Study Design: 

This was an observational study.

Objectives: 

This study aims to determine the correlation between patient-reported outcomes (PROs) pulled from a national spine registry and physician ratings from physician review websites (PRWs).

Summary of Background Data: 

PRWs are frequently utilized by patients to make health care decisions; however, many PRWs appear to incorporate subjective experiences unrelated to a surgeon’s clinical performance into ratings. As such, their utility as a health care decision-making tool remains unclear.

Materials and Methods: 

This study evaluated 8834 patients from the Quality Outcomes Database (QOD) who underwent 1-level elective lumbar spine surgery. The lumbar module of QOD was queried to rank 124 surgeons using PROs (Oswestry Disability Index, EuroQOL, Numerical Rating Scale—back/leg pain, and patient satisfaction). The QOD PRO-ranking system was compared against PRWs including Healthgrades, Vitals, WebMD, and Google. The Spearman correlation coefficients, Kruskal-Wallis tests, and multiple linear regression models were used for statistical comparison. The primary outcome was the correlation between PRW scores and PROs.

Results: 

Surgeon PRO-derived ranking showed high intercorrelational congruence with coefficients between the 3 PROs (Oswestry Disability Index, EuroQOL, Numerical Rating Scale back/leg) ranging between 0.70 and 0.88. Low correlations were observed between PRO-derived rankings and PRWs, ranging from 0.23 to 0.37. Healthgrades performed most similarly to PRO-derived rankings, correlating best with patient satisfaction, though the correlation was low (ρ=0.37).

Conclusions: 

While PRWs are often used to evaluate surgeon competency, these results demonstrate they poorly correlate with a surgeon’s clinical ability measured by PROs. PRWs should be used with caution when making health care decisions by patients, payers, and administrators.

Level of Evidence: 

Level III.

中文翻译：

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脊柱外科医生评级：医生评论网站与患者报告结果的排名

学习规划： 

这是一项观察性研究。

目标： 

本研究旨在确定从国家脊柱登记处提取的患者报告结果 (PRO) 与医生评论网站 (PRW) 的医生评级之间的相关性。

背景数据摘要： 

PRW 经常被患者用来做出医疗保健决定；然而，许多 PRW 似乎将与外科医生临床表现无关的主观体验纳入评级中。因此，它们作为医疗保健决策工具的效用仍不清楚。

材料和方法： 

本研究评估了质量结果数据库 (QOD) 中接受 1 级选择性腰椎手术的 8834 名患者。QOD 的腰椎模块使用 PRO（Oswestry 残疾指数、EuroQOL、数字评定量表——背部/腿部疼痛和患者满意度）对 124 名外科医生进行了排名。QOD PRO 排名系统与 PRW 进行了比较，包括 Healthgrades、Vitals、WebMD 和 Google。使用 Spearman 相关系数、Kruskal-Wallis 检验和多元线性回归模型进行统计比较。主要结果是 PRW 评分和 PRO 之间的相关性。

结果： 

外科医生 PRO 得出的排名显示出高度的相关一致性，3 个 PRO（Oswestry 残疾指数、EuroQOL、前后/腿数字评定量表）之间的系数介于 0.70 和 0.88 之间。PRO 得出的排名与 PRW 之间的相关性较低，范围为 0.23 至 0.37。健康等级的表现与 PRO 衍生的排名最相似，与患者满意度的相关性最好，尽管相关性较低 (ρ=0.37)。

结论： 

虽然 PRW 通常用于评估外科医生的能力，但这些结果表明它们与 PRO 衡量的外科医生临床能力的相关性较差。患者、付款人和管理者在做出医疗保健决策时应谨慎使用 PRW。

证据级别： 

三级。