A smart decision: smartphone use for operative data collection in arthroscopic shoulder instability surgery

Abstract

Objective This study tested validity, accuracy, and efficiency of the Orthopaedic Minimal Data Set Episode of Care (OME) compared with traditional operative report in arthroscopic surgery for shoulder instability. As of November 2017, OME had successfully captured baseline data on 97% of 18 700 eligible cases. Materials and Methods This study analyzes 100 cases entered into OME through smartphones by 12 surgeons at an institution from February to October 2015. A blinded reviewer extracted the same variables from operative report into a separate database. Completion rates and agreement were compared. They were assessed using raw percentages and McNemar’s test (with continuity correction). Agreement between nominal variables was assessed by unweighted Cohen’s kappa and a concordance correlation coefficient measured agreement between continuous variables. Efficiency was assessed by median time to complete. Results Of 37 variables, OME demonstrated equal or higher completion rates for all but 1 and had significantly higher capture rates for 49% (n = 18; P < .05). Of 33 nominal variables, raw proportional agreement was ≥0.90 for 76% (n = 25). Raw proportional agreement was perfect for 15% (n = 5); no agreement statistic could be calculated due to a single variable in operative note and OME. Calculated agreement statistic was substantial or better (κ > 0.61) for 51% (n = 17) for the 33 nominal variables. All continuous variables assessed (n = 4) demonstrated poor agreement (concordance correlation coefficient <0.90). Median time for completing OME was 103.5 (interquartile range, 80.5-151) seconds. Conclusions The OME smartphone data capture system routinely captured more data than operative report and demonstrated acceptable agreement for nearly all nominal variables, yet took <2 minutes to complete on average.

Validation of a Novel Smartphone-Based Electronic Data Capture System Following Surgical Fixation of Distal Radial Fractures

“…However, the OME data collection tool and resultant datasets have been previously validated for multiple surgical interventions and used in a growing number of contemporary studies. 7-12,15-17 Curtis et al 8 investigated the completion rates and agreement measures between OME- and EMR-based control datasets capturing peri/intraoperative details of primary total hip arthroplasty. The authors reported that the OME dataset demonstrated significantly higher completion rates in 41% of the evaluated variables.…”

“…The OME dataset has been previously shown to provide reliable data for upper extremity surgery. Mohr et al 10 evaluated the OME completion and agreement between 100 surgical treatment cases of arthroscopic shoulder instability. Datapoints were recorded in the OME by 12 surgeons and compared with EMR-based dataset extracted by a blinded reviewer.…”

“…The OME is currently the standard of care for all patients who undergo knee, hip, shoulder, and hand procedures. [7][8][9][10][11][12][15][16][17] Demographic data and PROMs are input preoperatively via a tablet on arriving at the surgical center. Surgeons are then e-mailed a restricted link specific to the surgical episode on the day of surgery.…”

“…Previous studies have established its effectiveness in hip, knee, and shoulder surgeries, but it has yet to be proven in hand surgery. 7-12…”

“…Previous studies have established its effectiveness in hip, knee, and shoulder surgeries, but it has yet to be proven in hand surgery. [7][8][9][10][11][12] This study aimed to evaluate the OME system as a data collection tool for DRF surgical fixation compared with manual extraction from operative reports. We aimed to both: (1) compare the completeness of the OME versus EMR data; and (2) test the agreement between the OME versus EMR data for DRF surgical fixation.…”