scholarly journals A Patient-Reported Outcome Tool to Triage Total Hip Arthroplasty Patients to Hospital or Video Consultation: Pilot Study With Expert Panels and a Cohort of 1228 Patients

10.2196/31232 ◽  
2021 ◽  
Vol 5 (12) ◽  
pp. e31232
Author(s):  
Yvette Pronk ◽  
Peter Pilot ◽  
Walter van der Weegen ◽  
Justus-Martijn Brinkman ◽  
Berend Willem Schreurs
Keyword(s):  
Pilot Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Severe Pain ◽  
Patient Reported Outcome ◽  
Patient Journey ◽  
Training Cohort ◽  
Total Hip ◽  
Patient Reported ◽  
Video Consultation

Background The digital transformation in health care has been accelerated by the COVID-19 pandemic. Video consultation has become the alternative for hospital consultation. It remains unknown how to select patients suitable for video consultation. Objective This study aimed to develop a tool based on patient-reported outcomes (PROs) to triage total hip arthroplasty (THA) patients to hospital or video consultation. Methods A pilot study with expert panels and a retrospective cohort with prospectively collected data from 1228 THA patients was executed. The primary outcome was a PRO triage tool to allocate THA patients to hospital or video consultation 6 weeks postoperatively. Expert panels defined the criteria and selected the patient-reported outcome measure (PROM) questions including thresholds. Data were divided into training and test cohorts. Distribution, floor effect, correlation, responsiveness, PRO patient journey, and homogeneity of the selected questions were investigated in the training cohort. The test cohort was used to provide an unbiased evaluation of the final triage tool. Results The expert panels selected moderate or severe pain and using 2 crutches as the triage tool criteria. PROM questions included in the final triage tool were numeric rating scale (NRS) pain during activity, 3-level version of the EuroQol 5 dimensions (EQ-5D-3L) questions 1 and 4, and Oxford Hip Score (OHS) questions 6, 8, and 12. Of the training cohort, 201 (201/703, 28.6%) patients needed a hospital consultation, which was statistically equal to the 150 (150/463, 32.4%) patients in the test cohort who needed a hospital consultation (P=.19). Conclusions A PRO triage tool based on moderate or severe pain and using 2 crutches was developed. Around 70% of THA patients could safely have a video consultation, and 30% needed a hospital consultation 6 weeks postoperatively. This tool is promising for selecting patients for video consultation while using an existing PROM infrastructure.

scholarly journals A Patient-Reported Outcome Tool to Triage Total Hip Arthroplasty Patients to Hospital or Video Consultation: Pilot Study With Expert Panels and a Cohort of 1228 Patients (Preprint)

2021 ◽  
Author(s):  
Yvette Pronk ◽  
Peter Pilot ◽  
Walter van der Weegen ◽  
Justus-Martijn Brinkman ◽  
Berend Willem Schreurs
Keyword(s):  
Pilot Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Severe Pain ◽  
Patient Reported Outcome ◽  
Patient Journey ◽  
Training Cohort ◽  
Total Hip ◽  
Patient Reported ◽  
Video Consultation

BACKGROUND The digital transformation in health care has been accelerated by the COVID-19 pandemic. Video consultation has become the alternative for hospital consultation. It remains unknown how to select patients suitable for video consultation. OBJECTIVE This study aimed to develop a tool based on patient-reported outcomes (PROs) to triage total hip arthroplasty (THA) patients to hospital or video consultation. METHODS A pilot study with expert panels and a retrospective cohort with prospectively collected data from 1228 THA patients was executed. The primary outcome was a PRO triage tool to allocate THA patients to hospital or video consultation 6 weeks postoperatively. Expert panels defined the criteria and selected the patient-reported outcome measure (PROM) questions including thresholds. Data were divided into training and test cohorts. Distribution, floor effect, correlation, responsiveness, PRO patient journey, and homogeneity of the selected questions were investigated in the training cohort. The test cohort was used to provide an unbiased evaluation of the final triage tool. RESULTS The expert panels selected moderate or severe pain and using 2 crutches as the triage tool criteria. PROM questions included in the final triage tool were numeric rating scale (NRS) pain during activity, 3-level version of the EuroQol 5 dimensions (EQ-5D-3L) questions 1 and 4, and Oxford Hip Score (OHS) questions 6, 8, and 12. Of the training cohort, 201 (201/703, 28.6%) patients needed a hospital consultation, which was statistically equal to the 150 (150/463, 32.4%) patients in the test cohort who needed a hospital consultation (<i>P</i>=.19). CONCLUSIONS A PRO triage tool based on moderate or severe pain and using 2 crutches was developed. Around 70% of THA patients could safely have a video consultation, and 30% needed a hospital consultation 6 weeks postoperatively. This tool is promising for selecting patients for video consultation while using an existing PROM infrastructure. CLINICALTRIAL

scholarly journals Patient-reported outcome after total hip arthroplasty: comparison between lateral and posterior approach

2017 ◽  
Vol 88 (3) ◽  
pp. 239-247 ◽  
Author(s):  
Signe Rosenlund ◽  
Leif Broeng ◽  
Anders Holsgaard-Larsen ◽  
Carsten Jensen ◽  
Søren Overgaard
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Patient Reported Outcome ◽  
Total Hip ◽  
Patient Reported ◽  
Lateral And Posterior Approach

Back Pain and Its Effects on Early Patient-Reported Outcome Measures in Total Hip Arthroplasty

2020 ◽  
Vol 4 (04) ◽  
pp. 180-186
Author(s):  
Vivek Singh ◽  
Stephen Zak ◽  
David Yeroushalmi ◽  
Ran Schwarzkopf ◽  
Roy I. Davidovitch
Keyword(s):  
Back Pain ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Smoking Status ◽  
Demographic Data ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Chi Square ◽  
Total Hip ◽  
Patient Reported

AbstractThe success of total hip arthroplasty (THA) may be negatively impacted in those with back pain as evidenced by patient-reported outcome (PRO) scores. The goal of this study was to determine whether the hip–spine relationship, as it relates to the presence of preoperative back pain, affected THA outcomes, and PRO scores. We retrospectively reviewed 243 patients who underwent primary THA and completed the Hip disability and Osteoarthritis Outcome Score Junior (HOOS Jr.), back pain questionnaire, and the Forgotten Joint Score-12 (FJS-12) preoperatively and at 12-weeks postoperatively. Patients were separated into two cohorts: those with preoperative back pain and those who were back pain free. Analysis was performed using t-test and chi-square to determine differences in demographic data. Regression analysis was utilized to account for differences in demographic data. There were significant demographic differences, which included body mass index, American Society of Anesthesiologists, smoking status, and length of stay between the two cohorts. Patients with preoperative back pain had lower preoperative HOOS Jr. scores than their counterparts (44.93 vs. 55.2; p = 0.029). Additionally, the preoperative back pain free group reported better FJS-12 and HOOS Jr. scores at 12-weeks postoperatively (FJS-12:62.00 vs. 43.32, p < 0.0001; HOOS Jr.: 81.33 vs. 75.68, p = 0.029). Patients with preoperative back pain had lower preoperative PRO scores and overall experienced less postoperative satisfaction and greater disability than patients who were back pain free. However, these patients' preoperative to postoperative improvement in PRO scores (delta change) was greater than that of the back pain free patients. These results suggest that THA may alter the hip-spine mechanics and potentially provide a reprieve from back pain.

Survivorship, Patient Reported Outcome and Satisfaction Following Resurfacing and Total Hip Arthroplasty

2013 ◽  
Vol 28 (5) ◽  
pp. 842-848 ◽  
Author(s):  
Michael R. Whitehouse ◽  
Alexander L. Aquilina ◽  
Sajal Patel ◽  
Stephen J. Eastaugh-Waring ◽  
Ashley W. Blom
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcome ◽  
Total Hip ◽  
Patient Reported

No clinically meaningful difference in 1-year patient-reported outcomes among major approaches for primary total hip arthroplasty

2021 ◽  
pp. 112070002199201
Author(s):  
◽  
James B Bircher ◽  
Atul F Kamath ◽  
Nicolas S Piuzzi ◽  
Wael K Barsoum ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Consecutive Series ◽  
Total Hip ◽  
Pain Scores ◽  
Significant Difference ◽  
Patient Reported ◽  
Primary Total Hip Arthroplasty

Background: Debate continues around the most effective surgical approach for primary total hip arthroplasty (THA). This study’s purpose was to compare 1-year patient-reported outcome measures (PROMs) of patients who underwent direct anterior (DA), transgluteal anterolateral (AL)/direct lateral (DL), and posterolateral (PL) approaches. Methods: A prospective consecutive series of primary THA for osteoarthritis ( n = 2,390) were performed at 5 sites within a single institution with standardised care pathways (20 surgeons). Patients were categorised by approach: DA ( n = 913; 38%), AL/DL ( n = 505; 21%), or PL ( n = 972; 41%). Primary outcomes were pain, function, and activity assessed by 1-year postoperative PROMs. Multivariable regression modeling was used to control for differences among the groups. Wald tests were performed to test the significance of select patient factors and simultaneous 95% confidence intervals were constructed. Results: At 1-year postoperative, PROMs were successfully collected from 1842 (77.1%) patients. Approach was a statistically significant factor for 1-year HOOS pain ( p = 0.002). Approach was not a significant factor for 1-year HOOS-PS ( p = 0.16) or 1-year UCLA activity ( p = 0.382). Pairwise comparisons showed no significant difference in 1-year HOOS pain scores between DA and PL approach ( p  > 0.05). AL/DL approach had lower (worse) pain scores than DA or PL approaches with differences in adjusted median score of 3.47 and 2.43, respectively ( p  < 0.05). Conclusions: Patients receiving the AL/DL approach had a small statistical difference in pain scores at 1 year, but no clinically meaningful differences in pain, activity, or function exist at 1-year postoperative.

No Clinically Meaningful Differences in 1-Year Patient-Reported Outcome Measures between Hip Resurfacing and Total Hip Arthroplasty: An Age-Matched Prospective Cohort Study

2021 ◽  
Author(s):  
Marcelo Siqueira ◽  
Keyword(s):  
Total Hip Arthroplasty ◽  
Outcome Measures ◽  
Hip Arthroplasty ◽  
Prospective Cohort ◽  
Patient Reported Outcome Measures ◽  
Hip Resurfacing ◽  
Patient Reported Outcome ◽  
Total Hip ◽  
Patient Reported

AbstractThis study compared patient-reported outcome measures (PROMs), readmissions, and reoperations between hip resurfacing (HR) and total hip arthroplasty (THA) in a matched prospective cohort. Between 2015 and 2017, 4,268 patients underwent HR or THA at a single institution. A prospective cohort of 2,147 patients were enrolled (707 HRs, 1,440 THAs). PROMs were collected at baseline and 1-year follow-up. Exclusion criteria: females (n = 2,008), inability/refusal to complete PROMs (n = 54), and diagnosis other than osteoarthritis (n = 59). Each HR patient was age-matched to a THA patient. Multivariate regression models were constructed to control for race, body mass index, education, smoking status, Charlson Comorbidity Index, mental health, and functional scores. A significance threshold was set at p = 0.017. A total of 707 HRs and 707 THAs were analyzed and 579 HRs (81.9%) and 490 THAs (69.3%) were followed up at 1 year. There was no statistically significant difference for Hip Injury and Osteoarthritis Outcomes Score (HOOS) Pain subscale (p = 0.129) and HOOS-Physical Function Shortform (HOOS-PS) (p = 0.03). HR had significantly higher median University of California in Los Angeles (UCLA) activity scores (p = 0.004). Ninety-day readmissions for HR and THAs were 1.8 and 3.5%, respectively (p = 0.06), and reoperations at 1 year were 1.2 and 2.3%, respectively (p = 0.24). For male patients, differences in medians for UCLA activity scores were 0.383 points, which were statistically significant but may not be clinically relevant. No differences exist in 90-day readmissions, reoperations, and HOOSpain and HOOS-PS scores. Because patients undergoing HR are advised to return to full activity at 1-year postoperative, follow-up is required. Metal ion levels were not obtained postoperatively for either group.

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