{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:46:56Z","timestamp":1791899216582,"version":"4.3.4"},"reference-count":7,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In 2024, the US News and World Report (USNWR)'s Best Hospitals began reporting complications following elective outpatient otolaryngology procedures in its ears, nose, and throat (ENT) ranking. However, this methodology has not been clinically adjudicated in a peer\u2010reviewed domain. We aimed to conduct manual health record adjudication to assess whether the USNWR methodology accurately attributes complications following elective outpatient otolaryngology procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Case\u2010cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A case\u2010cohort of n\u2009=\u200980 elective, outpatient otolaryngology procedure\/complication pairings from January 2019 to October 2023 across four academic medical centers using the 2024 USNWR otolaryngology procedure subgroups and Solventum Ambulatory Potentially Preventable Complications (AM\u2010PPC) software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the AM\u2010PPC\u2010defined complication types as our standard of comparison for our clinical adjudication. Using the electronic health record, we adjudicated: (1) Was there agreement (yes\/no) on complication type between our clinical adjudication and the Solventum AM\u2010PPC software? (2) Was the complication clinically related to, or a sequela of, the index otolaryngology procedure (yes\/no)?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The clinical adjudication agreed on complication type in 59\/80 (74%) of patients, and 63\/80 (79%) were judged to be clinically related to the index otolaryngology procedure. In total, 50\/80 (63%) complications were adjudicated to be in agreement on both the complication type and clinical relatedness to the index procedure, while 9\/80 (11%) complications did not agree with the complication type nor were clinically related to the index procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Outpatient complications reported in the USNWR ENT rating lack the specificity to exclude patients whose complications are sequelae of chronic underlying conditions or related to concurrent, non\u2010otolaryngology procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70494","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:59:03Z","timestamp":1791896343000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disagreement Between Outpatient Complications in the USNWR ENT Ratings and Clinical Adjudication"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4544-3158","authenticated-orcid":false,"given":"Benjamin D.","family":"Pollock","sequence":"first","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Health Care Delivery Research Mayo Clinic Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie S.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Vaver","sequence":"additional","affiliation":[{"name":"Quality &amp; Value Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subashnie","family":"Devkaran","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA"},{"name":"Quality &amp; Value Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean C.","family":"Dowdy","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA"},{"name":"Quality &amp; Value Mayo Clinic Rochester Minnesota USA"},{"name":"Division of Gynecologic Oncology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendall K.","family":"Tasche","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"738","DOI":"10.7326\/M23-2063","article-title":"The safety of outpatient health care: review of electronic health records","volume":"177","author":"Levine DM","year":"2024","journal-title":"Ann Intern Med"},{"key":"e_1_2_7_3_1","volume-title":"2026\u20132027 Best Hospitals Procedures & Conditions Methodology","author":"U.S. News & World Report","year":"2026"},{"key":"e_1_2_7_4_1","unstructured":"3M\u2122 Ambulatory Potentially Preventable Complications (AM\u2010PPC) Classification System. Methodology Overview Version 1.0. November2022."},{"key":"e_1_2_7_5_1","volume-title":"Methodology U.S. News & World Report 2024\u20132025 Best Hospitals: Procedures & Conditions Ratings","year":"2024"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.urology.2024.10.052","article-title":"Clinical adjudication of outpatient complications reported in the U.S. News and World Report's urology rankings","volume":"195","author":"Pollock BD","year":"2025","journal-title":"Urology"},{"issue":"15","key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1161\/CIRCULATIONAHA.107.747873","article-title":"Comparison of \u201crisk\u2010adjusted\u201d hospital outcomes","volume":"117","author":"Shahian DM","year":"2008","journal-title":"Circulation"},{"issue":"6","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1002\/ohn.1015","article-title":"Rethinking measures and mortality attribution in health care: the ENT example","volume":"171","author":"Patel S","year":"2024","journal-title":"Otolaryngol Head Neck Surg"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70494","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70494","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70494","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:59:05Z","timestamp":1791896345000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70494"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":7,"alternative-id":["10.1002\/ohn.70494"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70494","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"assertion":[{"value":"2025-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ohn.70494"}}