Department of Surgery, University of Wisconsin-Madison, Madison, WI.
Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Surgery. 2023 Jan;173(1):215-225. doi: 10.1016/j.surg.2022.05.046. Epub 2022 Nov 17.
The Collaborative Endocrine Surgery Quality Improvement Program tracks thyroidectomy outcomes with self-reported data, whereas the National Surgical Quality Improvement Program uses professional abstractors. We compare completeness and predictive ability of these databases at a single-center and national level.
Data consistency in the Collaborative Endocrine Surgery Quality Improvement Program and the National Surgical Quality Improvement Program at a single institution (2013-2020) was evaluated using McNemar's test. At the national level, data from the Collaborative Endocrine Surgery Quality Improvement Program and the National Surgical Quality Improvement Program (2016-2019) were used to compare predictive capability for 4 outcomes within each data source: thyroidectomy-specific complication, systemic complication, readmission, and reoperation, as measured by area under curve.
In the single-center analysis, 66 cases were recorded in both the Collaborative Endocrine Surgery Quality Improvement Program and the National Surgical Quality Improvement Program. The reoperation variable had the most discrepancies (2 vs 0 in the National Surgical Quality Improvement Program versus the Collaborative Endocrine Surgery Quality Improvement Program, respectively; χ = 2.00, P = .16). At the national level, there were 24,942 cases in the National Surgical Quality Improvement Program and 17,666 cases in the Collaborative Endocrine Surgery Quality Improvement Program. In the National Surgical Quality Improvement Program, 30-day thyroidectomy-specific complication, systemic complication, readmission, and reoperation were 13.25%, 2.13%, 1.74%, and 1.39%, respectively, and in the Collaborative Endocrine Surgery Quality Improvement Program 7.27%, 1.95%, 1.64%, and 0.81%. The area under curve of the National Surgical Quality Improvement Program was higher for predicting readmission (0.721 [95% confidence interval 0.703-0.737] vs 0.613 [0.581-0.649]); the area under curve of the Collaborative Endocrine Surgery Quality Improvement Program was higher for thyroidectomy-specific complication (0.724 [0.708-0.737] vs 0.677 [0.667-0.687]) and reoperation (0.735 [0.692-0.775] vs 0.643 [0.611-0.673]). Overall, 3.44% vs 27.22% of values were missing for the National Surgical Quality Improvement Program and the Collaborative Endocrine Surgery Quality Improvement Program, respectively.
The Collaborative Endocrine Surgery Quality Improvement Program was more accurate in predicting thyroidectomy-specific complication and reoperation, underscoring its role in collecting granular, disease-specific variables. However, a higher proportion of data are missing. The National Surgical Quality Improvement Program infrastructure leads to more rigorous data capture, but the Collaborative Endocrine Surgery Quality Improvement Program is better at predicting thyroid-specific outcomes.
协作内分泌手术质量改进计划使用自我报告的数据来跟踪甲状腺切除术的结果，而国家手术质量改进计划则使用专业的摘要员。我们在单一中心和国家层面比较了这两个数据库的完整性和预测能力。
使用 McNemar 检验评估协作内分泌手术质量改进计划和国家手术质量改进计划在单一机构（2013-2020 年）中的数据一致性。在国家层面，使用协作内分泌手术质量改进计划和国家手术质量改进计划（2016-2019 年）的数据来比较每个数据源内 4 个结果的预测能力：甲状腺切除术特定并发症、全身并发症、再入院和再次手术，以曲线下面积衡量。
在单中心分析中，协作内分泌手术质量改进计划和国家手术质量改进计划中分别记录了 66 例病例。再次手术变量的差异最大（国家手术质量改进计划中为 2 例，协作内分泌手术质量改进计划中为 0 例；χ2=2.00，P=0.16）。在国家层面，国家手术质量改进计划中有 24942 例，协作内分泌手术质量改进计划中有 17666 例。在国家手术质量改进计划中，30 天甲状腺切除术特定并发症、全身并发症、再入院和再次手术的发生率分别为 13.25%、2.13%、1.74%和 1.39%，而在协作内分泌手术质量改进计划中分别为 7.27%、1.95%、1.64%和 0.81%。国家手术质量改进计划预测再入院的曲线下面积较高（0.721[95%置信区间 0.703-0.737] vs 0.613[0.581-0.649]）；协作内分泌手术质量改进计划预测甲状腺切除术特定并发症（0.724[0.708-0.737] vs 0.677[0.667-0.687]）和再次手术（0.735[0.692-0.775] vs 0.643[0.611-0.673]）的曲线下面积较高。总体而言，国家手术质量改进计划和协作内分泌手术质量改进计划分别有 3.44%和 27.22%的数据缺失。
协作内分泌手术质量改进计划在预测甲状腺切除术特定并发症和再次手术方面更为准确，这突出了其在收集精细、特定于疾病的变量方面的作用。然而，数据缺失的比例更高。国家手术质量改进计划的基础设施导致了更严格的数据采集，但协作内分泌手术质量改进计划更擅长预测甲状腺特定的结果。
