Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 1;275(1):115-120.
doi: 10.1097/SLA.0000000000003931.

How to Establish Benchmarks for Surgical Outcomes?: A Checklist Based on an International Expert Delphi Consensus

Daniel Gero  1 , Xavier Muller  1 , Roxane D Staiger  1 , Christian A Gutschow  1 , René Vonlanthen  1 , Marco Bueter  1 , Pierre-Alain Clavien  1 , Milo A Puhan  2
Affiliations

How to Establish Benchmarks for Surgical Outcomes?: A Checklist Based on an International Expert Delphi Consensus

Daniel Gero et al. Ann Surg. .

Abstract

Objective: To define a standardized methodology for establishing benchmarks for relevant outcomes in surgery.

Summary background data: Benchmarking is an established tool to improve quality in industry and economics, and is emerging in assessing outcome values in surgery. Despite a recent 10-step approach to identify such benchmark values, a standardized and more widely agreed-on approach is still lacking.

Methods: A multinational web-based Delphi survey with a focus on methodological requirements for establishing benchmarks for surgical outcomes was performed. Participants were selected among internationally renowned specialists in abdominal, vascular, and thoracic surgery. Consensus was defined as ≥70% agreement and results were used to develop a checklist to establish benchmarks in surgery.

Results: Forty-one surgical opinion leaders from 19 countries and 5 continents were involved. Experts' response rates were 98% and 80% in rounds 1 and 2, respectively. Upon completion of the final Delphi round, consensus was successfully achieved for 26 of 36 items covering the following areas: center eligibility, validation of databases, patient cohort selection, procedure selection, duration of follow-up, statistical analysis, and publication requirements regarding center-specific outcomes.

Conclusions: This multinational Delphi survey represents the first expert-led process for developing a standardized approach for establishing benchmarks for relevant outcome measures in surgery. The provided consensual checklist customizes the methodology of outcome reporting in surgery and thus improves reproducibility and comparability of data and should ultimately serve to improve quality of care.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Jensen AM, Crandall ML, Tepas JJ 3rd, et al. ACS NSQIP Surgical Risk Calculator: pilot analysis on feasibility in an academic safety net hospital. J Surg Res 2019; 236:124–128.
    1. Porter ME. What is value in health care? N Engl J Med 2010; 363:2477–2481.
    1. Porter ME, Larsson S, Lee TH. Standardizing patient outcomes measurement. N Engl J Med 2016; 374:504–506.
    1. Lee VS, Kawamoto K, Hess R, et al. Implementation of a value-driven outcomes program to identify high variability in clinical costs and outcomes and association with reduced cost and improved quality. JAMA 2016; 316:1061–1072.
    1. Tatarian T, Aggarwal R. Value-based surgical care: evidence for the enigma. Ann Surg 2018; 268:28–29.

Publication types