scholarly journals Uniform criteria for total hip replacement surgery in patients with hip osteoarthritis: a decision tool to guide treatment decisions

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Femke Atsma ◽  
Olivier Molenkamp ◽  
Heinse Bouma ◽  
Stefan B Bolder ◽  
A Stef Groenewoud ◽  
...  
Keyword(s):  
Decision Making ◽  
Prediction Model ◽  
Internal Rotation ◽  
Hip Replacement ◽  
Prediction Models ◽  
Hip Osteoarthritis ◽  
Decision Making Process ◽  
Decision Tool ◽  
Replacement Surgery ◽  
Hip Replacement Surgery

Abstract Background Uniform criteria for performing hip replacement surgery in hip osteoarthritis patients are currently lacking. As a result, variation in surgery and inappropriateness of care may occur. The aim of this study was to develop a consensus-based decision tool to support the decision-making process for hip replacement surgery. Methods Patients with a diagnosis of unilateral or bilateral osteoarthritis were included. Consensus rounds with orthopedic surgeons were organized to blindly reassess medical files and to decide whether surgery is indicated or not, based on all available pre-treatment information. We compared the outcomes obtained from the blind reassessment by the consensus group with the actual treatment. Furthermore, prediction models were fitted on the reassessment outcome to identify which set of clinical parameters would be most predictive and uniformly shared in the decision to operate. Two prediction models were fitted, one model without radiologic outcomes and one model where radiologic outcomes were included. Results In total, 364 medical files of osteoarthritis patients were included and reassessed in the analyses. Key predictors in the prediction model without radiology were age, flexion, internal rotation and the Hip disability and Osteoarthritis Outcome Score–quality of life. The discriminative power was high (Area Under Receiver Operating Curve (AUC) = 0.86). Key predictors in the prediction model with radiology were age, internal rotation and Kellgren and Lawrence severity score (AUC = 0.94). Conclusion The study yielded a decision tool with uniform criteria for hip replacement surgery in osteoarthritis patients. The tool will guide the clinical decision-making process of physicians on whether to perform hip surgery and should be used together with information about patient preferences and social context.

scholarly journals Self-reported outcomes of patients undergoing total hip replacement surgery assessed by the WOMAC questionnaire

2011 ◽  
Vol 9 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Michele Ferreira de Souza Di Nubila ◽  
Carolina Gomes Matarazzo ◽  
Andrea Diniz Lopes-Albers ◽  
Fátima Cristina Martorano Gobbi
Keyword(s):  
Hip Fracture ◽  
Hospital Discharge ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Womac Questionnaire ◽  
Baseline Values

ABSTRACT Objective: To assess pain, stiffness and physical function outcomes among patients undergoing total hip replacement using the Western Ontario and McMaster Universities Osteoarthritis Index. Methods: From January 2009 to July 2010, 64 male and female patients were assessed using the WOMAC questionnaire at baseline, hospital discharge, 3-month follow-up, and 6-month follow-up; one group of patients with primary hip osteoarthritis (n = 42) and another group with hip fracture (n = 22). Results: Changes in the total scores of the osteoarthritis group were statistically significant comparing baseline, hospital discharge, 3-month and 6-month assessments, demonstrating continued improvement over time up to 6-month follow-up. The total scores of the hip fracture group demonstrated a worsening from baseline to discharge, followed by improvement. The differences were statistically significant between baseline and discharge, as well as between discharge and the 6-month assessment. No statistically significant differences were found between baseline values and the 3-month assessment or baseline values and the 6-month assessment, demonstrating that the patients returned to their baseline health status after 3 months and maintained this status up to 6-month follow-up. Conclusion: The Western Ontario and McMaster Universities Osteoarthritis Index questionnaire detected changes in outcome following hip replacement surgery among patients with primary diagnoses of hip osteoarthritis and hip fracture, with differences in the pattern of changes between the two groups.

scholarly journals How Prediction Accuracy Can Affect the Decision-Making Process in Pavement Management System

2021 ◽  
Vol 6 (2) ◽  
pp. 28
Author(s):  
Seyed Amirhossein Hosseini ◽  
Omar Smadi
Keyword(s):  
Decision Making ◽  
Prediction Model ◽  
Prediction Models ◽  
Reduction Rate ◽  
Pavement Management ◽  
Decision Making Process ◽  
Pavement Management Systems ◽  
Maintenance And Rehabilitation ◽  
Predicted Values ◽  
The Cost

One of the most important components of pavement management systems is predicting the deterioration of the network through performance models. The accuracy of the prediction model is important for prioritizing maintenance action. This paper describes how the accuracy of prediction models can have an effect on the decision-making process in terms of the cost of maintenance and rehabilitation activities. The process is simulating the propagation of the error between the actual and predicted values of pavement performance indicators. Different rate of error (10%, 30%, 50%, 70%, and 90%) was added into the result of prediction models. The results showed a strong correlation between the prediction models’ accuracy and the cost of maintenance and rehabilitation activities. The cost of treatment (in millions of dollars) over 20 years for five different scenarios increased from ($54.07–$92.95), ($53.89–$155.48), and ($74.41–$107.77) for asphalt, composite, and concrete pavement types, respectively. Increasing the rate of error also contributed to the prediction model, resulting in a higher benefit reduction rate.

Factors Influencing the Outcomes of Artificial Hip Replacements

2018 ◽  
Vol 206 (4-5) ◽  
pp. 254-262
Author(s):  
Xingen Zhang ◽  
Gang Shi ◽  
Xianjie Sun ◽  
Wei Zheng ◽  
Xueping Lin ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Specific Effect ◽  
Hip Osteoarthritis ◽  
Prosthetic Material ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Artificial Hip ◽  
Hip Replacements ◽  
Time Specific

Hip replacement is one of the most successful surgeries in the clinic for the removal of painful joints. Hip osteoarthritis and femoral head necrosis are the 2 main reasons for hip replacement. Several factors are associated with the outcomes of surgery. Nonsurgical factors include gender, age, body mass index, prosthetic material, and risk factors. Surgical factors are anesthesia, postoperative complications, and rehabilitation. Considering the increasing demand for hip arthroplasty and the rise in the number of revision operations, it is imperative to understand factor-related progress and how modifications of these factors promotes recovery following hip replacement. In this review, we first summarize recent findings regarding crucial factors that influence the outcomes of artificial hip replacement surgery. These findings not only show the time-specific effect for the treatment and recovery from hip arthroplasty in the clinic, but also provide suitable choices for different individuals for clinicians to consider. This, in turn, will help to develop the best possible postoperative program for specific patients.

How Prediction Accuracy can Affect the Decision-Making Process in Pavement Management System

2020 ◽  
Author(s):  
Seyed Amirhossein Hosseini ◽  
Omar Smadi
Keyword(s):  
Decision Making ◽  
Prediction Model ◽  
Prediction Models ◽  
Reduction Rate ◽  
Pavement Management ◽  
Decision Making Process ◽  
Pavement Management Systems ◽  
Maintenance And Rehabilitation ◽  
Predicted Values ◽  
The Cost

One of the most important components of pavement management systems is predicting the deterioration of the network through performance models. The accuracy of the prediction model is important for prioritizing maintenance action. This paper describes how the accuracy of prediction models can have an effect on the decision-making process in terms of the cost of maintenance and rehabilitation activities. The process is simulating the propagation of the error between the actual and predicted values of pavement performance indicators. Different rate of error was added into the result of prediction models. The results showed a strong correlation between the prediction models’ accuracy and the cost of maintenance and rehabilitation activities. Also, increasing the rate of error contribution to the prediction model resulting in a higher benefit reduction rate.

scholarly journals Diagnostic Analysis of Patients Qualified for Hip Replacement Using Multi-Criteria Methods

2020 ◽  
Vol 15 (4) ◽  
pp. 56-69
Author(s):  
Luiza Fabisiak ◽  
Karina Szczypor-Piasecka
Keyword(s):  
Decision Tree ◽  
Hip Replacement ◽  
Hip Osteoarthritis ◽  
Health Condition ◽  
Diagnostic Analysis ◽  
Ahp Method ◽  
Preference Model ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Electre Tri

Patients with advanced hip osteoarthritis are likely to suffer from biomechanical disorders. As many criteria inform how such patients are being qualified for alloplasty procedures, this article proposes a multi-criteria decisional framework in qualifying patients for treatment while undergoing diagnostic analysis for hip replacement surgery. In order to assess the patient's health condition, the competence of physicians and physiotherapists must first be checked. After creating the expert preference model and decision tree, the AHP method was applied followed by the Electre Tri method in the next stage of verification. Integrating these analytic procedures, a group of patients can be quickly evaluated and meaningfully profiled. Specifically, these patients can be classified in respect of their condition determined during hospitalisation as per the severity of degenerative disease and on the basis of their subjective feelings and diagnostics. The proposed methodology promises to allow optimal treatment to be assigned while enabling the appropriate classification and verification within group of patients targeted for hip replacement surgery.

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