Online physician ratings fail to predict actual performance on measures of quality, value, and peer review. (8th September 2017)

• Record Type: Journal Article
• Authors: Daskivich, Timothy J; Houman, Justin; Fuller, Garth; Black, Jeanne T; Kim, Hyung L; Spiegel, Brennan
• Is Part Of: Journal of the American Medical Informatics Association. Volume 25:Number 4(2018)
• Page Start: 401
• Page End: 407
• Publication Date: 2017-09-08
• Subjects: quality of health care -- value of health care -- quality assessment; Medical informatics -- Periodicals; Information Services -- Periodicals; Medical Informatics -- Periodicals; Médecine -- Informatique -- Périodiques; Informatica; Geneeskunde; Informatique médicale; Computer network resources; Electronic journals; 610.285
• DOI: 10.1093/jamia/ocx083
• Languages: English
• ISSNs: 1067-5027

Abstract

Abstract: Objective: Patients use online consumer ratings to identify high-performing physicians, but it is unclear if ratings are valid measures of clinical performance. We sought to determine whether online ratings of specialist physicians from 5 platforms predict quality of care, value of care, and peer-assessed physician performance. Materials and Methods: We conducted an observational study of 78 physicians representing 8 medical and surgical specialties. We assessed the association of consumer ratings with specialty-specific performance scores (metrics including adherence to Choosing Wisely measures, 30-day readmissions, length of stay, and adjusted cost of care), primary care physician peer-review scores, and administrator peer-review scores. Results: Across ratings platforms, multivariable models showed no significant association between mean consumer ratings and specialty-specific performance scores (β-coefficient range, −0.04, 0.04), primary care physician scores (β-coefficient range, −0.01, 0.3), and administrator scores (β-coefficient range, −0.2, 0.1). There was no association between ratings and score subdomains addressing quality or value-based care. Among physicians in the lowest quartile of specialty-specific performance scores, only 5%–32% had consumer ratings in the lowest quartile across platforms. Ratings were consistent across platforms; a physician's score on one platform significantly predicted his/her score on another in 5 of 10 comparisons. Discussion: Online ratings of specialist physicians do not predict objective measures of quality of care or peer assessment of clinical performance. Scores are consistent across platforms, suggesting that they jointly measure a latent construct that is unrelated to performance. Conclusion: Online consumer ratings should not be used in isolation to select physicians, given their poor association with clinical performance.