Metric 12

Use of Minimally Invasive Lung Surgery for Lung Cancer

Metric Category: Appropriateness

About the Metric

Definition

The percentage of all lung and thymus resection procedures performed that were minimally invasive.

Background

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.

Metric Ratings

Evidence
5/5
Expert Consensus
5/5
Clinician Buy-in
4/5
Economic Impact
3.5/5
Reduction in Avoidable Harm
4.5/5
Applicability to Medicare Data
5/5
Applicability to Medicaid
4/5

Applicable to EHR Data?

Requires Pharmacy Data?

How It Works

Numerator

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)

Denominator

The number of all lung resection procedures (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669) or thymus resection procedures (CPT codes: 60521, 60522) by a given physician during the study period.

Inclusion Criteria

All patients who underwent a lung or thymus resection procedure.

Exclusion Criteria

1. If a look back period of data is available prior to the study period, exclude patients who had any history of a lung or thymus resection (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669, 32670, 32671, 32482, 32488) prior to the study period.

Attribution

Surgeon performing the procedure

GAM Thresholds™

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.

  • Sample Size: 11+

    This threshold applies to a clinician with a minimum of 11 cases.

  • Outlier: <30%

    This constitutes the clinical threshold for an "outlier".

Cases Outlier
11+
<30%