National Neurosurgery Quality and Outcomes Database

Outcomes Modeling

Meeting Aug 21, 2012

Endpoints

  • Outcomes
    • VAS-Back Pain, VAS-Leg Pain
    • ODI Score
    • EQ-5D Score
    • Return to Work
    • Mortality: Hospital, 30-day, 3-month, 12-month
  • Quality
    • Length of Hospital Stay
    • Estimated Blood Loss
    • Surgery Time
    • Hospital Readmission (all causes), 30 days, 3 month
    • Revision Surgery (all causes), 3 month, 12 month
    • Patient Satisfaction (1 vs. 2~4, or 1~2 vs. 3~4)
    • Morbidities
      • Major
        • Pulmonary Embolism (PE)
        • Stroke
        • Myocardial Infarction (MI)
        • Surgical Site Infection (SSI)
        • Surgical Site Hematoma
        • Motor Deficit
      • Minor
        • Deep Venous Thrombosis (DVT)
        • Urinary Tract Infection (UTI)
  • Utilization
    • Arthrodesis per diagnosis

Covariates

  • Demographics
    • Gender
    • Age
    • Race (6-levels)
    • Hispanic (Yes/No)
    • Education (5 levels)
    • Employment & Activity
  • Practice Group
  • Surgeon
  • Risk Factors
    • Workers Compensation (Yes/No)
    • Disability Insurance (Yes/No)
    • Motor Vehicle Injury (Yes/No)
    • Employed (Yes/No)
    • Return to Work Plans (Yes/No)
    • Major Surgery in Past Year (Yes/No)
    • Comorbidity (Diabetes, etc, 5 in total)
    • BMI
    • Smoking (6 level)
  • Clinical Variables
    • Principal Diagnosis (one of 5 diagnoses)
    • Predominant Symptom (Back/Leg Pain or Both)
    • Motor Deficits (Yes/No)
    • Ambulation (3-level)
    • Duration (<3m, >3m or Unknown)
    • Modic Endplate Changes (Yes/No)
    • ASA Grade (1~5)
    • Surgical Approach (Posterior or Anterior Only)

Reports Format

  • Types of Reports
    • Overall report
    • Practice group report
    • Surgeon report
    • Decision aids
  • Subgroup Strata
    • By Diagnosis
    • By Procedure
    • Employment and Type of Occupation
    • Practice Group
  • Requests from ??
    • The first year report needs not to be risk adjusted.
    • Each site-specific endpoint should have a mean and distribution of the aggregate national data next to for context.
    • No crude site ranking needed.
    • Only the primary endpoints need graphic display.
    • Types of Reports
      • Surgeon Centered Report (for use with internal practice improvement)
        • Graphic displays of primary endpoints for the entire practice group and per diagnosis with national norms
        • Descriptive statistics on patient population compared to national norms
        • Time trends of primary endpoints
      • Practice Administrator Centered Format (for use with external entities)
        • Graphic displays of primary endpoints for the entire practice group and per diagnosis WITH and WITHOUT national norms
        • Treatment type per diagnosis with national norms
      • Patient Centered Format (for use with informed/shared decision making)
        • Easy to understand graphic display of endpoints per diagnosis for each site (to be shared with patients in clinic)
      • Comprehensive descriptive analysis of all variables (for detailed referencing)
        • Include detailed mean (SD) range of each variable recorded for the site's data
        • Include mean (SD) range of each variable recorded for the aggregate national data

Topic attachments
I Attachment Action Size Date Who Comment
AtlanticNS.pdfpdf AtlanticNS.pdf manage 143.6 K 26 Feb 2013 - 09:29 HuiNian  
N2QOD20130121.pdfpdf N2QOD20130121.pdf manage 573.4 K 26 Feb 2013 - 09:03 HuiNian  
N2QOD_2012Nov.pdfpdf N2QOD_2012Nov.pdf manage 547.0 K 26 Feb 2013 - 09:09 HuiNian  
STATISTICS_and_OUTCOMES_QUARTERLY_REPORT_30August_2012_for_Nov.docxdocx STATISTICS_and_OUTCOMES_QUARTERLY_REPORT_30August_2012_for_Nov.docx manage 25.1 K 04 Sep 2012 - 09:09 TedSperoff WIP for Nov N2QOD OutComes Nov report
baseline2.pdfpdf baseline2.pdf manage 164.3 K 02 Oct 2012 - 12:53 HuiNian  
outcome1a.pdfpdf outcome1a.pdf manage 10.3 K 02 Oct 2012 - 12:53 HuiNian  
outcome1b.pdfpdf outcome1b.pdf manage 6.9 K 02 Oct 2012 - 12:53 HuiNian  
outcome1c.pdfpdf outcome1c.pdf manage 6.5 K 02 Oct 2012 - 12:54 HuiNian  
outcome2.pdfpdf outcome2.pdf manage 147.1 K 02 Oct 2012 - 12:54 HuiNian  
outcome3LOS.pdfpdf outcome3LOS.pdf manage 124.0 K 02 Oct 2012 - 12:55 HuiNian  
outcome3PtSatisfaction.pdfpdf outcome3PtSatisfaction.pdf manage 141.4 K 02 Oct 2012 - 12:55 HuiNian  
outcome3ReturnWork.pdfpdf outcome3ReturnWork.pdf manage 134.8 K 02 Oct 2012 - 12:55 HuiNian  
outcome3odi.pdfpdf outcome3odi.pdf manage 132.5 K 02 Oct 2012 - 12:54 HuiNian  
precision.pdfpdf precision.pdf manage 58.4 K 01 Oct 2012 - 17:22 HuiNian  
vanderbilt.pdfpdf vanderbilt.pdf manage 242.5 K 01 Oct 2012 - 17:22 HuiNian  
Topic revision: r11 - 26 Feb 2013, HuiNian
 

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