Abstract
Background
Despite potential concerns regarding their validity, physician-rating websites continue to grow in number and utilization and feature prominently on major search engines, potentially affecting patient decision-making regarding physician selection.
Questions/Purposes
We sought to determine whether patient ratings on public physician-rating websites correlate with surgeon-specific outcomes for high-volume total knee replacement (TKR) surgeons in New York State (NYS) from 2010 to 2012.
Methods
Online patient ratings were compared to surgeon-specific outcomes from the Statewide Planning and Research Cooperative System (SPARCS) database from the NYS Department of Health. For each surgeon, we determined the infection rate, re-admission rate, and revision surgery rate within the study period, as well as the mean inpatient length of stay, for TKR from the SPARCS database. Online ratings were collected from two physician-rating websites (Vitals.com and HealthGrades.com).
Results
One hundred seventy-four high-volume TKR surgeons were identified in NYS from 2010 to 2012. The mean rates of in-hospital infection, 90-day infection, 30-day re-admission, 90-day re-admission, and revision surgery were 0.25, 1.00, 4.89, 8.43, and 1.31%, respectively. The mean number of ratings for individual surgeons on HealthGrades.com and Vitals.com were 24.0 (range: 0 to 109) and 19.3 (range: 0 to 114), respectively, and mean overall ratings were 4.2 and 4.1 (out of 5) stars, respectively. As with online patient ratings of individual surgeons, variability was observed in the total adverse event rate distribution for individual surgeons. Despite sufficient variability in both online patient rating and surgeon-specific outcomes for high-volume TKR surgeons in NYS, no correlation was observed.
Conclusion
There was no correlation between surgeon-specific TKR outcome measures and online patient ratings. We therefore advise that patients exert caution when interpreting ratings on these websites.
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Conflict of Interest
Samir K. Trehan, MD, Ting J. Pan, MPH, and Aaron Daluiski, MD, declare that they have no conflicts of interest. Robert Marx, MD, reports the following relationships outside this work: research support from DePuy Synthes; book royalties from Springer and Demos Health; and editorial board memberships with Journal of Bone and Joint Surgery, Evidence-Based Orthopedics, and HSS Journal; he also is chairperson of the newsletter committee of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine. Michael B. Cross, MD, reports the following relationships outside this work: Acelity (paid consultant, surgical advisory board), Exactech (paid consultant), Intellijoint Surgical (paid consultant, stock options), Link Orthopaedics (paid consultant), Smith and Nephew (paid consultant, research support), Theravance Biopharma (paid consultant), Zimmer Biomet (paid consultant); he also reports editorial board membership with Bone and Joint 360, Journal of Orthopaedics and Traumatology, and Techniques in Orthopaedics. Joseph T. Nguyen, MPH, and Stephen Lyman, PhD, report receiving funds from the Clinical Translational Science Center (CTSC), National Center for Advancing Translational Sciences (NCATS), grant no. UL1-RR024996. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NCATS, based in Rockville, MD.
Human/Animal Rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.
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Informed consent was waived from all patients for being included in this study.
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Level of Evidence: Level III: Retrospective, Cohort Study
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Trehan, S.K., Nguyen, J.T., Marx, R. et al. Online Patient Ratings Are Not Correlated with Total Knee Replacement Surgeon–Specific Outcomes. HSS Jrnl 14, 177–180 (2018). https://doi.org/10.1007/s11420-017-9600-6
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DOI: https://doi.org/10.1007/s11420-017-9600-6