US News And World Report Research Articles

Clinical adjudication of outpatient complications reported in the U.S. News and World Report’s urology rankings

ObjectivesTo assess whether the US News and World Report (USNWR) Urology specialty ranking methodology accurately captures and classifies complications following elective outpatient urology procedures. MethodsWe conducted electronic health record chart review of n=80 elective, outpatient urology procedures with complications from 2019-2023 across four hospitals in our integrated US health system. We used the Solventum AM-PPC software and USNWR methodology to determine eligibility and measure complications. For each complication identified by the software, we assessed: 1.) Whether the procedure was performed by a urologist; 2.) Whether the adjudicator agreed with the complication type; and 3.) Whether the complication was a clinically-related sequelae of the index procedure. We reported Clavien-Dindo severity of each complication. Results: Our adjudication agreed on complication type in 62/80 (78%) complications, and 64/80 (80%) complications were clinically related to the index urology procedure. Combined, 57/80 (71%) complications were concordant on both complication type and clinical relatedness. However, 38/80 (48%) index procedures were conducted by interventional radiologists, not urologists. Furthermore, 11/80 (13.8%) complications were false positive urinary tract infections (UTIs). ConclusionsThe USNWR methodology for elective outpatient urology procedural complications showed reasonable clinical validity but detected several false positive UTIs. Further, USNWR should clarify the extent to which procedures performed by interventional radiologists belong in urology rankings.

Clinical Outcomes, Costs, and Value of Surgery Among Older Patients with Colon Cancer at US News and World Report Ranked Versus Unranked Hospitals.

US News and World Report (USNWR) hospital rankings influence patient choice of hospital, but their association with surgical outcomes remains ill-defined. We sought to characterize clinical outcomes and costs of surgery for colon cancer among USNWR top ranked and unranked hospitals. Using Medicare Standard Analytic Files, patients aged ≥65 years undergoing surgery for colon cancer were identified. Hospitals were categorized as 'ranked' or 'unranked' based on USNWR cancer hospital rankings. One-to-one matching was performed between patients treated at ranked and unranked hospitals, and clinical outcomes and costs of surgery were compared. Among 50 ranked and 2522 unranked hospitals, 13,650 patient pairs were compared. Overall, 30-day mortality was 2.13% in ranked hospitals versus 3.68% in unranked hospitals (p<0.0001), and the overall paired cost difference was $8159 (p<0.0001). As patient risk increased, 30-day mortality differences became larger, with the ranked hospitals having 30-day mortality of 7.59% versus 11.84% for unranked hospitals among the highest-risk patients (p<0.0001). Overall paired cost differences also increased with increasing patient risk, with cost of care being $72,229 for ranked hospitals versus $56,512 for unranked hospitals among the highest-risk patients (difference = $14,394; p=0.02). The difference in cost per 1% reduction in 30-day mortality was $9009 (95% confidence interval [CI] $6422-$11,597) for lowest-risk patients, which dropped to $3387 (95% CI $2656-$4119) for highest-risk patients (p<0.0001). Treatment at USNWR-ranked hospitals, particularly for higher-risk patients, was associated with better outcomes but higher-cost care. The benefit of being treated at highly ranked USNWR hospitals was most pronounced among high-risk patients.

Social Media Use by American Association of Hip and Knee Surgeons Members.

Social media offers physicians marketing opportunities previously unavailable. We sought to evaluate social media use and its correlation with public rankings among Association of Hip and Knee Surgeons members. A list of members and demographics was collected. Social media sites were reviewed for each surgeon, and a score was calculated based on active use. The US News and World Report (NWR) was used to determine rating and number of reviews. The Spearman correlation coefficient and independent samples t-test were used to measure correlation and compare means between the groups, respectively. A total of 2436 members were analyzed. The average social media score was 4.14. The average US NWR score was 4.25. A strong correlation was observed between social media and US NWR scores (r = 0.74, P < 0.01) but not with the number of reviews (r = 0.40, P = 0.17). A strong association with US NWR rating (r = 0.74, P = 0.04) and a weak correlation with the total number of reviews (r = 0.61, P = 0.06) were found. Social media use is correlated with US NWR scores. Association of Hip and Knee Surgeons members may be underutilizing social media for the promotion of their practices. Future studies are needed to evaluate whether it affects patient volume and outcomes.

The Oral Medicine workforce and impact on access to care in the United States

The objective of this study was to characterize the current oral medicine (OM) workforce by examining the distribution of OM diplomates (OMDs) across the Unites States and to determine the need for expanding access to care. The OMD access was calculated based on the OMDs per 10,000 state population from the 2020 US Census data as well as their distance from state capitals and most populated cities. OMD penetrance in hospitals and cancer centers was assessed at National Cancer Care Network (NCCN) cancer centers, and Best Hospitals as reported in the 2022 US News and World Report (USNWR). OMDs are present in 64% of the states with an uneven geographic distribution. Primary workplaces included dental schools (47%), hospitals (30%), and private practices (19%). Of the OMDs in private practice, 57% limited their practice to OM. OMDs were noted at 28% of NCCN cancer centers, 30% of USNWR Best Hospitals for Cancer, and 20% of USNWR Best Hospitals. There is low density and uneven distribution of OMDs with approximately one-third of the population without access to an OMD in their state, thus limiting access to care. This suggests both vast opportunities for growth and expansion of OM, as well as challenges in developing and training the necessary workforce. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).

Reducing time from presentation to surgical intervention for testicular torsion: implementation of a quality improvement protocol

IntroductionTimely surgical intervention for patients with testicular torsion is a quality benchmark set by the U.S. News and World Report (USNWR) for pediatric urology. In this study, we describe and evaluate a quality improvement initiative to reduce the time to surgical intervention for testicular torsion at a single institution through the implementation of a clinical care pathway called “code torsion.”MethodsData abstraction was performed through retrospective chart review to assess process measures. Patients &amp;lt;21 years old with testicular torsion requiring surgical intervention were included. The clinical protocol “code torsion” was created by a multidisciplinary quality improvement workgroup with the primary goal of reducing the time from emergency department presentation to surgical intervention for testicular torsion. “Code torsion” was implemented in October 2021, which was assessed in addition to subsequent interventions through plan–do–study–act (PDSA) cycles.ResultsA total of 30 patients were identified prior to “code torsion” implementation and 14 thereafter. The mean time from triage to operating room (OR) was 228 min prior to “code torsion” compared with 180 min after protocol implementation (p = 0.047). The proportion of cases that had surgical intervention within the 4-h USNWR metric increased from 63% pre-protocol to 93% post-protocol (p = 0.07). Of the patients, 40% required orchiectomy prior to “code torsion” compared with 29% after implementation (p = 0.5). Patients requiring orchiectomy had a significantly longer time from symptom onset to surgical intervention (87 vs. 9.8 h, p &amp;lt; 0.001).ConclusionImplementation of the protocol “code torsion” was successful in reducing the time from presentation to surgical intervention for testicular torsion. The rates of testicular salvage did not differ after “code torsion” implementation and were instead found to be dependent on the total ischemia time.

Resources Utilized by Otolaryngology Fellowship Directors When Determining Reputations of Residency Programs.

Residency program reputation is consistently reported as an important factor by fellowship directors when considering applicants. This study sets out to determine resources fellowship directors rely on when determining residency program reputation. Cross-sectional study. Using an anonymous online survey of all 2022 Otolaryngology (OHNS) fellowship program directors. The 13-question survey sought to assess fellowship director's perspectives and resource utilization when determining residency program reputation. Representing all OHNS fellowship program directors and co-directors (N = 287), 103 responded to our survey, response rate 35.9%. Most participants reported that residency reputation was important for fellowship candidacy. On a Likert scale of 1 to 5, 1 being most important and 5 being not important, personal knowledge of the residency program (2.03 out of 5) and program faculty/mentor reputation (2.09 out of 5) were the most important factors cited. 63% were unfamiliar with the survey methodology of Doximity Residency Navigator (DRN), while 53% contributed to DRN by filling out surveys. Nearly all fellowship directors (N = 100, 97%) reported their rank list was not influenced by DRN. Most fellowship directors reported that US News and World Report (USNWR) and DRN were neither consistent nor inconsistent with their perceptions of residency reputations (38% and 56%, respectively), suggesting ambivalence toward these resources. Residency reputation is important for fellowship directors when evaluating fellowship candidates. Directors do not rely on USNWR, National Institute of Health (NIH) ranking, or DRN when gauging residency reputation, but rather personal knowledge of the applicant's residency program or reputation of the otolaryngology faculty.

Sex-based Disparities in the Management of Pediatric Gonadal Torsion

IntroductionIn 2015, the U.S. News and World Report (USNWR) implemented a quality metric to expedite surgery for testicular torsion (TT), but not ovarian torsion (OT). This study examined OR timing among children with suspected TT and OT before and after this metric. MethodsA single-center retrospective cohort study of children (1–18yr) who underwent surgery for suspected gonadal torsion was performed. Time to OR (TTOR) from hospital presentation to surgery start was calculated. An interrupted time series analysis identified changes in TTOR for suspected TT versus OT after the 2015 USNWR quality metric. ResultsOverall, 216 patients presented with TT and 120 with OT. Median TTOR for TT was 147 min (IQR:99–198) versus 462 min (IQR:308–606) for OT. Post-quality metric, children with TT experienced a 27.8 min decrease (95% CI:-51.7,-3.9, p = 0.05) in annual median TTOR. No significant decrease was observed for children with OT (p = 0.22). Children with history of a known ovarian mass (N = 62) experienced a shorter TTOR compared to those without (422 vs 499min; p = 0.04). ConclusionImplementation of a national quality metric for TT expedited surgical care for children with TT, but not children with OT. These findings highlight the need for equitable quality metrics for children presenting with suspected gonadal torsion. Level of EvidenceIII. Type of StudyRetrospective Comparative Study, Observational Cohort Study.

The Rich Get Richer: The Matthew Effect in Open Payments

IntroductionThe Matthew Effect refers to a pattern of accumulated advantage, specifically how social status can lead to increased wealth and recognition. The Physician Payments Sunshine Act of the Affordable Care Act requires industry payments and the affiliated hospital to be publicly available through the Open Payments Database (OPD). The US News and World Report (USNWR) publishes a ranking of best medical school (research) programs yearly. The Blue Ridge Institute for Medical Research (BRIMR) ranks medical schools annually by the amount of funding from the National Institutes of Health (NIH). Whether medical school–affiliated hospitals with higher social ranking and more NIH funding receive more industrial support is unknown. This study aims to evaluate the relationship between open payment of medical school–affiliated hospitals and USNWR and BRIMR ranking. MethodsWe performed a cross-sectional analysis of the OPD for the fiscal year of 2021. Hospital industry payment information was collected for affiliated hospitals in general and research categories. NIH funding data and program rankings were collected from BRIMR and USNWR, respectively. All data were collected for the fiscal year of 2021. The open payments of schools ranked in the top 50 for USNWR (n = 50) and BRIMR (n = 49) were compared to the schools not ranked in the top 50 using SPSS with chi-squared and Mann–Whitney U tests. A multivariate linear regression was performed to evaluate the association between open payments, USNWR ranking, and BRIMR ranking. ResultsA total of 91 medical schools were included in this study. The top 50 ranked medical schools by BRIMR were found to have a higher median of total open payment ($5,652,628 versus $2,558,372, P < 0.001), open payment in research ($4,707,297 versus $1,992,597, P = 0.003), and general open payment ($1,083,018 versus $392,045, P < 0.001). When ranked by USNWR, the top 50 ranked medical schools were found similarly to have a higher median of total open payment (P < 0.001), open payment in research (P < 0.001), and general open payment (P < 0.001). USNWR ranking was an independent predictor of more total open payment (Coefficient 0.016, 95% confidence interval 0.002-0.029, P = 0.026) and research open payment (coefficient 0.018, 95% confidence interval 0.002-0.034, P = 0.028). USNWR ranking was not found to predict general open payments. BRIMR ranking was not associated with open payment in total, research, or general. ConclusionsHospital open payments were associated with the social reputation of their medical schools. NIH funding was not associated with open payments. A Matthew effect exists in current industry payments to medical school–affiliated hospitals.

Medical School Factors Associated With Students Entering Otolaryngology

To determine medical school characteristics that are associated with medical students entering otolaryngology residency programs. Cross-sectional study. Publically available data on otolaryngology residents and academic otolaryngology programs. Publicly available websites were used to collect demographic and bibliometric characteristics for 1527 residents in Accreditation Council for Graduate Medical Education (ACGME)-accredited otolaryngology programs accounting for the 2017 to 2021 match periods. For each medical school, information on class size, number of otolaryngology faculty, presence of a home academic otolaryngology program, NIH research funding, presence of a student interest group, and top 10 ranking by Doximity or U.S. News and World Report (USNWR) were collected. Univariate and multivariate analyses were performed between the medical school factors and the percentage of each medical school class that matriculated into an otolaryngology residency program. On multivariate analysis, the following factors were found to be associated with a higher percentage of graduates entering an otolaryngology residency program: presence of a home academic otolaryngology program (standardized beta value (β) = 0.397, p < 0.0001), a 2021 top 10 ENT ranking according to USNWR (β = 0.206, p = 0.0028), and the average h-index of students from a medical school (β = 0.327, p < 0.0001). After controlling for multiple factors including research productivity, we found that the presence of a home academic program and a top 10 ranking on USNWR were associated with an increasing percentage of medical school graduates entering otolaryngology. NIH funding and the number of otolaryngology faculty were not associated with more students matriculating into an otolaryngology residency program. These findings can help guide medical schools and otolaryngology programs to recruit students into the field.

Removing or Only Moving a Barrier? Screening Applications with US Medical Licensing Examination Step 2CK Instead of Step 1 May Benefit Women but Not Underrepresented Minorities in Orthopaedics.

We reviewed all 855 Electronic Residency Application Service applications submitted to the University of Pennsylvania's orthopaedic surgery residency program in the 2020-2021 cycle. Applicant age, sex, medical school of graduation, self-identified race, and permanent zip code were evaluated for association with Step 1 and Step 2CK scores using a 2-sample t test. A multivariable linear regression analysis was conducted to understand the predictive value of demographic features and medical school features on Step 1 and 2CK scores. Multivariable linear regression revealed both Step 1 and 2CK scores were lower for applicants of URM status (Step 1: p < 0.001; Step 2CK: p < 0.001) and from international medical schools (p = 0.043; p = 0.006). Step 1 scores but not Step 2CK scores were lower for applicants who were women (p < 0.001; p = 0.730), ≥30 years of age (p < 0.001; p = 0.079), and from medical schools outside the top 25 in National Institutes of Health (NIH) funding or US News and World Report (USNWR) ranking (p = 0.001; p = 0.193). Conversion of Step 1 grading to Pass/Fail may reduce barriers for groups with lower average Step 1 scores (URM, female, ≥30 years of age, and from institutions with lower NIH funding or USNWR rankings). However, if Step 2CK scores replace Step 1 as a screening tool, groups with lower Step 2CK scores, notably URM applicants, may not experience this benefit. Level IV. See Instructions for Authors for a complete description of levels of evidence.

Defining existing practices to support the sleep of hospitalized patients: A mixed-methods study of top-ranked hospitals.

The objective of this study was to understand the existing practices and attitudes regarding inpatient sleep at the 2020 US News and World Report (USNWR) Honor Roll pediatric (n = 10) and adult (n = 20) hospitals. Section chiefs of Hospital Medicine from these institutions were surveyed and interviewed between June and August 2021. Among 23 of 30 surveyed physician leaders (response rate = 77%), 96% (n = 22) rated patient sleep as important, but only 43% (n = 10) were satisfied with their institutions' efforts. A total of 96% (n = 22) of institutions lack sleep equity practices. Fewer than half (48%) of top hospitals have sleep‐friendly practices, with the most common practices including reducing overnight vital sign monitoring (43%), decreasing ambient light in the wards (43%), adjusting lab and medication schedules (35%), and implementing quiet hours (30%). Major themes from qualitative interviews included: importance of universal sleep‐friendly cultures, environmental changes, and external incentives to improve patient sleep.

Trends in outpatient versus inpatient urologic surgery at a university academic medical center.

To analyze trends in outpatient and inpatient urologic surgeries at a large university academic medical center and test the hypothesis that the proportion of outpatient surgeries has been increasing as compared to inpatient surgeries in urology. We analyzed a total of 33,054 claims for urologic surgeries at a large university academic medical center from 2010 to 2020, of which 23.2% met inpatient criteria (n = 7695), whereas 76.7% were outpatient (n = 25,359). Although outpatient claims increased yearly by an average of 24%, inpatient claims increased yearly by an average of only 1%. Over the same period, Medicare-specific outpatient claims mirrored these trends, and Medicare-specific inpatient claims decreased. Outcomes of inpatient surgeries are used as a metric for quality by the Centers for Medicare and Medicaid Services (CMS) as well as US News and World Report (USNWR) rankings. However, with increasing numbers of minimally invasive operations, a large proportion of urologic surgeries are performed on an outpatient basis. As this trend continues, it will be important for organizations like CMS and USNWR to incorporate methods of measuring quality that better reflect outpatient surgical outcomes for the urologic subspecialty.

MP16-20 PREDICTORS OF DISCHARGE TO HOME FOLLOWING MAJOR SURGERY FOR UROLOGIC MALIGNANCIES

You have accessJournal of UrologyCME1 May 2022MP16-20 PREDICTORS OF DISCHARGE TO HOME FOLLOWING MAJOR SURGERY FOR UROLOGIC MALIGNANCIES Nehizena Aihie, Deukwoo Kwon, Matthew Mason, Helen Yang Hougen, Dimple Chananmolu, Sanoj Punnen, Bruno Nahar, Dipen Parekh, Mark Gonzalgo, and Chad Ritch Nehizena AihieNehizena Aihie More articles by this author , Deukwoo KwonDeukwoo Kwon More articles by this author , Matthew MasonMatthew Mason More articles by this author , Helen Yang HougenHelen Yang Hougen More articles by this author , Dimple ChananmoluDimple Chananmolu More articles by this author , Sanoj PunnenSanoj Punnen More articles by this author , Bruno NaharBruno Nahar More articles by this author , Dipen ParekhDipen Parekh More articles by this author , Mark GonzalgoMark Gonzalgo More articles by this author , and Chad RitchChad Ritch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002549.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Discharge to home is a measurable patient outcome used to assess quality of care for hospitals. The 2021 US news and world report (USNWR) uses this metric to rate patient outcomes when calculating Urology hospital rankings. Our objective was to identify patient risk factors that predict non-home discharge after surgery for urologic malignancies. METHODS: The ACS-NSQIP database was queried using urology specific Current Procedural Terminology (CPT) codes to retrospectively identify patients who had undergone open, laparoscopic, or robotic surgery for urologic malignancies including prostate, bladder, kidney, or upper tract urothelial cancer from 2011-2019. Descriptive statistics were used to compare patients who were discharged to home versus non-home discharges. Univariable and multivariable logistic regression analysis were performed to identify patient characteristics that were associated with non-home discharges. All tests were two-sided and statistical significance was considered when p<0.05. RESULTS: Non-home discharge occurred in 3.03% of the 103,244 patients in our study. In our study population 91.7% were male while 8.3% were female. Women were more likely to have non-home discharges (male:female OR 0.62 p<0.0001). As expected, non-home discharge was more common in patients who underwent cystectomy when compared to nephrectomy (OR 1.51 p=0.016) or prostatectomy (OR 1.56 p=0.002). Those with elevated BMI were less likely to experience non-home discharge (OR 0.85 p=0.002) while patients who were identified as underweight and those with unexpected weight loss prior to surgery were more likely to have non-home discharges (OR 1.90 p<0.0001, OR 2.02, p<0.0001). Comorbidities including diabetes and cardiopulmonary disease were also found to be significant independent predictors of non-home discharges. CONCLUSIONS: Patient factors including age, gender, weight, comorbidities, and site of procedure were found to be independent predictors of non-home discharge following surgery for urologic malignancies. Patients with these risk factors should be counseled pre-operatively on the likelihood of requiring a non-home discharge to help manage expectations and create a standardized transition of care pathway following surgery. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e283 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nehizena Aihie More articles by this author Deukwoo Kwon More articles by this author Matthew Mason More articles by this author Helen Yang Hougen More articles by this author Dimple Chananmolu More articles by this author Sanoj Punnen More articles by this author Bruno Nahar More articles by this author Dipen Parekh More articles by this author Mark Gonzalgo More articles by this author Chad Ritch More articles by this author Expand All Advertisement PDF DownloadLoading ...

Price Transparency for Primary Hip & Knee Arthroplasty: An Overview of the Top 50 US News and World Report Orthopedic Hospitals

BackgroundThe Centers for Medicare and Medicaid Services (CMS) has mandated all hospitals to publish the charges of 300 common procedures to provide price transparency. The aims of our study are to evaluate 50 top orthopedic hospitals to determine compliance with this mandate and to assess the ease of finding cost information for arthroplasty procedures. MethodsThe websites of the top 50 US News and World Report (USNWR) orthopedic hospitals were searched to find publicly accessible procedural charges. Data included the number of clicks to locate pricing documents, number of files provided, and number of data rows pertaining to arthroplasty. Charge data was queried based on Diagnosis related group (DRG) codes (469, 470), Current Procedural Technology (CPT) codes (27130, 27477), and keyword searches (“arthroplasty”, “total hip”, and “total knee”). ResultsForty-four (88%) of the top 50 USNWR Orthopedic institutions had publicly accessible files containing cost information. Thirty three of the 44 institutions provided results with DRG search while less than 10 institutions used CPT and keyword searches. There was an average of 226,190 (range 304-1,121,876) rows of data per file. Average charges varied depending on the use of DRG, CPT or keyword searches ($6,663-$117,072). ConclusionThe majority of compliant hospitals published large data files requiring the use of DRG codes to find cost information with extreme variation in resultant charges provided. These findings underscore the lack of direct patient benefit afforded by the current mandate, as pricing determinations require expert knowledge in medical coding and have a high variability in the reported charges.

A track record of diversity: Medical schools ranked by successful black applicants to orthopaedic residencies

BackgroundOrthopaedic surgery is the least diverse surgical subspecialty in medicine. However, to date, there is no literature that shows which medical schools have successfully contributed to improving orthopaedic surgeon diversity. ObjectiveThe purpose of this study is to identify the top U.S. medical schools that have successfully matched black applicants into orthopaedic surgery residencies and juxtapose this ranking to the current top medical schools as ranked by the U.S. News and World Report (USNWR). MethodsThe J. Robert Gladden Orthopaedic Society (JRGOS) database was queried for all orthopaedic surgeons, fellows, and residents who identified as black or multi-racial with black being one of the included races, yielding 938 physicians, of which 672 met our inclusion criteria. From this list, a ranking of the top 20 medical schools was generated. ResultsThe top five medical schools ranked in the JRGOS database are Howard University College of Medicine (HUCOM), Meharry Medical College, Harvard Medical School (HMS), the University of Pennsylvania, and Morehouse School of Medicine (MSM). In addition, 10 (50%) of the medical schools ranked in the top 20 by the JRGOS database were also ranked by the USNWR. When ranking medical schools for black female applicants, HUCOM, MSM, HMS are the top three programs. Lastly, a ranking by region identified that the northeast contained the highest number of ranked medical schools. ConclusionThere are both historically black and non-historically black medical schools which have a proven track record of producing a significant number of future black orthopaedic surgery residents.

Association of Twitter Metrics and Cardiology and Heart Surgery National Hospital Rankings.

Since 1990, the U.S. News and World Report (USNWR) has been publishing rankings of US adult and children’s hospitals. The aim of this study was to analyze the association between hospital Twitter metrics and the 2020 USNWR hospital cardiology and heart surgery ranking. We collected data on the cardiology and heart surgery overall ranking score and expert opinion. Twitter metrics were obtained on October 20, 2020, and included time on Twitter, number of followers, accounts being followed, total tweets, reach score (difference between followers and followed), and annual tweet rate (total tweets divided by time on Twitter). The final cohort consisted of 463 hospitals (48 of which were top-ranking hospitals). A significant positive relation was observed with Twitter metrics and hospital ranking. On multivariable regression after adjusting for time on Twitter, the overall score was independently associated with annual tweet rate and reach score (β=12.45% and β=0.34% for each 1,000 tweets per year and 10,000 reach score accounts; P<.001). Similarly, expert opinion was independently associated with annual tweet rate and reach score (β=0.025% and β=0.002% for each 1000 tweets per year and 10,000 reach score accounts; P<.001). Our results emphasize how hospital leaders may leverage social media platforms as an important medium to disseminate accomplishments and increase their visibility and reputation, potentially translating to higher USNWR ranking.

Reducing Over-Interviewing in the Anesthesiology Residency Match

BackgroundThe U.S. residency recruitment process is expensive and time-consuming because of application inflation and over-invitation.ObjectiveUsing interview and match data, we quantify the predicted effects if anesthesiology residency programs excluded interviews for applicants who are very unlikely to match.MethodsWe previously published the validity and accuracy of the logistic regression model based on data from interview scheduling software used by 32 U.S. anesthesiology residency programs and 1300 applicants from 2015-18. Data used were program region, applicant address, numbers of interviews of the interviewee, medical school US News and World Report (USNWR) rank, the difference between United States Medical Licensing Exam (USMLE) Step 1 and 2 Clinical Knowledge (CK) scores, and the historical average of USMLE scores of program residents. In the current study completed in 2020, the predicted probabilities and their variances were summed among interviewees for 30 deidentified programs.ResultsFor anesthesiology, the median residency program could reduce their interviews by 16.9% (97.5% confidence interval 8.5%-24.1%) supposing they would not invite applicants if the 99% upper prediction limit for the probability of matching was less than 10.0%. The corresponding median savings would be 0.80 interviews per matched spot (0.34-1.33). In doing so, the median program would sustain a risk of 5.3% (97.5% confidence interval 2.3%-7.9%) of having at least one interviewee removed from their final rank-to-match list.ConclusionUsing novel interview data and analyses, we demonstrate that residency programs can substantively reduce interviews with less effect on rank-to-match lists. The data-driven approach to manage marginal interviews allows program leadership to better weigh costs and benefits when composing their annual list of interviewees.

Reputation and the MBA Program Portfolio

This study examines the within-niche product proliferation of Masters in Business Administration (MBA) programs. Building on the resource-based view and on the product proliferation literature, we conceptualize business schools’ MBA portfolio offers as dependent on their reputation, and the market segment in which they and their university operate. We test our hypotheses using data on the portfolio of MBA programs offered by the 200 U.S. universities whose full-time MBA programs are listed in the 2015 U.S. News and World Report (USNWR). For the 96 unranked universities, the decision to offer an MBA program seems to be a reflection of the intention to exploit their economies of scale and graduate specialization. Among 104 ranked universities, there seem to be two different rationales. Among the top ranked universities, MBA program portfolio decisions tend to reflect efforts to maintain a high rankings and a research focus; while for lower ranked universities, the decision seems to be based on reputation and graduate specialization. Our results suggest that top ranked compared to lower ranked and unranked universities are less likely to offer online and part-time MBAs and that executive MBA is exclusive to ranked universities. We discuss the implications on the literature and for university deans and administrators.

Correlation of Ophthalmology Residency Application Characteristics with Subsequent Performance in Residency.

Purpose Only from reviewing applications, it is difficult to identify which applicants will be successful ophthalmology residents. The change of the USMLE Step 1 scoring to "Pass/Fail" removes another quantitative metric. We aimed to identify application attributes correlated with successful residency performance. This study also used artificial intelligence (AI) to evaluate letters of recommendation (LOR), the Dean's letter (MSPE), and personal statement (PS). Design Retrospective analysis of application characteristics versus residency performance was conducted. Participants Residents who graduated from the Dean McGee Eye Institute/University of Oklahoma Ophthalmology residency from 2004 to 2019 were included in this study. Methods Thirty-four attributes were recorded from each application. Residents were subjectively ranked into tertiles and top and bottom deciles based on residency performance by faculty present during their training. The Ophthalmic Knowledge Assessment Program (OKAP) examination scores were used as an objective performance metric. Analysis was performed to identify associations between application attributes and tertile/decile ranking. Additional analysis used AI and natural language processing to evaluate applicant LORs, MSPE, and PS. Main Outcome Measures Characteristics from residency applications that correlate with resident performance were the primary outcome of this study. Results Fifty-five residents and 21 faculty members were included. A grade of "A" or "Honors" in the obstetrics/gynecology (OB/GYN) clerkship and the presence of a home ophthalmology department were associated with ranking in the top tertile but not the top decile. Mean core clerkship grades, medical school ranking in the top 25 U.S. News and World Report (USNWR) primary care rankings, and postgraduate year (PGY)-2 and PGY-3 OKAP scores were predictive of being ranked in both the top tertile and the top decile. USMLE scores, alpha-omega-alpha (AOA) status, and number of publications did not correlate with subjective resident performance. AI analysis of LORs, MSPE, and PS did not identify any text features that correlated with resident performance. Conclusions Many metrics traditionally felt to be predictive of residency success (USMLE scores, AOA status, and research) did not predict resident success in our study. We did confirm the importance of core clerkship grades and medical school ranking. Objective measures of success such as PGY-2 and PGY-3 OKAP scores were associated with high subjective ranking.

Correlation between an Independent Electronic Health Record &amp;amp; External Ranking of Children’s Hospitals

Introduction: To evaluate the correlation between the presence of an independent EHR (compared to a shared EHR system within an adult hospital system) and an externally-derived third party ranking of children’s hospitals. Methods: Children’s hospitals that ranked in the top fifty of the 2019-2020 US News and World Report (USNWR) were included in the analysis. The mean and median ranking of children’s hospitals with independent versus a shared EHR was evaluated. The 2019-2020 USNWR rankings of the top twenty adult hospitals in the United States were then evaluated. For each children’s hospital with an associated adult hospital that was both ranked, it was noted as to whether the EHR for the children’s hospital was independent or shared and statistical differences in rankings compared. Results: Among the top 50 children’s hospitals included, the median USNWR ranking for hospitals was statistically different with an independent EHR than with a shared EHR (13 vs. 30.0) (p = 0.002). The 21 top ranked adult hospitals were associated with 17 children’s hospitals ranked in the top 50. The median ranking for those with an independent EHR was statistically different for those with independent EHR versus shared EHR (7 vs. 28) (p = 0.002). Conclusion: Children’s hospitals with an independent EHR are associated with higher scores on an independent external ranking of hospital quality compared to those which share an EHR with a partner adult hospital.