Abstract
The era of value-based health care is characterized by an increasing interest in patient-reported
health outcomes. For this purpose we developed the rhinoplasty health care monitor
(RHM), a streamlined outcome measurement protocol, including all rhinoplasty patients
since 2014. Statistical analyses of patient-reported outcome data are automated and
visually presented on a custom web-based dashboard. We describe the clinical and practical
benefits of the RHM and discuss how routine prospective outcome measurements have
upgraded our care standards. For this prospective study, 979 consecutive patients
referred for functional (revision) rhinoplasty from April 2014 to August 2023 were
included. Preoperative and 3- and 12-month postoperative scores on the Nasal Obstruction
Symptom Evaluation scale (NOSE), Utrecht Questionnaire (UQ), and visual analog scales
(VAS) were obtained. Of 979 referred patients, 599 (61.2%) were eligible for rhinoplasty.
One year postoperatively, mean NOSE scale sum score improved from 69.1 ± 22.8 to 23.1 ± 23.5
(p < 0.001). Functional VAS scores improved from 4.1 ± 2.8 (left) and 4.1 ± 2.8 (right)
to 7.5 ± 1.9 (left) and 7.3 ± 2.0 (right; p < 0.001). Mean UQ sum score improved from 12.0 ± 6.4 to 6.8 ± 3.3 and aesthetic VAS
score improved from 4.5 ± 2.5 to 7.4 ± 1.7 (p < 0.001) 1 year postoperatively. Benefits of the outcome routine were improved patient
selection, data-driven expectation management and patient empowerment, and targeted
critical appraisals of surgical performance. In conclusion, routine, automated, prospective
outcome monitoring provides physicians with a response to the increasing demand for
data-driven insights in health outcomes. The limited effort that is needed to gather
and monitor outcome data is heavily repaid by valuable insights into aspects of care
that can be improved.
Keywords
rhinoplasty - nasal obstruction - patient-reported outcome measures - value-based
health care - patient empowerment
