Variations In Good Patient Reported Outcomes After Total Knee Arthroplasty

Kiran, Amit; Bottomley, Nicholas; Biant, Leela; Javaid, M K; Carr, Andrew; Cooper, Cyrus; Field, Richard E.; Murray, David; Price, Andrew; Beard, David; Arden, N K

doi:10.1016/j.arth.2015.02.039

Cited by 33 publications

(29 citation statements)

References 26 publications

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“…All these 12 studies used the terminology MCID alone except for one study [25] which used both MCID and MIC. Of the remaining 6 (33%) studies, two studies [13,26] used clinically important difference (CID) alone, one study [12] used MCIC alone, one study [27] used MID alone, and one study [28] used both MIC and MID. Hence, although MCID was the most frequently used terminology to indicate clinically important change after TKA, other related terminologies are employed in about one third of the available studies.…”

Section: Resultsmentioning

confidence: 99%

Minimal clinically important difference of commonly used patient-reported outcome measures in total knee arthroplasty: review of terminologies, methods and proposed values

Maredupaka¹,

Meshram²,

Chatte³

et al. 2020

Knee Surg & Relat Res

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The aim of this article was to highlight various terminologies and methods of calculation of minimal clinically important difference (MCID) and summarize MCID values of frequently used patient-reported outcome measures (PROMs) evaluating total knee arthroplasty (TKA). Materials and methods: PubMed and EMBASE databases were searched through May 2019. Of 71 articles identified, 18 articles matched and underwent a comprehensive analysis for terminologies used to indicate clinical significance, method of calculation, and reported MCID values. Results: MCID was the most common terminology (67% studies) and anchor-based methods were most commonly employed (67% studies) to calculate it. The analytical methods used to calculate and the estimated values of MCID for clinical use are highly variable. MCID values reported for WOMAC scores are 20.5 to 36.0, 17.6 to 33.0 and 12.9 to 25.0 for pain, function and stiffness sub-scales, respectively, and 4.7 to 10.0 for OKS. Conclusion: There was lack of standardization in the methodology employed to calculate MCID in the available studies. MCID values reported in this review could be used for patients undergoing TKA, although caution is advised in their interpretation and application.

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Section: Resultsmentioning

confidence: 99%

Minimal clinically important difference of commonly used patient-reported outcome measures in total knee arthroplasty: review of terminologies, methods and proposed values

Maredupaka¹,

Meshram²,

Chatte³

et al. 2020

Knee Surg & Relat Res

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show abstract

“…Based on findings of previous studies e a limited number of which actually report variances between responders and non-responders e this difference in pre-operative OKS was not expected 10,11,50 . Non-responders had, on average, lower (worse) mean pre-operative OKS score than responders, suggesting that a group of patients with worse severity of post-operative symptoms were not accounted for and there was therefore a higher chance of type II error.…”

Section: Limitationsmentioning

confidence: 88%

Do foot & ankle assessments assist the explanation of 1 year knee arthroplasty outcomes?

Gates

Bowen

Sanchez‐Santos

et al. 2017

Osteoarthritis and Cartilage

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“…In addition, age-associated differences in postoperative expectations may impart influence on how patients perceive the care they have received. 19 Therefore, this report assessed which factors from the PG survey affect the experience of care in patients who are aged younger than 50 years, from 50 to 80 years of age, and older than 80 years of age. While the mean scores of individual PG domains were not significantly different between the three age groups, several different domains were observed to impart significant influence on the overall hospital rating between the groups.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is an abundance of literature highlighting age-related differences in patient expectation of care. [19][20][21] However, it is not well understood whether the age of TKA patients imparts any kind of influence on PG scores and hospital ratings. Therefore, we asked (1) is there a difference in how patients rate PG survey elements between patients < 50 years of age, 50 to 80 years of age, and > 80 years of age and (2) what factors influence PG overall hospital rating in the various age groups?…”

mentioning

confidence: 99%

Does Age Influence How Patients Rate Their Experience of Care after Total Knee Arthroplasty?

et al. 2017

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The Centers for Medicare and Medicaid Services (CMS) have recently modified models for physician compensation with the use of patient administered surveys, such as the Press Ganey (PG). Currently, it is not well understood how the age of total knee arthroplasty (TKA) patients influences PG scores and hospital ratings. Therefore, we asked: (1) is there a difference in how patients rate PG survey elements between patients < 50 years of age, 50 to 80 years of age, and > 80 years of age and (2) what factors influence PG overall hospital rating in the various age groups? The PG database from our institution was queried from November 2009 to January 2015, yielding 728 patients who received a primary TKA. Patients were stratified by age at the time of surgery, based on those < 50 years (n = 43), 50 to 80 years (n = 639), and > 80 years of age (n = 46). The means for each domain was calculated and multiple regression analyses were performed separately for the three cohorts, to assess the influence (β-weight) of each domain on overall hospital ratings. Chi-square tests and Student's t-tests were performed appropriately to assess differences in categorical and continuous data between the three cohorts. No significant difference in mean scores was observed in any individual domain category between the three age groups. Communication with nurses had a significant influence on overall hospital rating in all three age groups. In addition, perception of pain demonstrated a significant influence on overall hospital rating for patients < 50 years of age (β = 0.807, p = 0.011) and those 50 to 80 years of age (β = 0.248, p = 0.014). For patients who were < 50 years of age, communication regarding medication had a significantly negative influence on overall hospital ratings (β = − 0.387, p = 0.025). For patients who were > 80 years of age, staff responsiveness (β = 0.403, p = 0.002) also significantly influenced overall hospital ratings. With physician reimbursement partially dependent on patient-reported experiences of care, orthopaedists must recognize and improve on the factors that affect patient satisfaction to avoid financial penalties. Although age was found to not have a global effect on PG scores after TKA, the factors that patients consider most important during their experience of care may vary by age group.

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Variations In Good Patient Reported Outcomes After Total Knee Arthroplasty

Cited by 33 publications

References 26 publications

Minimal clinically important difference of commonly used patient-reported outcome measures in total knee arthroplasty: review of terminologies, methods and proposed values

Minimal clinically important difference of commonly used patient-reported outcome measures in total knee arthroplasty: review of terminologies, methods and proposed values

Do foot & ankle assessments assist the explanation of 1 year knee arthroplasty outcomes?

Does Age Influence How Patients Rate Their Experience of Care after Total Knee Arthroplasty?

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