Success in Spine Care: The Proof Is in the Measurements, Part III

摘要

In the first Science in Spine article for this series, we covered the ABCs of spine measurements, including (A) baseline factors, (B) treatment factors, and (C) perioperative/immediate posttreatment events. Without these considerations, it is difficult to make much sense of the outcomes we measure. In the second article in this series, we discussed the importance of identifying and measuring “clinically important” outcomes. Selecting clinically important outcomes is a challenging task; however, much thought should go into this decision and it should be tied directly to project objectives and desired claims. Given the increasing costs of health care, health care purchasers, payers, and hospital systems are adopting the concept of value-based purchasing, which is having a significant impact on low-quality providers and hospitals. Quality rankings are now being publicly reported. True measures of quality, such as surgical complications and validated patient-reported outcomes (PROs) of effectiveness, may be burdensome and costly to collect. Therefore, the selection of the appropriate measures should be done judiciously, with an understanding of what makes a quality measure while considering the burden and the yield of such selection. In this final article of this series, we will discuss the selection of PROs, the anatomy of a quality outcome measure, and the importance of understanding why you are collecting the measures you are.