OrthoQCDR

Brief description of the measure:

The change in a validated knee measure score will be used as a performance measure for surgeons performing knee arthroscopy for meniscal repair. Two measures will be created and reported by each surgeon. Surgeons will report the average knee measure change score for patients treated during the observation period. In addition, surgeons will produce a risk-adjusted knee measure change score ratio by dividing the average patient knee measure change score by the average predicted patient knee measure change score calculated using the formula provided. These measures will serve as sports medicine performance measures at the eligible surgeon level.

Eligible validated knee patient reported outcome measures include: : International Knee Documental Committee (IKDC) Subjective Knee Form (Pedi-IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), Single Assessment Numeric Evaluation (SANE)

Defining the population:
CPT-4 procedure codes will be used to identify patients who received meniscal repair for meniscal repair.

Meniscal repair during the reporting period CPT-4 Codes: 29882, 29883. Excluding concurrent procedures including Anterior Cruciate Ligament Reconstruction (29888).

Surgeons who performed a minimum of 25 meniscal repair procedures a year will be eligible to submit this measure.
Time period for data collection and reporting:
This measure will be calculated using all patients who underwent meniscal repair during the observation period. Patients receiving meniscal repair during the period 18 to 6 months prior to the reporting data will be included in the analysis to ensure 6 months of patient-reported follow-up in the knee measure score are available.

Measures:
Two surgeon-level performance measures will be reported. The unadjusted measure will be the average 6-month knee measure change score across all meniscal repair patients treated by the surgeon. The adjusted measure will be the ratio of the average knee measure change score divided by the average predicted knee measure change score for all patients treated by the surgeon.
Unadjusted measure: Average Knee Measure Change Score

NUMERATOR: Sum of knee measure change scores from pre-surgery to 6-months post-surgery across all meniscal repair patients in the denominator.

DENOMINATOR: The number of all patients who received meniscal repair during the observation window from the surgeon.

Type of score: Validated knee measure change score average
Risk adjusted measure: Knee Measure Change Score Ratio

NUMERATOR: Average 6-month knee measure change score for all meniscal repair patients treated by surgeon.

DENOMINATOR: Average predicted 6-month knee measure change score for all meniscal repair patients treated by surgeon.

Risk adjustment methods and variables:
The predicted 6-month knee measure change scores are estimated for each patient using the Center for Effectiveness Research in Orthopaedics’ (CERortho) risk adjustment regression model that includes the following patient variables: age, gender, BMI, smoking status, comorbidities, worker’s compensation status, history or prior knee surgery, sport participation/activity level, osteoarthritis, concomitant chondral injury, the baseline knee measure, and baseline measures of pain, knee function, and quality of life.[2-4]

Variables included in the current CERortho risk model are based on information in available databases. CERortho plans to constantly update these specified variables based on input from evaluated surgeons and specialty organizations. Appendix A contains the list of baseline concepts from peer-reviewed literature that are thought to affect outcomes of treatment and will be candidates for future inclusion in the model.