Validation of a Novel Surgical Data Capturing System Following Total Hip Arthroplasty

Curtis, Gannon L.; Tariq, Muhammad; Brigati, David P.; Faour, Mhamad; Barsoum, Wael K.; Bloomfield, Michael R.; Brooks, Peter J.; Klika, Alison K.; Krebs, Viktor E.; Mesko, Nathan W.; Molloy, Robert; Murray, Trevor G.; Muschler, George F.; Nickodem, Robert J.; Patel, Preetesh D.; Sosic, Elizabeth; Spindler, Kurt P.; Stearns, Kim L.; Strnad, Greg

doi:10.1016/j.arth.2018.07.011

Cited by 34 publications

(30 citation statements)

References 10 publications

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“…2;4;21 As of February, 2018, OME is used by 57 surgeons at 10 sites within the Cleveland Clinic Health System to document surgical details and PROMs on 97% of 21,500 elective knee, shoulder, and hip surgeries. Validation studies for OME in total knee arthroplasty, 21 total hip arthroplasty, 4 ACL and meniscus repair have demonstrated excellent performance of this new system in point-of-care implant documentation. Having developed and now validated the OME system for data collection, one of our future objectives is to use the OME system to create a standardized operative report and integrate with EMR systems to replace the existing methods of creating operative reports.…”

Section: Discussionmentioning

confidence: 99%

Validity and efficiency of a smartphone-based electronic data collection tool for operative data in rotator cuff repair

Sahoo

Mohr

Strnad

et al. 2019

Journal of Shoulder and Elbow Surgery

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Purpose-This study tested validity and efficiency of Orthopaedic Minimal Data Set (OrthoMiDaS) Episode of Care (OME).Methods-100 isolated rotator cuff repair cases in the OME database were analyzed. Surgeons completed a traditional operative note and OME report. A blinded reviewer extracted data from operative notes and implant logs in electronic medical records by manual chart review. OME and EMR data were compared with data counts and agreement between 40 variables of rotator cuff pathology and repair procedures. Data counts were assessed using raw percentages and *

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Section: Discussionmentioning

confidence: 99%

Validity and efficiency of a smartphone-based electronic data collection tool for operative data in rotator cuff repair

Sahoo

Mohr

Strnad

et al. 2019

Journal of Shoulder and Elbow Surgery

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“…We considered potentially eligible all patients who underwent primary elective unilateral THA or TKA at one of seven large, urban hospitals in Ohio and Florida within a tertiary healthcare system between November 2018 and December 2019 [19, 20]. Data were obtained via a previously described and validated institutional data collection system [6, 19]. This system captures more than 97% of elective orthopaedic surgical interventions and records baseline patient demographics, comorbidities, perioperative and postoperative details, as well as 90-day readmissions in the healthcare system.…”

Section: Methodsmentioning

confidence: 99%

Racial Disparities in Outcomes After THA and TKA Are Substantially Mediated by Socioeconomic Disadvantage Both in Black and White Patients

Hadad

Rullán-Oliver

Grits

et al. 2022

Clin Orthop Relat Res

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Background Demographic factors have been implicated in THA and TKA outcome disparities. Specifically, patients' racial backgrounds have been reported to influence outcomes after surgery, including length of stay, discharge disposition, and inpatient readmissions. However, in the United States, health-impacting socioeconomic disadvantage is sometimes associated with racial differences in ways that can result in important confounding, thereby raising the question of whether race-associated post-THA/TKA adverse outcomes are an independent function of race or a byproduct of confounding from socioeconomic deprivation, which is potentially addressable. To explore this, we used the Area Deprivation Index (ADI) as a proxy for socioeconomic disadvantage, since it is a socioeconomic parameter that estimates the likely deprivation associated with a patient's home address. Questions/purposesThe goal of this study was to investigate (1) whether race (in this study, Black versus White) was independently associated with adverse outcomes, including prolonged length of stay (LOS > 3 days), nonhome discharge, 90-day readmission, and emergency department (ED) visits while controlling for age, gender, BMI, smoking, Charlson comorbidity index (CCI), and insurance; and (2) whether socioeconomic disadvantage, measured by ADI, substantially mediated any association between race and any of the aforementioned measured outcomes. Methods Between November 2018 and December 2019, 2638 underwent elective primary THA and 4915 patients underwent elective primary TKA for osteoarthritis at one of seven hospitals within a single academic center. Overall, 12% (742 of 5948) of patients were Black and 88% (5206 of 5948) were White. We included patients with complete demographic data, ADI data, and who were of Black or White race; with these criteria, 11% (293 of 2638) were excluded in the THA group, and 27% (1312 of 4915) of patients were excluded in the TKA group. In this retrospective, comparative study, patient follow-up was obtained using a longitudinally maintained database, leaving 89% (2345 of 2638) and 73% (3603 of 4915) for analysis in the THA and TKA groups, respectively. For both THA and TKA, Black patients had higher ADI scores, slightly higher BMIs, and were more likely to be current smokers at baseline. Furthermore, within the TKA cohort there was a higher proportion of Black women compared with White women. Multivariable regression analysis was utilized to assess associations between race and LOS of 3 or more days, nonhome discharge disposition, 90-dayThe authors certify that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Ethical appro...

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“…A cohort of consecutive patients who underwent primary unilateral THA or TKA at a single large hospital system from December 2016 through March 2020 were identified (n = 13,190) 15,16 . Data were obtained via a previously described and validated institutional data collection system, the Orthopaedic Minimal Data Set Episode of Care (OME) 16,17 . This system captures >97% of elective orthopaedic surgical interventions and records baseline patient demographics, comorbidities, perioperative details (surgical details and discharge disposition), and 90-day readmission occurring in the health-care system and does not require procedural-code-dependent data extraction.…”

Section: Study Design and Settingmentioning

confidence: 99%

PLAN and AM-PAC “6-Clicks” Scores to Predict Discharge Disposition After Primary Total Hip and Knee Arthroplasty

Hadad

Orr

Klika

et al. 2021

Journal of Bone and Joint Surgery

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Background: Determination of the appropriate post-discharge disposition after total hip (THA) and knee (TKA) arthroplasty is a challenging multidisciplinary decision. Algorithms used to guide this decision have been administered both preoperatively and postoperatively. The purpose of this study was to simultaneously evaluate the predictive ability of 2 such tools-the preoperatively administered Predicting Location after Arthroplasty Nomogram (PLAN) and the postoperatively administered Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" basic mobility tools-in accurately determining discharge disposition after elective THA and TKA. Methods:The study included 11,672 patients who underwent THA (n = 4,923) or TKA (n = 6,749) at a single large hospital system from December 2016 through March 2020. PLAN and "6-Clicks" basic mobility scores were recorded for all patients. Regression models and receiver operator characteristic curves were constructed to evaluate the tools' prediction concordance with the actual discharge disposition (home compared with a facility).Results: PLAN scores had a concordance index of 0.723 for the THA cohort and 0.738 for the TKA cohort. The first "6-Clicks" mobility score (recorded within the first 48 hours postoperatively) had a concordance index of 0.813 for the THA cohort and 0.790 for the TKA cohort. When PLAN and first "6-Clicks" mobility scores were used together, a concordance index of 0.836 was observed for the THA cohort and 0.836 for the TKA cohort. When the PLAN and "6-Clicks" agreed on home discharge, higher rates of discharge to home (98.0% for THA and 97.7% for TKA) and lower readmission rates (5.1% for THA and 7.0% for TKA) were observed, compared with when the tools disagreed.Conclusions: PLAN and "6-Clicks" basic mobility scores were good-to-excellent predictors of discharge disposition after primary total joint arthroplasty, suggesting that both preoperative and postoperative variables influence discharge disposition. We recommend that preoperative variables be collected and used to generate a tentative plan for discharge, and the final decision on discharge disposition be augmented by early postoperative evaluation.Clinical Relevance: The determination of post-discharge needs after THA and TKA remains a complex clinical decision.This study shows how simultaneously exploring the predictive ability of preoperative and postoperative assessment tools on discharge disposition after total joint arthroplasty may be a useful aid in a value-driven health-care model. P rimary total hip (THA) and knee (TKA) arthroplasties are widely successful orthopaedic operations with >50% growth expected over the next decade 1,2 . Uneventful postoperative home discharge is anticipated for most patients; however, after up to 22.2% of TKAs and 19.5% of THAs, the patients are discharged to a higher level of post-discharge care, such as a skilled nursing facility (SNF) and an inpatient rehabilitation facility (IRF) 3,4 . Notably, non-home discharge (to an SNF or IRF) is independently associated w...

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Validation of a Novel Surgical Data Capturing System Following Total Hip Arthroplasty

Cited by 34 publications

References 10 publications

Validity and efficiency of a smartphone-based electronic data collection tool for operative data in rotator cuff repair

Validity and efficiency of a smartphone-based electronic data collection tool for operative data in rotator cuff repair

Racial Disparities in Outcomes After THA and TKA Are Substantially Mediated by Socioeconomic Disadvantage Both in Black and White Patients

PLAN and AM-PAC “6-Clicks” Scores to Predict Discharge Disposition After Primary Total Hip and Knee Arthroplasty

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