Opinion
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Timothy Lyon, MD, on recent change to outpatient complications metric in urology rankings
Author(s):
"We have communicated with Solventum, who makes this software, and they have made changes based on our feedback," says Timothy D. Lyon, MD.
Investigators recently identified key concerns in the US News & World Report’s outpatient complications metric for urology rankings. The findings were published in the study, “Clinical Adjudication of Outpatient Complications Reported in the U.S. News and World Report's Urology Rankings.”1
In a recent interview with Urology Times®, Timothy D. Lyon, MD, shares the recommendations that were made based on findings from this study, as well as what changes were implemented to improve the system.
Specifically, investigators in the study found that the software used to identify complications had “reasonable clinical validity, but detected several false positive [urinary tract infections] UTIs,” the authors reported. Overall, 13.8% of the complications identified were determined to be false positive UTIs.
Additionally, the study found that 48% of the index procedures identified by the software were conducted by interventional radiologists (IRs), not urologists. The software did perform well in regard to complication type, however. Upon assessment, the investigators agreed on complication type in 78% of complications, and 80% were found to be clinically related to the index urology procedure.
Based on these findings, the authors issued 3 recommendations: excluding procedures performed by IRs, improving the definition of catheter-associated UTI, and identifying commonly staged urologic procedures so they aren’t counted as complications. Based on this feedback, Solventum, the maker of the software, decided to remove 3 of the procedure-specific groups (PSGs) from the urology grouping.
Lyon concluded, “That's fantastic news, and we think that change is very likely to drastically reduce the number of IR procedures that are being miscategorized in the urology rankings. Now, so far, that's just for the outpatient complications, which is only a small part of the overall US News rankings, but we're hopeful that US News will follow suit and will exclude these same PSG rankings from their overall ranking system.”
REFERENCE
1. Pollock D, Ugwuowo UC, Anderson SS, et al. Clinical adjudication of outpatient complications reported in the U.S. News and World Report's Urology Rankings. Urology. 2025:195:60-65. doi:10.1016/j.urology.2024.10.052
