Metric Category: Appropriateness
The percentage of all lung and thymus resection procedures performed that were minimally invasive.
Minimally Invasive surgery (MIS) is a safe and effective option for lung and thymus surgery. Minimally invasive lobectomy and thymectomy procedures performed through a video-assisted thoracoscopic surgical approach are associated with fewer postoperative complications and a shorter length of stay compared to open resection. Minimally invasive surgeries may also be associated with lower costs, a shorter hospital stay, reduced opiate use, and an overall quicker recovery.
Applicable to EHR Data?
Requires Pharmacy Data?
The number of procedures from the denominator that were minimally invasive lung resection procedures (CPT codes: 32663, 32666, 32667, 32668, 32669, 32670, 32671) or minimally invasive thymus resection procedures (CPT codes: 32673)
The number of all lung resection procedures (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669, 32670, 23671) or thymus resection procedures (CPT codes: 60521, 60522, 23673) by a given physician during the study period.
All patients who underwent a lung or thymus resection procedure.
1. If a look back period of data is available prior to the study period, exclude patients who had any history of a lung (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669, 32670, 23671) or thymus resection procedure (CPT codes: 60521, 60522, 23673)
The surgeon performing the procedure.
GAM establishes clinical thresholds using the input of key physician leaders within a specialty and the GAM clinical team. GAM utilizes an elaborate consensus building process with final adjudication by our leadership team.
|Cases||Pattern of Concern||Outlier|
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2. Long H, Tan Q, Luo Q, et al. Thoracoscopic surgery versus thoracotomy for lung cancer: short-term outcomes of a randomized trial. Ann Thorac Surg. 2018;105(2):386-392. doi: 10.1016/j.athoracsur.2017.08.045. https://www.sciencedirect.com/science/article/abs/pii/S0003497517311918
3. Cooper MA, Segev DL, Makary MA. Hospital level under-utilization of minimally invasive surgery in the United States: retrospective review. BMJ. 2014;349:g4198. doi: https://doi.org/10.1136/bmj.g4198. https://www.bmj.com/content/349/bmj.g4198
4. Friedant AJ, Handorf EA, Su S, Scott WJ. Minimally invasive versus open thymectomy for thymic malignancies: systematic review and meta-analysis. J Thorac Oncol. 2016;11(1):30-8. doi: 10.1016/j.jtho.2015.08.004. https://pubmed.ncbi.nlm.nih.gov/26762737/
5. Boffa DJ, Kosinski AS, Furnary AP, et al. Minimally invasive lung cancer surgery performed by thoracic surgeons as effective as thoracotomy. J Clin Oncolo. 2018; 36(23):2378-2385. doi: 10.1200/JCO.2018.77.8977. https://pubmed.ncbi.nlm.nih.gov/29791289/
6. Manerikar A, Querrey M, Cerier E, et al. Comparative effectiveness of surgical approaches for lung cancer. Journal of Surgical Research. 2021;263:274-284. https://doi.org/10.1016/j.jss.2020.10.020. https://www.sciencedirect.com/science/article/abs/pii/S0022480420307563