Evidence map›Paper›PMID 20694714›Full record

ArticleDer Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen2011

[Minimal provider volume in total knee replacement : an analysis of the external quality assurance program of North Rhine-Westphalia (QS-NRW)].

T Kostuj, U Schulze-Raestrup, M Noack, K Buckup, R Smektala

Abstract read
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In one paragraph

Article in Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

T KostujAbteilung für Unfallchirurgie, Chirurgische Universitätsklinik, Knappschaftskrankenhaus Bochum - Langendreer Universitätsklinik, Ruhr-Universität, Bochum, Deutschland. tanja.kostuj@kk-bochum.de
U Schulze-Raestrup
M Noack
K Buckup
R Smektala

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA minimal provider volume for total knee replacement (TKR) was introduced in 2006. Does this lead to an improvenment in quality or not? The records of treatment in the compulsory external quality assurance program of the Land of North Rhine-Westphalia (QS-NRW) were evaluated.

methodA total of 125,324 comparable records from the QS-NRW program were available to determine the appearance of general and surgical complications. In a logistical regression model the risk factors age, gender, ASA classification, comorbidity and duration were taken into account.

resultsA significant reduction could only be shown for pneumonia, thrombotic events and lung embolisms as well as vascular injury. In 2006 and 2007 malpositioning of implants was significantly higher and from 2005 to 2008 the number of fractures rose compared to 2004. Deep infections and reoperations did not change significantly during the whole study period.

conclusionThis evaluation could not show an improvement in quality due to the minimal provider volume. Thus the minimal provider volume should not be taken into account as a main criterion to improve quality. Further outcome studies and creating an arthroplasty register in Germany are more useful.

Indexed as

AdultAgedArthroplasty, Replacement, KneeClinical CompetenceCross-Sectional StudiesFemaleGermanyHumansLogistic ModelsMaleMiddle AgedOdds RatioOutcome Assessment, Health CarePneumoniaPostoperative ComplicationsPulmonary Embolism

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.