Spine QOD and the American Spine Registry
Launched in February 2012, the National Neurosurgery Quality & Outcomes Database (N2QOD) was aimed at meeting the neurosurgical need to measure and promote quality care. A collaboration with national stakeholders, this unprecedented program expanded beyond the boundaries of its name, rebranding in 2017 as the Quality Outcomes Database (QOD). Participants in QOD included U.S. surgeons, practice groups and hospital systems who would contribute to and access aggregate quality and outcomes data through this centralized, nationally-coordinated quality program.
In an effort to broaden the scope of the registry and foster continued cross-specialty partnerships, on August 19, the American Association of Neurological Surgeons (AANS) and the American Academy of Orthopaedic Surgeons (AAOS) entered into an agreement to develop a cooperative spine surgery registry program called the American Spine Registry (ASR). The ASR facilitates the participation of all North American Spine surgeons on a common data collection platform. This type of collaborative effort is part of a broader AANS strategic initiative to develop intelligent cross-specialty partnerships to ensure the sustainability and relevance of our data programs. Cross-specialty partnerships such as the ASR have long been encouraged by a variety of health care stakeholders, including CMS, private insurers, the medical device industry, many large health care delivery institutions, the Joint Commission and patient advocacy groups.
The ASR leverages the operational experience of AAOS in administering the American Joint Replacement Registry in over 1,000 clinical sites, with the quality science expertise developed within the Neuropoint Alliance (NPA) in coordinating the QOD Spine Program, the largest spine registry program in the United States.
Since spine surgery is performed by both neurosurgeons and orthopedic surgeons, the development of a common data platform fuels the creation of a consistent, reliable quality information source for all major stakeholders, including physicians, patients, payors, regulatory groups and industry.
The ASR registry launched in January 2020 and efforts were focused on converting existing QOD sites to the new registry. As of June 2020, there were 117 total ASR participants, representing 75 contracts (61 from QOD, 14 non-QOD).
By the end of calendar year 2019, the QOD spine registries had over 105 contracted centers across the country with more than 150,000 patients enrolled across 98 active centers.
The NPA would like to thank the following centers for their participation in the QOD registries over the years.
QOD Tumor
In February 2019, the NPA launched a pilot of the long-awaited QOD Tumor Registry. Initially developed in the spring of 2012 by members of the Tumor Section Outcomes Committee, including Mark Linskey, MD, FAANS; Fred Barker, MD, FAANS, FACS; Elana Farace, PhD; Steve Kalkanis, MD, FAANS; Ian Parney, MD, PhD, FAANS; Jason Sheehan MD, PhD, FAANS; and Andrew Sloan MD, FAANS, the tumor registry was presented to the QOD Scientific Committee for development and was met with support.
The tumor registry was revised over the years, leading into 2018 when the NPA reached out to members of the AANS/CNS Section on Tumors, including Steve Kalkanis, MD, FAANS and Manish Aghi, MD, PhD, FAANS, about proceeding with a pilot test of the tumor registry. A QOD Tumor Working Group was established to perform a secondary review of the tumor registry outline and prepare the registry for pilot testing.
Member of the QOD Tumor Working Group included Anthony Asher, MD, FAANS; Mohamad Bydon, MD, FAANS; Robert Harbaugh, MD, FAANS, Steve Kalkanis, MD, FAANS; Jack Knightly, MD, FAANS; Debraj Mukherjee, MD, MPH; Yaron Moshel, MD, FAANS; Marie Roguski, MD; and Brad Zacharia, MD, FAANS. The registry was further refined based on recommendations by the QOD Tumor Working Group and was renamed the QOD Simplified Tumor Registry (STR). Build of the STR began in November 2018, followed by launch of the pilot in February 2019.
The QOD STR pilot was initially scheduled to run 6-12 months with a March 31, 2020, end date. The pilot was extended in March 2020 and has been ongoing, with eight pilot centers continuing to enroll patients. Preliminary findings from the registry were presented in AANS Virtual 2020.
The NPA, along with the QOD Coordinating Center at Vanderbilt University Medical Center, managed ongoing operations of the pilot with oversight from QOD Vice Director Mohamad Bydon, MD, FAANS, and Debraj Mukherjee, MD, FAANS. In May 2020 and after a competitive bid process, the NPA selected the Mayo Clinic as the Coordinating Center for the QOD Tumor Registry. The NPA, Vanderbilt University Medical Center and the Mayo Clinic have been focused on closing the pilot and transitioning the registry to Mayo Clinic. The NPA anticipates a September 2020 launch of the full registry.
The QOD Simplified Tumor Registry follows patients receiving surgery for intracranial metastases, primary meningeal, high-grade/malignant, low-grade/benign, pituitary and other intracranial tumors. Demographics, ICD-10 and CPT codes, comorbidities, hospital stay, 30-day readmission rates, post-operative complications, recurrent surgery and patient-reported outcomes (PROs) are collected.
The NPA would like to thank the following pilot centers for their continued participation in the QOD Tumor Registry:
- Atlantic Neurosurgical Specialists, Surgeon Champion: John Jack Knightly, MD, FAANS
- Carolina Neurosurgery & Spine Associates, Surgeon Champion: Anthony Asher, MD, FAANS
- Henry Ford Health System, Surgeon Champion: Steve Kalkanis, MD, FAANS
- Maine Medical Partners, Surgeon Champion: Anand Rughani, MD, FAANS
- Mayfield Clinic, Surgeon Champion: Andrew Ringer, MD, FAANS
- Tufts Medical Center, Surgeon Champion: Carl Heilman, MD, FAANS
- St. Luke’s University Hospital & Health Network, Surgeon Champion: Hugh Moulding, MD, FAANS
- Saint Luke’s Hospital, Surgeon Champion: Cheerag Upadhyaya, MD, FAANS