Room for “quality” improvement? Validating National Surgical Quality Improvement Program-Pediatric (NSQIP-P) appendectomy data
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In brief
In brief
Single-institution validation study comparing NSQIP-P registry data to a prospective research database for 250 pediatric appendectomies found significant discrepancies in disease severity classification and complication rates. Results question the accuracy and representativeness of NSQIP-P sampling methodology for quality benchmarking.
Written by the GCMD Library team from the article.
Introduction
Accurate data are essential for the validity of clinical registries. This study aimed to validate NSQIP-P data, assess representativeness, and evaluate risk-adjusted predictive ability at a single institution.
Methods
A prospective appendectomy-specific pediatric surgery research database (RD) maintained by clinical researchers was compared to the NSQIP-P data for appendectomies performed in 2016 at a tertiary children's hospital. NSQIP-P sampled data collected by trained surgical clinical reviewers (SCRs) were compared to matched RD patients. Both datasets used NSQIP-P definitions. Using χ2, datasets were compared by patient demographics, disease severity (simple vs. complicated), and outcomes.
Results
458 appendectomies for acute appendicitis were performed in 2016, of which 250 (55%) were abstracted by SCRs and matched to RD patients. Patient demographics were similar between datasets. Disease severity (NSQIP-P:50% complicated vs RD:31% complicated) and composite morbidity (NSQIP-P:6.0% vs RD:14.4%) were significantly different (both p