Evaluation of the Multi-Attribute Prioritisation Tool for Total Joint Replacement

Nganga, Michael; Bramwell, Donald; Monaghan, Jenifer; Doerr, Christine; Mercer, Graham; Krishnan, Jeganath

doi:10.1016/j.jor.2018.01.004

Cited by 7 publications

(18 citation statements)

References 10 publications

(21 reference statements)

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“…Nganga (30) reported a cohort study from Australia, including 308 patients undergoing total hip or knee arthroplasty from June 2008 to March 2009. The study examined pre-operative and post-operative Multi-Attribute Prioritisation Tool (MAPT) scores for these patients.…”

Section: Resultsmentioning

confidence: 99%

“…The quality of the individual studies that we included in this review was measured using two tools. In addition to the four intervention studies, we evaluated three of the other studies with ROBINS-I considering the longitudinal assessment of their outcome variable (29, 30, 35). The relevant CASP reading tool was used to evaluate the other ten studies.…”

Section: Resultsmentioning

confidence: 99%

“…We judged five studies to have an overall moderate quality ((29, 30, 35, 37, 40) and two studies to have a serious risk of bias in their methodology (32, 39). Details of ROBINS-I evaluation for each domain is shown in Figure 2 and Figure 3.…”

Section: Resultsmentioning

confidence: 99%

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Patient prioritisation methods to shorten waiting times for elective surgery: a systematic review of how to improve access to surgery

Rathnayake

Clarke²,

Jayasinghe

2021

Preprint

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Background: Concern about long waiting times for elective surgeries is not a recent phenomenon, but it has been heightened by the impact of the COVID-19 pandemic and its associated measures. One way to alleviate the problem might be to use prioritisation methods for patients on the waiting list and a wide range of research is available on such methods. However, significant variations and inconsistencies have been reported in prioritisation protocols from various specialties, institutions, and health systems. To bridge the evidence gap in existing literature, this comprehensive systematic review will synthesise global evidence on policy strategies with a unique insight to patient prioritisation methods to reduce waiting times for elective surgeries. This will provide evidence that might help with the tremendous burden of surgical disease that is now apparent in many countries because of operations that were delayed or cancelled due to the COVID-19 pandemic and inform policy for sustainable healthcare management systems. Methods: We searched PubMed, EMBASE, SCOPUS, Web of Science, and the Cochrane Library, with our most recent searches in January 2020. Articles published after 2013 on major elective surgery lists of adult patients were eligible, but cancer and cancer-related surgeries were excluded. Both randomised and non-randomised studies were eligible and the quality of studies was assessed with ROBINS-I and CASP tools. We registered the review in PROSPERO (CRD42019158455) and reported it in accordance with the PRISMA statement. Results: The electronic search in five bibliographic databases yielded 7543 records (PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane) and 17 eligible articles were identified in the screening. There were four quasi-experimental studies, 11 observational studies and two systematic reviews. These demonstrated a moderate to low risk of bias in their research methods. Three studies tested generic approaches using common prioritisation systems for all elective surgeries in common. The other studies assessed specific prioritisation approaches for re-ordering the waiting list for a particular surgical specialty. Conclusions: Explicit prioritisation tools with a standardised scoring system based on clear evidence-based criteria are likely to reduce waiting times and improve equitable access to health care. Multiple attributes need to be considered in defining a fair prioritisation system to overcome limitations with local variations and discriminations. Collating evidence from a diverse body of research provides a single framework to improve the quality and efficiency of elective surgical care provision in a variety of health settings. Universal prioritisation tools with vertical and horizontal equity would help with re-ordering patients on waiting lists for elective surgery and reduce waiting times. Keywords: Patient prioritisation, elective surgery, waiting time, systematic review

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Patient prioritisation methods to shorten waiting times for elective surgery: a systematic review of how to improve access to surgery

Rathnayake

Clarke²,

Jayasinghe

2021

Preprint

View full text Add to dashboard Cite

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“…26 In traditional surgery, preoperative imaging and template measurements assist in the intraoperative placement of the prosthesis. 27,28 However, because of the large number of factors affecting preoperative imaging and the unstable position of the intraoperative patient, the positions of pelvis and femur change, 29 causing deviations between the intraoperative and preoperative results and ultimately affecting the placement of the prosthesis. 28 Imageless navigation technology uses computer technology to accurately correlate the preoperative imaging data with the intraoperative anatomy of the patient, tracks the surgical instruments in real time by detecting markers and displaying them in a virtual scene, 10,30 and transmits the information to the surgeon in real time.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

et al. 2019

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Objective This study was performed to compare the clinical efficacy between the OrthoPilot navigation system and conventional manual surgery in patients undergoing total hip arthroplasty. Methods The Embase, PubMed, CINAHL, and Cochrane databases were searched for clinical trials. The outcome measurements were the anteversion angle, inclination angle, and complications. Review Manager 5.3 statistical software was used for the data analysis. Results Significant differences were found in the femoral offset and overall complication rate between the conventional and navigation groups. Additionally, the conventional group had significantly less anteversion than the navigation group. However, the navigation group had significantly better inclination. The operation time was significantly shorter in the conventional than navigation group. Conclusion Both the OrthoPilot navigation system and conventional total hip arthroplasty result in significant improvements in patient function with similar overall complication rates and have their own advantages in achieving good cup position. The conventional procedure has a shorter operation time than does use of a navigation system.

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“…[26] In traditional surgery, preoperative imaging, and template measurements assist in the intraoperative placement of the prosthesis. [27] However, due to the large number of factors affecting preoperative imaging, and the unstable position of the intraoperative patient, the position of pelvis and femur changes, [28] causing deviations between the intraoperative and preoperative results, which ultimately affect the placement of the prosthesis. [29]…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of orthopilot navigation system versus conventional manual of total hip arthroplasty

Jia

Zhao

et al. 2019

Medicine

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Background: To compare the clinical efficacy between Orthopilot navigation system and conventional manual surgery in total hip arthroplasty (THA). Methods: Electronic databases were searched to identify randomized controlled trials (RCTs) investigating Orthopilot navigation system versus conventional manual in patients undergoing THA. Outcome measurements include anteversion angle, inclination angle, preoperative leg length discrepancy, postoperative leg length discrepancy and femoral offset. Statistical software Stata 12.0 was used for data-analysis. Results: A total of 5 studies were finally included in this meta-analysis. The results showed that the conventional manual group have a less anteversion angle than that in Orthopilot navigation system group (weighted mean difference (WMD) = 4.67, 95% confidence interval (CI) = 3.53, 5.82, P = .000). And pooled analysis showed that the inclination angle in Orthopilot navigation group was less than that in conventional manual group (WMD = −4.19, 95% CI = −8.00, −0.37, P = .031). There was no significant difference between the preoperative leg length discrepancy and postoperative leg length discrepancy ( P > .05). Orthopilot navigation system compared with conventional manual procedure was associated with decreased of femoral offset by 2.76 (WMD = −2.76, 95%CI = −3.90, −1.62, P = .000). Conclusion: Both Orthopilot navigation system and conventional THA result in significant improvements in patient function with similar overall complication rates and have their own edges in cup position.

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Evaluation of the Multi-Attribute Prioritisation Tool for Total Joint Replacement

Abstract: TJR patients prioritised by the MAPT questionnaire do experience pain relief as portrayed by a reduction in postoperative MAPT score. A longer length of time on the waiting list seems to effect the improvement a high priority patient can have postoperative.

Cited by 7 publications

References 10 publications

Patient prioritisation methods to shorten waiting times for elective surgery: a systematic review of how to improve access to surgery

Patient prioritisation methods to shorten waiting times for elective surgery: a systematic review of how to improve access to surgery

Clinical efficacy of OrthoPilot navigation system versus conventional manual total hip arthroplasty: A systematic review and meta‐analysis

Clinical efficacy of orthopilot navigation system versus conventional manual of total hip arthroplasty

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