The Effect of Individualized Surgeon Comparative Feedback on Arthroplasty Outcomes: An Interrupted Time Series Analysis

The impact of providing comparative individual surgeon performance feedback on outcomes has received little attention. The objective was to determine whether repeated distribution and discussion among orthopedic surgeons of their own customized comparative surgeon performance feedback concerning Patient-Reported Outcome Measures, implant costs, and procedure time had an impact on these same outcomes, surgeon rating, and procedure time. This quality improvement initiative utilized a single-group interrupted time series design evaluating pre- to postexposure to surgeon feedback reports for surgeries in 2236 total knee arthroplasty and 1582 total hip arthroplasty patients to assess differences in implant costs, procedure time, change in patient-reported Oxford Knee/Hip Scores, surgeon rating after surgery, and shared decision after surgery. There was no consistent evidence that the receipt and discussion of comparative surgeon performance feedback by surgeons resulted in improvement in the outcomes considered.