دورية أكاديمية
أعرض في EDS

Public Reporting of Heart Transplant Center Performance: Promoting Clarity or Causing Confusion?

التفاصيل البيبلوغرافية
العنوان: Public Reporting of Heart Transplant Center Performance: Promoting Clarity or Causing Confusion?
المؤلفون: Amdani S; Children's Institute Department of Heart, Vascular and Thoracic, Division of Cardiology and Cardiovascular Medicine, Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA. Electronic address: amdanis@ccf.org., Dewey EN; Center for Populations Health Research, Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA., Schold JD; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
المصدر: JACC. Heart failure [JACC Heart Fail] 2024 Jul; Vol. 12 (7), pp. 1274-1283. Date of Electronic Publication: 2024 Apr 10.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101598241 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-1787 (Electronic) Linking ISSN: 22131779 NLM ISO Abbreviation: JACC Heart Fail Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Elsevier, [2013]-
مواضيع طبية MeSH: Heart Transplantation*, Humans ; United States ; Registries ; Heart Failure/surgery ; Waiting Lists ; Public Reporting of Healthcare Data ; Adult ; Reproducibility of Results
مستخلص: Background: Transplant center report cards are publicly available and used by regulators, insurance payers, and importantly patients and families.
Objectives: In this study, the authors sought to evaluate the variability in reported public performance ratings of pediatric and adult heart transplant centers.
Methods: Program-specific reports from the Scientific Registry of Transplant Recipients from 2017-2021 were used to evaluate stability, volatility, and reliability of 3 publicly reported ratings: waitlist survival (WS), getting to a faster transplant (FT), and post-transplantation graft failure (GF).
Results: There were 112 adult and 55 pediatric centers. Over the study period, nearly all centers (98%) had at least 1 change in rating in at least 1 of the tiers. The average time to the first rating change of any magnitude was 12-18 months for all tiers and centers. For adult centers, the most volatile rating was WS (SD: 0.77), followed by GF (SD: 0.76) and then FT (SD: 0.57). For pediatric centers, the most volatile rating was WS (SD: 0.79), followed by both GF (SD: 0.66) and FT (SD: 0.68), which were equally volatile. All tiers except adult FT had an estimated Fleiss's kappa <0.20, indicating poor agreement/consistency across the study period. In addition, the intraclass correlation coefficient for all tiers was <0.50, indicating poor reliability.
Conclusions: The current 5-tier reporting of transplant center performance is highly volatile and has poor reliability and consistency. Given the unintended and significant negative consequences these reports can have, critical revision of these ratings is warranted.
Competing Interests: Funding Support and Author Disclosures The statistical analysis for this study was supported by the Center for Population Health Research, Cleveland Clinic. Dr Amdani is a site primary investigator for a multicenter study led by the University of Michigan (receives no salary support). Dr Schold is vice-chair of the United Network for Organ Sharing data advisory committee. Dr Dewey has reported that she has no relationships relevant to the contents of this paper to disclose.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: adult; heart transplant; pediatric; performance ratings; public reporting
تواريخ الأحداث: Date Created: 20240413 Date Completed: 20240703 Latest Revision: 20240703
رمز التحديث: 20240704
DOI: 10.1016/j.jchf.2024.01.021
PMID: 38613559
قاعدة البيانات: MEDLINE
الوصف
تدمد:2213-1787
DOI:10.1016/j.jchf.2024.01.021