An SGO Commentary: U.S. News and World Report gynecologic oncology procedural ratings

Published in the March issue of Gynecologic Oncology, “An SGO Commentary: U.S. News and World Report gynecologic oncology procedural ratings,” discusses the implications of endometrial and ovarian cancer ratings on quality of gynecologic care.  

Publicly available measures of hospital performance that consider patient experience and health outcomes are important for patient decision-making and ensuring the integrity of healthcare practices.  Though imperative, evaluation of hospital performance is not necessarily straightforward. and ratings may not always accurately reflect the standard of care provided by a particular institution. “The U.S. News and World Report (USNWR) rankings are largely based on volume and reputation, which may not necessarily correlate with quality,” notes contributing author Sean Dowdy, MD, of Mayo Clinic. 

Continued research and collaboration are necessary to improve the accuracy of procedural ratings. “We need to focus on developing standardized quality metrics that truly reflect the quality of care provided to patients,” Dr. Dowdy explains. By prioritizing the development of evidence-based quality metrics, the gynecologic oncology community can better assess and improve the delivery of care across institutions. 

For example, the SGO commentary points out that the methodology for evaluating endometrial cancer specifically could be enhanced by incorporating minimally invasive surgery (MIS). “We feel that outcomes that matter to patients should be prioritized when hospitals are evaluated,” says Dr. Dowdy. “While surgical approach is only a single process measure for endometrial cancer care, the use of MIS has a large impact on short-term outcomes like overall recovery, hospital length of stay, function, and time to return to work.” 

Evaluating ovarian cancer surgery poses the challenge that improved long-term outcomes such as disease-free survival may occur at the expense of short-term outcomes. “Disease free survival is not a measure in databases available to USNWR, so there is potential to penalize institutions who aggressively cytoreduce,” Dr. Dowdy explains. 

The commentary also raises concerns about the potential impact on patient care. “Patients may interpret these rankings as a measure of quality, leading them to seek care at institutions solely based on their ranking rather than considering other important factors,” says Dr. Dowdy. This underscores the importance of educating patients about the limitations of healthcare rankings and encouraging them to engage in informed decision-making when selecting a healthcare provider. 

SGO also calls on the USNWR to include subject matter experts in annual discussions to update the methodology for procedure and condition ratings as best practices evolve. “Only providers caring for patients with gynecologic malignancies understand best practices and the potential for unintended consequences when quality is incorrectly measured in any given specialty,” Dr. Dowdy states.  By improving the accuracy and fairness of performance metrics, gynecologic oncologists can assess and continuously improve the global care they provide to patients, and patients can be better informed about the quality of care they can expect to receive at hospitals across the United States.