Validity of Patient-Reported Complications: 6 Important Points

Can Patients Accurately Report Surgical Complications?

Yes. Two different studies from 2012 prove the validity of patient-reported complications. Not only are they valid, but they are also more accurate than administrative data commonly used.

The Two Studies

• Patient-reported complications after elective joint replacement surgery: are they correct?
• The Validity of Self-Report as a Technique for Measuring Short-Term Complications After Total Hip Arthroplasty in a Joint Replacement Registry

Here’s what you need to know

• Patient-reported complication tracking is more accurate than traditional methods.
• Don’t ask about ‘bleeding’- just don’t. It doesn’t work.
• Recall bias is real. Patients are not able to accurately report the month, or sometimes even year, of the complication, if more than 2 years have gone by.
• Traditional methods of complication tracking are less than ideal. The 2 standard methods for getting post-op complication information are through insurance billing data (aka ‘administrative claim data’), or the office and hospital records (aka institutional data). Hospital billers and orthopedic billers do things very differently, which makes administrative claim data an unreliable source. The variation between ‘hospitals’ and ‘orthopedic’ bill coding is huge.
• 65.6% of patients who suffer a post-op complication do not go back to the hospital/provider that did the original surgery. Just another reason why administrative claim data doesn’t work.
• When asking patients questions about ‘fractures’ and ‘infections’, be specific. The goal is to find out whether or not they had a surgical complication, not the details about their last sinus infection, which is what you will get if you don’t clarify upfront.

Validated patient-reported outcomes provide an opportunity for surgeons to accurately follow up on patients. To read more on complications, Check out Why Surgeons Need to Track Total Joint Complications. Collection of the outcomes the right way can provide unique opportunities for innovation/improvements to procedures.