Clinical registries and quality measurement in surgery: A systematic review

Stey, Anne M.; Russell, Marcia M.; Ko, Clifford Y.; Sacks, Greg D.; Dawes, Aaron J.; Gibbons, Melinda M.

doi:10.1016/j.surg.2014.08.097

Cited by 73 publications

(60 citation statements)

References 120 publications

(36 reference statements)

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“…7,8,86,140 In this latter capacity, this registry will serve as a tool for conducting research in areas of comparative effectiveness, cost effectiveness, and appropriate use criteria. In addition, participation science has shown that use of structured measurement allows practitioners to compare their performance against risk-adjusted benchmarks to improve individual and site health care quality.…”

Section: Rationalementioning

confidence: 99%

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The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

Parker¹,

McGirt

Bekelis

et al. 2015

FOC

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Meaningful quality measurement and public reporting have the potential to facilitate targeted outcome improvement, practice-based learning, shared decision making, and effective resource utilization. Recent developments in national quality reporting programs, such as the Centers for Medicare & Medicaid Services Qualified Clinical Data Registry (QCDR) reporting option, have enhanced the ability of specialty groups to develop relevant quality measures of the care they deliver. QCDRs will complete the collection and submission of Physician Quality Reporting System (PQRS) quality measures data on behalf of individual eligible professionals. The National Neurosurgery Quality and Outcomes Database (N2QOD) offers 21 non-PQRS measures, initially focused on spine procedures, which are the first specialty-specific measures for neurosurgery. Securing QCDR status for N2QOD is a tremendously important accomplishment for our specialty. This program will ensure that data collected through our registries and used for PQRS is meaningful for neurosurgeons, related spine care practitioners, their patients, and other stakeholders. The 2015 N2QOD QCDR is further evidence of neurosurgery’s commitment to substantively advancing the health care quality paradigm. The following manuscript outlines the measures now approved for use in the 2015 N2QOD QCDR. Measure specifications (measure type and descriptions, related measures, if any, as well as relevant National Quality Strategy domain[s]) along with rationale are provided for each measure.

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Section: Rationalementioning

confidence: 99%

“…There exist numerous other national and local registries in surgery as well as various surgical specialties including thoracic, trauma, transplant, oncology, etc. 15,140 Interestingly, a systematic review has identified that several of these programs have identified decreases in risk-adjusted mortality associated with registry participation.…”

Section: Rationalementioning

confidence: 99%

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

Parker¹,

McGirt

Bekelis

et al. 2015

FOC

View full text Add to dashboard Cite

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“…i2b2 utilizes a hive system, which maintains server-side software modules that either store data or contain analysis methods that facilitate the use of data. 2 At the University of Rochester, we use an Oracle platform to integrate a data repository and the i2b2 software. Fulltime employees (FTEs) are required to manage the i2b2 platform and continue to develop the tool.…”

Section: Role Of I2b2 In Collecting Clinical Datamentioning

confidence: 99%

“…The second use is to conduct an in-depth study on a specific population in support of outcome studies. 2 Some examples of data currently available include patient demographics, diagnoses, medications, procedures, providers, laboratory results, microbiology results, patient questionnaires, and social histories. De-identified data are available for study feasibility assessment and planning.…”

Section: Role Of I2b2 In Collecting Clinical Datamentioning

confidence: 99%

“…The EHR system is useful for identifying individual patient-level data; however, a limited number of processes are available to generate reports and queries on a cohort of patients. 2 Therefore, the University of Rochester developed a complementary tool to automate the process of moving clinical information from i2b2 to REDCap by using an innovative graphical user interface. REDCap, developed at Vanderbilt University and made freely available through the REDCap Consortium, is used for the collection and management of data for biomedical research.…”

Section: Role Of I2b2 In Collecting Clinical Datamentioning

confidence: 99%

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Neurosurgery clinical registry data collection utilizing Informatics for Integrating Biology and the Bedside and electronic health records at the University of Rochester

Pittman

Miranpuri

2015

FOC

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In a population health-driven health care system, data collection through the use of clinical registries is becoming imperative to continue to drive effective and efficient patient care. Clinical registries rely on a department’s ability to collect high-quality and accurate data. Currently, however, data are collected manually with a high risk for error. The University of Rochester’s Department of Neurosurgery in conjunction with the university’s Clinical and Translational Science Institute has implemented the integrated use of the Informatics for Integrating Biology and the Bedside (i2b2) informatics framework with the Research Electronic Data Capture (REDCap) databases.

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Assessing the Appropriateness of Carotid Revascularization

2017

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For years, debate has ensued as to what constitutes a patient who is "appropriate" for carotid revascularization. Generally, the decision to surgically intervene on carotid disease is dependent on the degree of stenosis, 1 how rapidly the stenosis progressed over time, and the presence of symptoms 2 ; however, some have posited that a surgeon's enthusiasm may also drive use. Assessing the appropriateness of carotid revascularization procedures, like quantifying beauty, can be difficult, and ultimately this task is left to the beholder or the consulting surgeon.In this issue of JAMA Surgery, Nguyen and colleagues 3 examined the effect of a factor that may influence a physician's measure of appropriateness: the physician payment model in which patients receive their care. They compared rates of carotid revascularization within the Military Health System's salaried model and within Paid Care, a fee-for-service model. The authors noted increased odds of surgical intervention for patients within the Paid Care model, even after adjusting for patient factors. The resilience of this effect suggests that the difference in surgical intervention rates may be driven by physicians rather than patient characteristics.More than 30 years ago, Wennberg and colleagues 4 described the phenomenon of "supplier-induced demand," in which professional uncertainty was associated with greater variability in the use of surgical procedures. Based on this con-

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Clinical registries and quality measurement in surgery: A systematic review

Cited by 73 publications

References 120 publications

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

The National Neurosurgery Quality and Outcomes Database Qualified Clinical Data Registry: 2015 measure specifications and rationale

Neurosurgery clinical registry data collection utilizing Informatics for Integrating Biology and the Bedside and electronic health records at the University of Rochester

Assessing the Appropriateness of Carotid Revascularization

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