Table 4.

Strengths and limitations of the American Society of Breast Surgeons quality measurement program

Strengths

Specialty measures and their specifications developed by surgeons

Justifiable “exceptions” to not meeting performance defined by surgeons

Real-time surgeon data entry lessens recall bias, abstractor error, and misclassification of attribution for not meeting a performance requirement

Real-time peer performance comparison

Large sample size of patient-measure encounters (>1,000,000) for comparisons

General surgeons able to compare breast surgical performance to breast-specialty surgeons

Low level of erroneous reporting based on audits

Participation satisfies American Board of Surgery Maintenance of Certification Part 4

Public transparency of individual surgeon performance in 2015 on the American Society of Breast Surgeons (ASBrS) website in 2016

Capability to use the program for “plan-do-study-act” cycles52,53

No participation fee for members before 2016a

Limitations

Peer performance comparison not yet risk-adjusted

Unknown rate of nonconsecutive patient data entry

No significant patient or payer input into quality measure list or ranking to reflect their preferences and values54

Unknown rate of surgeon “dropout” due to their perception of poor performance

^a$100.00 began 2016