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Yusuf H, Hillman A, Stegeman JA, Cameron A, Badger S. Expanding access to veterinary clinical decision support in resource-limited settings: a scoping review of clinical decision support tools in medicine and antimicrobial stewardship. Front Vet Sci 2024; 11:1349188. [PMID: 38895711 PMCID: PMC11184142 DOI: 10.3389/fvets.2024.1349188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/13/2024] [Indexed: 06/21/2024] Open
Abstract
Introduction Digital clinical decision support (CDS) tools are of growing importance in supporting healthcare professionals in understanding complex clinical problems and arriving at decisions that improve patient outcomes. CDS tools are also increasingly used to improve antimicrobial stewardship (AMS) practices in healthcare settings. However, far fewer CDS tools are available in lowerand middle-income countries (LMICs) and in animal health settings, where their use in improving diagnostic and treatment decision-making is likely to have the greatest impact. The aim of this study was to evaluate digital CDS tools designed as a direct aid to support diagnosis and/or treatment decisionmaking, by reviewing their scope, functions, methodologies, and quality. Recommendations for the development of veterinary CDS tools in LMICs are then provided. Methods The review considered studies and reports published between January 2017 and October 2023 in the English language in peer-reviewed and gray literature. Results A total of 41 studies and reports detailing CDS tools were included in the final review, with 35 CDS tools designed for human healthcare settings and six tools for animal healthcare settings. Of the tools reviewed, the majority were deployed in high-income countries (80.5%). Support for AMS programs was a feature in 12 (29.3%) of the tools, with 10 tools in human healthcare settings. The capabilities of the CDS tools varied when reviewed against the GUIDES checklist. Discussion We recommend a methodological approach for the development of veterinary CDS tools in LMICs predicated on securing sufficient and sustainable funding. Employing a multidisciplinary development team is an important first step. Developing standalone CDS tools using Bayesian algorithms based on local expert knowledge will provide users with rapid and reliable access to quality guidance on diagnoses and treatments. Such tools are likely to contribute to improved disease management on farms and reduce inappropriate antimicrobial use, thus supporting AMS practices in areas of high need.
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Affiliation(s)
| | | | - Jan Arend Stegeman
- Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
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Özden F, Sarı Z. The effect of mobile application-based rehabilitation in patients with total knee arthroplasty: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 113:105058. [PMID: 37172329 DOI: 10.1016/j.archger.2023.105058] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 05/07/2023] [Accepted: 05/07/2023] [Indexed: 05/14/2023]
Abstract
OBJECTIVE Mobile applications have been used frequently in post-operative orthopedic rehabilitation in recent years. However, no systematic review has emphasized the importance of mobile applications in the rehabilitation process after total knee arthroplasty (TKA). This systematic review and meta-analysis aimed to evaluate the effectiveness of mobile application-based rehabilitation practices in patients with TKA. MATERIAL AND METHODS PubMed, Web-of-Science, Scopus, ScienceDirect and Cochrane databases were searched. The Physiotherapy Evidence Database (PEDro) and the Revised Cochrane risk-of-bias tool randomized trials 2 (RoB2) tools were used to demonstrate the methodological quality and risk of bias. RESULTS A total of 584 articles were screened. Finally, six papers were included in the systematic review. PEDro scores ranged from 4 to 7 (median: 5.5), indicating fair to good methodological quality. All studies were classified as "some concerns" in RoB2. Mobile application-based rehabilitation demonstrated better scores on pain, range of motion (ROM), objective and subjective function, satisfaction and compliance in general. Meta-analysis proved that mobile application-based telerehabilitation demonstrated better results on subjective function (ES:0.57, 95% CI: 0.11-1.02). CONCLUSION Compared to conventional rehabilitation, application-based telerehabilitation provides more effective results in function, pain and ROM. Furthermore, mobile application-based rehabilitation should also be considered regarding patient satisfaction and compliance.
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Affiliation(s)
- Fatih Özden
- Department of Health Care Services, Muğla Sıtkı Koçman University, Köyceğiz Vocational School of Health Services, Muğla, Turkey.
| | - Zübeyir Sarı
- Physiotherapy and Rehabilitation Department, Marmara University, Faculty of Health Sciences, İstanbul, Turkey
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Sweerts L, Dekkers PW, van der Wees PJ, van Susante JLC, de Jong LD, Hoogeboom TJ, van de Groes SAW. External Validation of Prediction Models for Surgical Complications in People Considering Total Hip or Knee Arthroplasty Was Successful for Delirium but Not for Surgical Site Infection, Postoperative Bleeding, and Nerve Damage: A Retrospective Cohort Study. J Pers Med 2023; 13:jpm13020277. [PMID: 36836512 PMCID: PMC9964485 DOI: 10.3390/jpm13020277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Although several models for the prediction of surgical complications after primary total hip or total knee replacement (THA and TKA, respectively) are available, only a few models have been externally validated. The aim of this study was to externally validate four previously developed models for the prediction of surgical complications in people considering primary THA or TKA. We included 2614 patients who underwent primary THA or TKA in secondary care between 2017 and 2020. Individual predicted probabilities of the risk for surgical complication per outcome (i.e., surgical site infection, postoperative bleeding, delirium, and nerve damage) were calculated for each model. The discriminative performance of patients with and without the outcome was assessed with the area under the receiver operating characteristic curve (AUC), and predictive performance was assessed with calibration plots. The predicted risk for all models varied between <0.01 and 33.5%. Good discriminative performance was found for the model for delirium with an AUC of 84% (95% CI of 0.82-0.87). For all other outcomes, poor discriminative performance was found; 55% (95% CI of 0.52-0.58) for the model for surgical site infection, 61% (95% CI of 0.59-0.64) for the model for postoperative bleeding, and 57% (95% CI of 0.53-0.61) for the model for nerve damage. Calibration of the model for delirium was moderate, resulting in an underestimation of the actual probability between 2 and 6%, and exceeding 8%. Calibration of all other models was poor. Our external validation of four internally validated prediction models for surgical complications after THA and TKA demonstrated a lack of predictive accuracy when applied in another Dutch hospital population, with the exception of the model for delirium. This model included age, the presence of a heart disease, and the presence of a disease of the central nervous system as predictor variables. We recommend that clinicians use this simple and straightforward delirium model during preoperative counselling, shared decision-making, and early delirium precautionary interventions.
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Affiliation(s)
- Lieke Sweerts
- Department of Orthopaedics, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
- Correspondence:
| | - Pepijn W. Dekkers
- Department of Orthopaedics, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Philip J. van der Wees
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
- Department of Rehabilitation, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | | | - Lex D. de Jong
- Department of Orthopedics, Rijnstate Hospital, 6800 TA Arnhem, The Netherlands
| | - Thomas J. Hoogeboom
- IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Sebastiaan A. W. van de Groes
- Department of Orthopaedics, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
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DXA-Based Finite Element Analysis as Support for Pre and Post-operative Evaluation of Hip Arthroplasty. J Med Biol Eng 2022. [DOI: 10.1007/s40846-022-00740-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Deere K, Whitehouse MR, Kunutsor SK, Sayers A, Mason J, Blom AW. How long do revised and multiply revised hip replacements last? A retrospective observational study of the National Joint Registry. THE LANCET. RHEUMATOLOGY 2022; 4:e468-e479. [PMID: 36394063 PMCID: PMC9647039 DOI: 10.1016/s2665-9913(22)00097-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Background Hip replacements are common and effective operations but patients that undergo this intervention are at risk of the replacements failing, requiring costly and often complex revision surgery with poorer outcomes than primary surgery. There is paucity of reliable data examining the treatment pathway for hip replacements over the life of the patient in terms of risk of revision and re-revisions. We aim to provide detailed information on the longevity of hip revision surgery. Methods We did a retrospective observational registry-based study of the National Joint Registry, using data on hip replacements from all participating hospitals in England and Wales, UK. We included data on all first revisions, with an identifiable primary procedure, with osteoarthritis as the sole indication for the original primary procedure. Kaplan-Meier estimates were used to determine the cumulative probability of revision and subsequent re-revision after primary hip replacement. Analyses were stratified by age and gender, and the influence of time from first to second revision on the risk of further revision was explored. Findings Between April 1, 2003, and Dec 31, 2019, there were 29 010 revision hip replacements with a linked primary episode. Revision rates of revision hip replacements were higher in patients younger than 55 years than in older age groups. After revision of primary total hip replacement, 21·3% (95% CI 18·6-24·4) of first revisions were revised again within 15 years, 22·3% (20·3-24·4) of second revisions were revised again within 7 years, and 22·3% (18·3-27·0) of third revisions were revised again within 3 years. After revision of hip resurfacing, 23·7% (95% CI 19·6-28·5) of these revisions were revised again within 15 years, 21·0% (17·0-25·8) of second revisions were revised again within 7 years, and 19·3% (11·9-30·4) of third revisions were revised again within 3 years. A shorter time between revision episodes was associated with earlier subsequent revision. Interpretation Younger patients are at an increased risk of multiple revisions. Patients who undergo a revision have a steadily increasing risk of further revision the more procedures they undergo, and each subsequent revision lasts for approximately half the time of the previous one. Although hip replacements are effective for improving pain and function and usually last a remarkably long time, if they are revised, successive revisions are progressively and markedly less successful. Funding NIHR Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Healthcare Quality Improvement Partnership; and the National Joint Registry.
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Affiliation(s)
- Kevin Deere
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol, UK
| | - Michael R Whitehouse
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Setor K Kunutsor
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Adrian Sayers
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol, UK
| | - James Mason
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Ashley W Blom
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
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Cuthbert AR, Giles LC, Glonek G, Kalisch Ellett LM, Pratt NL. A comparison of survival models for prediction of eight-year revision risk following total knee and hip arthroplasty. BMC Med Res Methodol 2022; 22:164. [PMID: 35668349 PMCID: PMC9172144 DOI: 10.1186/s12874-022-01644-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 05/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background There is increasing interest in the development and use of clinical prediction models, but a lack of evidence-supported guidance on the merits of different modelling approaches. This is especially true for time-to-event outcomes, where limited studies have compared the vast number of modelling approaches available. This study compares prediction accuracy and variable importance measures for four modelling approaches in prediction of time-to-revision surgery following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Methods The study included 321,945 TKA and 151,113 THA procedures performed between 1 January 2003 and 31 December 2017. Accuracy of the Cox model, Weibull parametric model, flexible parametric model, and random survival forest were compared, with patient age, sex, comorbidities, and prosthesis characteristics considered as predictors. Prediction accuracy was assessed using the Index of Prediction Accuracy (IPA), c-index, and smoothed calibration curves. Variable importance rankings from the Cox model and random survival forest were also compared. Results Overall, the Cox and flexible parametric survival models performed best for prediction of both TKA (integrated IPA 0.056 (95% CI [0.054, 0.057]) compared to 0.054 (95% CI [0.053, 0.056]) for the Weibull parametric model), and THA revision. (0.029 95% CI [0.027, 0.030] compared to 0.027 (95% CI [0.025, 0.028]) for the random survival forest). The c-index showed broadly similar discrimination between all modelling approaches. Models were generally well calibrated, but random survival forest underfitted the predicted risk of TKA revision compared to regression approaches. The most important predictors of revision were similar in the Cox model and random survival forest for TKA (age, opioid use, and patella resurfacing) and THA (femoral cement, depression, and opioid use). Conclusion The Cox and flexible parametric models had superior overall performance, although all approaches performed similarly. Notably, this study showed no benefit of a tuned random survival forest over regression models in this setting. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01644-3.
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Affiliation(s)
- Alana R Cuthbert
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, PO Box 11060, Adelaide, SA, 5001, Australia. .,South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia.
| | - Lynne C Giles
- School of Public Health, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Gary Glonek
- School of Mathematical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Lisa M Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, PO Box 11060, Adelaide, SA, 5001, Australia
| | - Nicole L Pratt
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, PO Box 11060, Adelaide, SA, 5001, Australia
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Sabah SA, Alvand A, Beard DJ, Price AJ. Minimal important changes and differences were estimated for Oxford hip and knee scores following primary and revision arthroplasty. J Clin Epidemiol 2021; 143:159-168. [PMID: 34920113 DOI: 10.1016/j.jclinepi.2021.12.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To create estimates for clinically meaningful changes and differences in pain and joint function for the Oxford Hip and Knee Scores (OHS/OKS) in primary and revision joint replacement. STUDY DESIGN AND SETTING 694,487 primary and revision joint replacement procedures were analysed from the NHS PROMs dataset between 2012-2020. Minimal important changes (MIC) and differences (MID) were calculated using distribution and anchor-based methods (including receiver-operating characteristic (ROC) curve and predictive-modelling techniques). RESULTS For comparison of two or more groups (such as in a clinic trial), MID estimates were ∼5 points. For cohort studies investigating changes over time in a single group of patients, MICgroup estimates were 12.4 points (primary hip replacement), 8.6 points (revision hip replacement), 10.5 points (primary knee replacement) and 9.4 points (revision knee replacement). For studies investigating changes over time at the individual patient level, MICadjusted estimates were ∼8 points, ∼6 points, ∼7 points and ∼6 points respectively. CONCLUSION This study has calculated contemporary estimates of clinically important changes and differences for the OHS/OKS for primary and revision hip and knee replacement. These estimates can be used to inform sample size calculations and to interpret changes in joint function over time and differences between groups.
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Affiliation(s)
- S A Sabah
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford.
| | - A Alvand
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; Nuffield Orthopaedic Centre, Oxford.
| | - D J Beard
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford.
| | - A J Price
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; Nuffield Orthopaedic Centre, Oxford.
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Deere K, Whitehouse MR, Kunutsor SK, Sayers A, Price AJ, Mason J, Blom AW. How long do revised and multiply revised knee replacements last? An analysis of the National Joint Registry. THE LANCET. RHEUMATOLOGY 2021; 3:e438-e446. [PMID: 35043097 PMCID: PMC7612217 DOI: 10.1016/s2665-9913(21)00079-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Knee replacements are common and effective operations but patients that undergo this intervention are at risk of needing subsequent costly and often complex revision surgery with poorer outcomes than primary surgery. The treatment pathway over the life of the patient in terms of risk of revision and re-revision(s) is poorly described. We aim to provide detailed information on the longevity of revision surgery. METHODS This was a retrospective observational registry-based study of the National Joint Registry. Kaplan-Meier estimates were used to determine the cumulative probability of revision and subsequent re-revision(s) following primary knee replacement. Analyses were stratified by age and gender and the influence of time from first to second revision on the risk of further revision was explored. FINDINGS There were 33,292 revision knee replacements with a linked primary episode. Revision rates of revision knee replacements were higher in males and younger patients. 19·9% of revisions were revised again within 13 years, 20·7% of second revisions were revised again within 5 years and 20·7% of third revisions were revised again within 3 years. A shorter time between revision episodes was associated with earlier subsequent revision. INTERPRETATION Males and younger patients are at higher risk of multiple revisions. Patients who undergo a revision have steadily increasing risk of further revision the more procedures they undergo, and each subsequent revision lasts for approximately half the time of the previous one. FUNDING This study was supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston National Health Service Foundation Trust and the University of Bristol. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. This study was also supported by funding from Healthcare Quality Improvement Partnership and the National Joint Registry. Posts of authors of this work are part funded by a grant from the National Joint Registry to conduct statistical analysis for the National Joint Registry. AS was funded by a Medical Research Council Strategic Skills Fellowship MR/L01226X/1.
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Affiliation(s)
- Kevin Deere
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, 1st Floor Learning & Research Building, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Michael R Whitehouse
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, 1st Floor Learning & Research Building, Southmead Hospital, Bristol, BS10 5NB, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol
| | - Setor K Kunutsor
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, 1st Floor Learning & Research Building, Southmead Hospital, Bristol, BS10 5NB, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol
| | - Adrian Sayers
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, 1st Floor Learning & Research Building, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Andrew J Price
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, Windmill Road, Oxford, OX3 7LD, UK
| | - James Mason
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Ashley W Blom
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, 1st Floor Learning & Research Building, Southmead Hospital, Bristol, BS10 5NB, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol
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Trela-Larsen L, Kroken G, Bartz-Johannessen C, Sayers A, Aram P, McCloskey E, Kadirkamanathan V, Blom AW, Lie SA, Furnes ON, Wilkinson JM. Personalized estimation of one-year mortality risk after elective hip or knee arthroplasty for osteoarthritis. Bone Joint Res 2020; 9:808-820. [PMID: 33179531 PMCID: PMC7672327 DOI: 10.1302/2046-3758.911.bjr-2020-0343.r1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIMS To develop and validate patient-centred algorithms that estimate individual risk of death over the first year after elective joint arthroplasty surgery for osteoarthritis. METHODS A total of 763,213 hip and knee joint arthroplasty episodes recorded in the National Joint Registry for England and Wales (NJR) and 105,407 episodes from the Norwegian Arthroplasty Register were used to model individual mortality risk over the first year after surgery using flexible parametric survival regression. RESULTS The one-year mortality rates in the NJR were 10.8 and 8.9 per 1,000 patient-years after hip and knee arthroplasty, respectively. The Norwegian mortality rates were 9.1 and 6.0 per 1,000 patient-years, respectively. The strongest predictors of death in the final models were age, sex, body mass index, and American Society of Anesthesiologists grade. Exposure variables related to the intervention, with the exception of knee arthroplasty type, did not add discrimination over patient factors alone. Discrimination was good in both cohorts, with c-indices above 0.76 for the hip and above 0.70 for the knee. Time-dependent Brier scores indicated appropriate estimation of the mortality rate (≤ 0.01, all models). CONCLUSION Simple demographic and clinical information may be used to calculate an individualized estimation for one-year mortality risk after hip or knee arthroplasty (https://jointcalc.shef.ac.uk). These models may be used to provide patients with an estimate of the risk of mortality after joint arthroplasty. Cite this article: Bone Joint Res 2020;9(11):808-820.
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Affiliation(s)
- Lea Trela-Larsen
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gard Kroken
- Department of Orthopaedic Surgery, The Norwegian Arthroplasty Register, Haukeland University Hospital, Bergen, Norway
| | - Christoffer Bartz-Johannessen
- Department of Orthopaedic Surgery, The Norwegian Arthroplasty Register, Haukeland University Hospital, Bergen, Norway
| | - Adrian Sayers
- Department of Orthopaedic Surgery, The Norwegian Arthroplasty Register, Haukeland University Hospital, Bergen, Norway
| | - Parham Aram
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Eugene McCloskey
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
- MRC-Versus Arthritis Centre for Integrated Research Into Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, United Kingdom
| | - Visakan Kadirkamanathan
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Ashley W. Blom
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute of Health Research Biomedical Research Centre, Bristol, UK
| | - Stein Atle Lie
- Department of Orthopaedic Surgery, The Norwegian Arthroplasty Register, Haukeland University Hospital, Bergen, Norway
| | - Ove Nord Furnes
- Department of Orthopaedic Surgery, The Norwegian Arthroplasty Register, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - J. Mark Wilkinson
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield, UK
- MRC-Versus Arthritis Centre for Integrated Research Into Musculoskeletal Ageing (CIMA), University of Sheffield, Sheffield, United Kingdom
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