving surgery and the reversal of temporary stomas. If APERs were excluded from the estimate there is a risk that it would incentivise their use.