Publicly reported wound healing rates: the fantasy and the reality.
Open accessAbstract
Significance: We compare real-world data from the U.S. Wound Registry (USWR) with randomized controlled trials and publicly reported wound outcomes and develop criteria for honest reporting of wound outcomes, a requirement of the new Quality Payment Program (QPP). Recent Advances: Because no method has existed by which wounds could be stratified according to their likelihood of healing among real-world patients, practitioners have reported fantastically high healing rates. The USWR has developed several risk-stratified wound healing quality measures for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) as part of its Qualified Clinical Data Registry (QCDR). This allows practitioners to report DFU and VLU healing rates in comparison to the likelihood of whether the wound would have healed. Critical Issues: Under the new QPP, practitioners must report at least one practice-relevant outcome measure, and it must be risk adjusted so that clinicians caring for the sickest patients do not appear to have worse outcomes than their peers. The Wound Healing Index is a validated risk-stratification method that can predict whether a DFU or VLU will heal, leveling the playing field for outcome reporting and removing the need to artificially inflate healing rates. Wound care practitioners can report the USWR DFU and VLU risk-stratified outcome measure to satisfy the quality reporting requirements of the QPP. Future Directions: Per the requirements of the QPP, the USWR will begin publicly reporting of risk-stratified healing rates once quality measure data have met the reporting standards of the Centers for Medicare and Medicaid Services. Some basic rules for data censoring are proposed for public reporting of healing rates, and others are needed, which should be decided by consensus among the wound care community.
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In 1434 patients who were candidates for either surgery or endovascular treatment (71.8% had diabetes), surgical bypass appeared superior to endovascular therapy for major adverse limb events or death (42.6% vs 57.4%; HR, 0.68; 95% CI, 0.59-0.79).
“In 1434 patients who were candidates for either surgery (including a singlesegment great saphenous vein for bypass) or endovascular treatment (71.8% had diabetes), surgical bypass appeared to be superior to endovascular therapy based on the risk of major adverse limb events, defined as major amputation or a major limb reintervention (repeat bypass graft, graft revision, thrombectomy, or thromboly”
From Diabetic Foot Ulcers (2023) · cites this paper as [84]
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- Authors
- Fife, C. E., Eckert, K. A., & Carter, M. J.
- Affiliations
- Baylor College of Medicine (US)
- Strategic Solutions, Inc.
- Corresponding author
- Fife, Caroline E.
- Venue
- Advances in Wound Care
- Publisher
- SAGE Publications
- Published
- 2018-03
- Volume
- 7
- Issue
- 3
- Pages
- 77-94
- ISSN
- 2162-1918 (ISSN-L)
- 2162-1934
- PMC
- PMC5833884
- OpenAlex
- W2759665824
- Cited by
- 132
- References
- 61
- Citations by year
- 2026: 13 · 2025: 21 · 2024: 18 · 2023: 15 · 2022: 12 · 2021: 23 · 2020: 15 · 2019: 10 · 2018: 5
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Advances in Wound Care (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- University of Social Welfare and Rehabilitation Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Keywords
- wound healing rate, diabetic foot ulcer, venous leg ulcers, risk stratification, wound healing index, Quality Payment Program, data censoring
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