Metric Category: Appropriateness
The percentage of all lung resection procedures performed for lung cancers that were minimally invasive lung resections.
Minimally invasive surgery is a safe and effective option for the resection of non-small cell lung cancer. Minimally invasive techniques may allow for surgical resection in high risk patients for whom an open resection may be prohibitive. Minimally invasive lobectomies, performed through a video assisted thoracoscopic surgical approach, are associated with similar long-term survival, fewer postoperative complications, and shorter length of stay compared to open resection. MIS may also be associated with lower costs.
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).
The number of all lung resection procedures (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669) performed for lung cancers (ICD-10-CM codes: C34.1, C34.2, C34.3, C34.8, C34.9) by a given physician during the study period.
All patients who underwent a lung resection procedure for lung cancer.
1. Patients who underwent a pneumonectomy or bilobectomy (CPT code: 32670, 32671, 32482, 32488) on the day of the lung resection procedure.
2. Patients who had any history of lung 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.
|Minimal number of patients required in the denominator||Clinical threshold of what constitutes an outlier|
1. Bendixen M, Kronborg C, Jørgensen OD, Andersen C, Licht PB. Cost-utility analysis of minimally invasive surgery for lung cancer: a randomized controlled trial. Eur J Cardiothorac Surg. 2019 Oct 1;56(4):754-761. doi: 10.1093/ejcts/ezz064. PMID: 30838382.
2. Long H, Tan Q, Luo Q, Wang Z, Jiang G, Situ D, Lin Y, Su X, Liu Q, Rong T. Thoracoscopic Surgery Versus Thoracotomy for Lung Cancer: Short-Term Outcomes of a Randomized Trial. Ann Thorac Surg. 2018 Feb;105(2):386-392. doi: 10.1016/j.athoracsur.2017.08.045. Epub 2017