Potential patient harms from misinterpretation of publically reported surgical outcomes

Niranjan J. Sathianathen, Jacob Albersheim-Carter, Lucas Labine, Brett Watson, Badrinath R. Konety, Christopher J. Weight

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


OBJECTIVE: To determine how the general public interprets surgical complication rates presented from a publicly available online surgical-rating website.

SUBJECTS AND METHODS: An in-person electronic survey was administered at the local State Fair to a convenience sample. Participants were presented with a representative output from an online surgeon-rating website and were asked to choose from three statistically equivalent surgeons for a hypothetical medical decision. We then suggested that their insurance company would only cover one surgeon and probed their willingness to pay to switch surgeons for a small chance of lowering the risk of a complication (0.7%, 95% confidence interval [CI] -8.1% to 9.5%, P = 0.9). We quantified the characteristics of those willing to switch, the degree of misinterpretation, and the subsequent potential patient harms.

RESULTS: There were 343 completed responses. When presented with a hypothetical healthcare decision, most participants (n = 209, 61%) said they were willing to pay out-of-pocket expenses to switch to a statistically equivalent surgeon. Those who were willing to pay to switch surgeons were more likely to be older (odds ratio [OR] 1.02, 95% CI 1.01-1.03), poorer (OR 1.81, 95% CI 1.07-3.11), previously had cancer (OR 5.9, 95% CI 1.9-25), and misinterpreted the data (OR 3.03, 95% CI 1.87-4.96). Those who were willing to pay out-of-pocket expenses were more inaccurate in their estimation of surgeon complication rates (mean estimate 34.0% vs 8.9%, P < 0.001, correct rate = 3.6%), and on average were willing to pay $6 494 (95% CI 4 108-8 880).

CONCLUSION: Understanding of a publicly reported surgical-complication website is often prone to misinterpretation by the general population and may lead to patient harm from a financial aspect.

Original languageEnglish (US)
Pages (from-to)180-186
Number of pages7
JournalBJU International
Issue number1
StatePublished - Jan 2019

Bibliographical note

Funding Information:
Badrinath R. Konety has relationships with Genomic Health, Roche/Genentech, Photocure MDx Health, Bristol Myers Squibb, Pacific Edge Diagnostics, NxThera, Journal of Urology, Urologic Oncology and has received grant funding from National Institutes of Health and Depatment of Defense.

Publisher Copyright:
© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd


  • data interpretation
  • health literacy
  • information literacy
  • outcomes research
  • postoperative complications
  • Decision Making
  • Economic Status
  • Surgeons/standards
  • Age Factors
  • Risk Assessment
  • Humans
  • Middle Aged
  • Postoperative Complications/etiology
  • Male
  • Comprehension
  • Health Expenditures
  • Insurance Coverage
  • Patient Harm
  • Surgical Procedures, Operative/adverse effects
  • Adult
  • Female
  • Surveys and Questionnaires
  • Internet
  • Insurance, Health

PubMed: MeSH publication types

  • Journal Article


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