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Tytuł pozycji:

The use of patient-reported outcome measures to guide referral for hip and knee arthroplasty.

Tytuł :
The use of patient-reported outcome measures to guide referral for hip and knee arthroplasty.
Autorzy :
Price AJ; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
Kang S; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
Cook JA; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
Dakin H; Health Economics Research Centre, University of Oxford, Oxford, UK.
Blom A; Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
Arden N; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
Fitzpatrick R; Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Beard DJ; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Oxford, UK.
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Corporate Authors :
ACHE Study team
Źródło :
The bone & joint journal [Bone Joint J] 2020 Jul; Vol. 102-B (7), pp. 941-949.
Typ publikacji :
Journal Article
Język :
English
Journal Info :
Publisher: British Editorial Society of Bone & Joint Surgery Country of Publication: England NLM ID: 101599229 Publication Model: Print Cited Medium: Internet ISSN: 2049-4408 (Electronic) Linking ISSN: 20494394 NLM ISO Abbreviation: Bone Joint J Subsets: Core Clinical (AIM); MEDLINE
Imprint Name(s) :
Original Publication: London : British Editorial Society of Bone & Joint Surgery
MeSH Terms :
Arthroplasty, Replacement, Hip*
Arthroplasty, Replacement, Knee*
Patient Reported Outcome Measures*
Quality-Adjusted Life Years*
Referral and Consultation*
Osteoarthritis, Hip/*surgery
Osteoarthritis, Knee/*surgery
Aged ; Disability Evaluation ; Female ; Humans ; Male ; Middle Aged ; Probability ; United Kingdom
References :
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Contributed Indexing :
Keywords: Arthroplasty; Hip; Knee; Patient-reported outcome measure; Referral; Threshold
Entry Date(s) :
Date Created: 20200701 Date Completed: 20200713 Latest Revision: 20200729
Update Code :
20201020
PubMed Central ID :
PMC7376303
DOI :
10.1302/0301-620X.102B7.BJJ-2019-0102.R2
PMID :
32600142
Czasopismo naukowe
Aims: To calculate how the likelihood of obtaining measurable benefit from hip or knee arthroplasty varies with preoperative patient-reported scores.
Methods: Existing UK data from 222,933 knee and 209,760 hip arthroplasty patients were used to model an individual's probability of gaining meaningful improvement after surgery based on their preoperative Oxford Knee or Hip Score (OKS/OHS). A clinically meaningful improvement after arthroplasty was defined as ≥ 8 point improvement in OHS, and ≥ 7 in OKS.
Results: The upper preoperative score threshold, above which patients are unlikely to achieve any meaningful improvement from surgery, is 41 for knees and 40 for hips. At lower scores, the probability of improvement increased towards a maximum of 88% (knee) and 95% for (hips).
Conclusion: By our definition of meaningful improvement, patients with preoperative scores above 41 (OKS) and 40 (OHS) should not be routinely referred to secondary care for possible arthroplasty. Using lower thresholds would incrementally increase the probability of meaningful benefit for those referred but will exclude some patients with potential to benefit. The findings are useful to support the complex shared decision-making process in primary care for referral to secondary care; and in secondary care for experienced clinicians counselling patients considering knee or hip arthroplasty, but should not be used in isolation. Cite this article: Bone Joint J 2020;102-B(7):941-949.

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