Rating Spine Surgeons: Physician Review Websites Versus a Patient-reported Outcomes-derived Ranking. Clin Spine Surg 2022 Oct 01;35(8):E643-E648
Date
05/06/2022Pubmed ID
35509107DOI
10.1097/BSD.0000000000001333Scopus ID
2-s2.0-85139375092 (requires institutional sign-in at Scopus site) 1 CitationAbstract
STUDY DESIGN: This was an observational study.
OBJECTIVES: This study aims to determine the correlation between patient-reported outcomes (PROs) pulled from a national spine registry and physician ratings from physician review websites (PRWs).
SUMMARY OF BACKGROUND DATA: PRWs are frequently utilized by patients to make health care decisions; however, many PRWs appear to incorporate subjective experiences unrelated to a surgeon's clinical performance into ratings. As such, their utility as a health care decision-making tool remains unclear.
MATERIALS AND METHODS: This study evaluated 8834 patients from the Quality Outcomes Database (QOD) who underwent 1-level elective lumbar spine surgery. The lumbar module of QOD was queried to rank 124 surgeons using PROs (Oswestry Disability Index, EuroQOL, Numerical Rating Scale-back/leg pain, and patient satisfaction). The QOD PRO-ranking system was compared against PRWs including Healthgrades, Vitals, WebMD, and Google. The Spearman correlation coefficients, Kruskal-Wallis tests, and multiple linear regression models were used for statistical comparison. The primary outcome was the correlation between PRW scores and PROs.
RESULTS: Surgeon PRO-derived ranking showed high intercorrelational congruence with coefficients between the 3 PROs (Oswestry Disability Index, EuroQOL, Numerical Rating Scale back/leg) ranging between 0.70 and 0.88. Low correlations were observed between PRO-derived rankings and PRWs, ranging from 0.23 to 0.37. Healthgrades performed most similarly to PRO-derived rankings, correlating best with patient satisfaction, though the correlation was low (ρ=0.37).
CONCLUSIONS: While PRWs are often used to evaluate surgeon competency, these results demonstrate they poorly correlate with a surgeon's clinical ability measured by PROs. PRWs should be used with caution when making health care decisions by patients, payers, and administrators.
LEVEL OF EVIDENCE: Level III.
Author List
Wanner JP, Pennings JS, Nian H, Sivaganesan A, Gupta R, Asher AL, Bydon M, Abtahi A, Zuckerman SL, Devin C, Archer KR, Stephens BF 2ndAuthor
John P. Wanner MD Assistant Professor in the Orthopaedic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Back PainHumans
Lumbar Vertebrae
Lumbosacral Region
Patient Reported Outcome Measures
Patient Satisfaction
Surgeons
