scholarly journals Implementation of Patient-Reported Outcome Measures in U.S. Total Joint Replacement Registries

2014 ◽  
Vol 96 (suppl 1) ◽  
pp. 104-109 ◽  
Author(s):  
Patricia D. Franklin ◽  
David Lewallen ◽  
Kevin Bozic ◽  
Brian Hallstrom ◽  
William Jiranek ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported

scholarly journals Are responders to patient health surveys representative of those invited to participate? An analysis of the Patient-Reported Outcome Measures Pilot from the Australian Orthopaedic Association National Joint Replacement Registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254196
Author(s):  
Ian A. Harris ◽  
Kara Cashman ◽  
Michelle Lorimer ◽  
Yi Peng ◽  
Ilana Ackerman ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Joint Replacement ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Telephone Call ◽  
Joint Replacement Registry ◽  
Asa Score ◽  
Significant Difference ◽  
Patient Reported

Background Patient-reported outcome measures (PROMs) are commonly used to evaluate surgical outcome in patients undergoing joint replacement surgery, however routine collection from the target population is often incomplete. Representative samples are required to allow inference from the sample to the population. Although higher capture rates are desired, the extent to which this improves the representativeness of the sample is not known. We aimed to measure the representativeness of data collected using an electronic PROMs capture system with or without telephone call follow up, and any differences in PROMS reporting between electronic and telephone call follow up. Methods Data from a pilot PROMs program within a large national joint replacement registry were examined. Telephone call follow up was used for people that failed to respond electronically. Data were collected pre-operatively and at 6 months post-operatively. Responding groups (either electronic only or electronic plus telephone call follow up) were compared to non-responders based on patient characteristics (joint replaced, bilaterality, age, sex, American Society of Anesthesiologist (ASA) score and Body Mass Index (BMI)) using chi squared test or ANOVA, and PROMs for the two responder groups were compared using generalised linear models adjusted for age and sex. The analysis was restricted to those undergoing primary elective hip, knee or shoulder replacement for osteoarthritis. Results Pre-operatively, 73.2% of patients responded electronically and telephone follow-up of non-responders increased this to 91.4%. Pre-operatively, patients responding electronically, compared to all others, were on average younger, more likely to be female, and healthier (lower ASA score). Similar differences were found when telephone follow up was included in the responding group. There were little (if any) differences in the post-operative comparisons, where electronic responders were on average one year younger and were more likely to have a lower ASA score compared to those not responding electronically, but there was no significant difference in sex or BMI. PROMs were similar between those reporting electronically and those reporting by telephone. Conclusion Patients undergoing total joint replacement who provide direct electronic PROMs data are younger, healthier and more likely to be female than non-responders, but these differences are small, particularly for post-operative data collection. The addition of telephone call follow up to electronic contact does not provide a more representative sample. Electronic-only follow up of patients undergoing joint replacement provides a satisfactory representation of the population invited to participate.

scholarly journals Revision Surgery in Total Joint Replacement Is Cost-Intensive

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Markus Weber ◽  
Tobias Renkawitz ◽  
Florian Voellner ◽  
Benjamin Craiovan ◽  
Felix Greimel ◽  
...  
Keyword(s):  
Infection Rate ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Revision Arthroplasty ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Complication Rates ◽  
Joint Replacements ◽  
Patient Reported ◽  
One Year

Revisions after total joint replacement increase constantly. In the current study, we analyzed clinical outcome, complication rates, and cost-effectiveness of revision arthroplasty. In a retrospective analysis of 162 revision hip and knee arthroplasties from our institutional joint registry responder rate, patient-reported outcome measures (EQ-5D, WOMAC), complication rates, and patient-individual charges in relation to reimbursement were compared with a matched control group of primary total joint replacements. Positive responder rate one year postoperatively was lower for revision arthroplasties with 72.9% than for primary arthroplasties with 90.1% (OR=0.30, 95%CI=0.18–0.59, p=0.001). Correspondingly, improvement in patient-reported outcome measures one year after surgery was lower in revision than in primary joint arthroplasty with EQ-5D 0.19±0.25 to 0.30±0.24 (p<0.001) and WOMAC 24.3±30.3 to 41.2±21.3 (p<0.001). Infection rate was higher in revision (6.8%) compared to primary replacements (0%, p=0.001). Mean charges in revision arthroplasty were 76.0% higher than in matched primary joint replacements (7110.8±2249.4$ to 4041.1±975.7$, p<0.001), whereas reimbursement was only 23.6% higher (9243.3±2258.4$ in revision and 7477.9±703.1$ in primary arthroplasty, p<0.001). Revision arthroplasty is associated with lower outcome and higher infection rate compared to primary replacements. The high financial expense of revision arthroplasty is only partly covered by a higher reimbursement.

National Implementation of an Electronic Patient Reported Outcome Measures Program for Joint Replacement Surgery (Preprint)

2021 ◽  
Author(s):  
Emma L. Heath ◽  
Ilana I. Ackerman ◽  
Michelle F. Lorimer ◽  
Sophia Rainbird ◽  
Grace O’Donohue ◽  
...  
Keyword(s):  
Data Collection ◽  
Outcome Measures ◽  
Joint Replacement ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Successful Implementation ◽  
Replacement Surgery ◽  
Patient Registration ◽  
National Implementation ◽  
Patient Reported

BACKGROUND There is a global emphasis on expanding data collection for joint replacement procedures beyond implant attributes and progression to revision surgery. Patient reported outcome measures (PROMs) are increasingly considered as an important measure of surgical outcomes from a patient’s perspective. However, a major limitation preventing wider use of PROMs data in national data collection has been the inability to systematically collect and share electronic information with relevant stakeholders in a comprehensive and financially sustainable manner. OBJECTIVE We aim to report on the development of an electronic data capture and reporting system by a national registry for the collection of PROMs and the processes used to identify and overcome barriers to implementation and uptake. We also aim to provide a cost breakdown of establishing and maintaining a nationwide electronic PROMs program. METHODS Between 2018 and 2020 three governance and advisory committees were established to develop and implement a PROMs pilot program nested within a nationwide joint replacement registry. The program involved electronic collection of pre- and 6-month post-operative data for hip, knee or shoulder replacement surgery from 44 Australian hospitals. Resource requirements for the program included a Project Manager, Software Developers, Data Manager and Statistician. An online platform was tested, refined, and implemented for electronic PROMs collection with scalability considered for future expansion to all Australian hospitals and additional data fields. Technical capabilities included different access for multiple user types, patient registration, automatic reminders via SMS and email, online consent and patient outcome real-time dashboards accessible for different user groups (surgeons, patients, hospitals and project stakeholders). RESULTS During the PROMs pilot period, there were 14,890 procedures registered in the electronic system. This equated to 60% of people who had a joint replacement at participating hospitals during this period. Patient registration and data collection were efficient (20-30 seconds and 10-12 minutes, respectively). Engagement with the reporting dashboards (proportion of those who viewed their dashboard) varied by user group: 197 (71.1%) hospital administrators, 68 (52.7%) project stakeholders, 177 (45.3%) surgeons and 1138 (12.9%). Cost analysis determined an overall cost per patient of AUD7 - AUD15 (approximately USD5 - USD12) for two PROMs collections per joint replacement procedure once the program was established. CONCLUSIONS Successful implementation of an orthopaedic PROMs program with planned scalability for a broader national rollout requires significant funding and staffing resources. However, this expenditure can be considered worthwhile, given that collection and reporting of PROMs can drive healthcare improvement processes. Further consideration of strategies to improve stakeholder engagement with electronic reporting dashboards (particularly for patients and surgeons) will be critical to the ongoing success of a national PROMs program.

Impact of Depression on Patient-Reported Outcome Measures After Lumbar Spine Decompression

Spine ◽  
2018 ◽  
Vol 43 (6) ◽  
pp. 434-439 ◽  
Author(s):  
Robert K. Merrill ◽  
Lukas P. Zebala ◽  
Colleen Peters ◽  
Sheeraz A. Qureshi ◽  
Steven J. McAnany
Keyword(s):  
Lumbar Spine ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported
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