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Benchmarking Performance in Pancreatic Surgery: a Systematic Review of Published Quality Metrics

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Pancreatic surgery is performed in relatively few centres. There are validated quality benchmarks for pancreatic surgery, although it remains unclear how published benchmarks compare with each other. This study aimed to systematically review published literature to summarise metrics that define quality benchmarks for pancreatic surgery.

Method

A search of MEDLINE, EMBASE and CENTRAL was undertaken until June 2019. Articles that developed or validated published quality benchmarks for pancreatic surgery were included. Benchmarks were classified into three domains using the Donabedian framework, and their quality assessed using the AIRE Instrument.

Results

Nineteen studies included 55 quality metrics, of which 8 developed new metrics, and 11 studies validated previously published metrics. The methodology of metric development was either expert opinion-driven or data-driven. All metrics demonstrated moderate quality scores. There was partial agreement in some metrics (e.g. < 10 h total operative duration), but lack of consensus for most others (e.g. lymph node yield ≥ 10, ≥ 12, ≥ 15, ≥ 16). No metrics related to patient reported outcomes.

Conclusions

Published quality benchmarks for pancreatic surgery predominantly arise from eight studies, with heterogeneity in how the metrics were developed. There was not consensus for all metrics. Metrics need to be reviewed as new data emerge, technologies develop and opinions change.

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Authors and Affiliations

  1. Department of Surgery, University of Auckland, Auckland, New Zealand

    Cindy Ou, Michaela Rektorysova, John A. Windsor & Benjamin P. T. Loveday

  2. Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia

    Bushra Othman & Benjamin P. T. Loveday

  3. Department of Surgery, Auckland District Health Board, Auckland, New Zealand

    John A. Windsor

  4. HPB and Transplant Unit, Freeman Hospital, Newcastle, Upon Tyne, UK

    Sanjay Pandanaboyana

  5. Department of Surgery, Royal Melbourne Hospital, Melbourne, Australia

    Benjamin P. T. Loveday

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  1. Cindy Ou
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Correspondence to Benjamin P. T. Loveday.

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Ou, C., Rektorysova, M., Othman, B. et al. Benchmarking Performance in Pancreatic Surgery: a Systematic Review of Published Quality Metrics. J Gastrointest Surg 25, 834–842 (2021). https://doi.org/10.1007/s11605-020-04827-9

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  • DOI: https://doi.org/10.1007/s11605-020-04827-9

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