A New Composite Measure for Assessing Surgical Performance

Surgeon scorecards can improve transparency and empower patients to become informed consumers, but previous efforts have fallen short. In response, we have developed the Colectomy Scorecard, a composite measure that utilizes high-quality clinical registry data to assess surgeon performance on colectomies across five domains: survival, morbidity avoidance, anastomotic leak avoidance, SSI bundle compliance, and utilization. We seek to compare our measure with ProPublica's Surgeon Scorecard for reliability and agreement in predicting future surgeon performance. Methods This study used surgeon-specific clinical registry data from the Michigan Surgical Quality Collaborative (MSQC) generated from elective colectomy cases over a 30-month time period (n = 7032). Our model utilized 34 weighted items across 5 domains to develop a composite score for each surgeon, and ratings were assigned to low-and high-performing outliers. Statistical reliability and testretest agreement were assessed using actual and simulated data sets. The analytic approach from ProPublica's Surgeon Scorecard was also applied utilizing MSQC data, and test-retest agreement was compared between the two models.