Development and Validation of a Novel Literature-Based Method to Identify Disparity-Sensitive Surgical Quality...

Area of Science:

• Healthcare Quality
• Surgical Care Disparities
• Health Metrics

Background:

• Surgical care disparities hinder equitable, high-quality treatment delivery.
• Quantifiable metrics are crucial for pinpointing areas needing intervention in surgical care.
• The Metrics for Equitable Access and Care in Surgery (MEASUR) group developed a literature-based Disparity-Sensitive Score (DSS) system.

Purpose of the Study:

• To assess the alignment between the MEASUR DSS and expert panel ratings of surgical quality metrics.
• To determine the disparity sensitivity of surgical quality metrics using a novel scoring system.
• To compare a literature-based metric selection method with consensus-based approaches.

Main Methods:

• 534 surgical metrics were scored using Disparity-Sensitive Score (DSS) criteria by MEASUR co-investigators.
• An expert advisory panel (EAP) rated the disparity sensitivity of these metrics.
• Agreement between the DSS and EAP ratings was evaluated using the Bland-Altman method.

Main Results:

• The Disparity-Sensitive Score (DSS) showed high agreement with expert importance (96.8%) and validity (94.6%) ratings.
• The DSS results were comparable to subjective expert ratings (94.4%).
• The literature-based DSS method successfully identified disparity-sensitive surgical metrics.

Conclusions:

• The MEASUR Disparity-Sensitive Score (DSS) system effectively identifies disparity-sensitive surgical quality metrics from existing literature.
• This literature-based metric selection method shows comparable results to consensus-based Delphi methods.
• In fields with substantial literature, composite scores can potentially replace the need for consensus panels in selecting quality metrics.