Evidence map›Paper›PMID 27027795›Full record

ArticleHealthcare policy = Politiques de sante2016

Appropriateness for Total Joint Replacement: Perspectives of Decision-Makers.

Nathalie Clavel, Carolyn De Coster, Marie-Pascale Pomey, Claudia Sanmartin, Éric Bohm, Michael J Dunbar, C Y Frank, Gillian Hawker, Tom Noseworthy

Abstract read
PubMed Full text at PMC
In one paragraph

Article in Healthcare policy = Politiques de sante, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
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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

9 authors.

Nathalie ClavelPhD Student, École de Santé Publique de l'Université de Montréal (ESPUM), Université de Montréal, Montréal, QC.
Carolyn De CosterAdjunct Research Professor, Department of Community Health Sciences, University of Calgary, Calgary, AB.
Marie-Pascale PomeyFull Professor, École de Santé Publique de l'Université de Montréal (ESPUM), Université de Montréal, Montréal, QC.
Claudia SanmartinAdjunct Research Professor, Department of Community Health Sciences, University of Calgary, Calgary, AB.
Éric BohmAssistant Professor, Department of Surgery, Section of Orthopaedic Surgery, University of Manitoba, Winnipeg, MB.
Michael J DunbarProfessor, Division of Orthopaedics, Dalhousie University, Halifax, NS.
C Y FrankProfessor, Division of Orthopaedics/Department of Surgery, University of Calgary, Calgary, AB.
Gillian HawkerDepartment of Medicine, Women's College Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON.
Tom NoseworthyProfessor, Department of Community Health Sciences and Institute for Public Health, University of Calgary, Calgary, AB.

Funding

CIHR
6 · The paper itself

Abstract

backgroundImproving access to total joint replacement (TJR) has been a priority. Without robust mechanisms to ensure appropriateness, these procedures may be overused, incurring substantial costs. In that context, decision-makers are particularly concerned with the appropriateness of TJR.

objectiveWhile our previous research focused on the appropriateness of TJR from clinical and patient perspectives, this study is aimed at understanding decision-makers' perspectives.

methodsUsing a semi-structured guide, we interviewed a convenience sample of decision-makers in four Canadian provinces (Alberta, Manitoba, Nova Scotia and Quebec) between February and March 2013. For the purposes of this study, a decision-maker was defined as a manager, institutional leader or policy maker.

resultsFifteen interviews were conducted with decision-makers at ministry (n = 3), regional (n = 6) and institutional levels (n = 8). Decision-makers see themselves as having a key role in the appropriateness discourse, that of optimizing resource allocation and efficient delivery of services for TJR, to improve population outcomes.

conclusionThe decision-makers' view of appropriateness recognizes the importance of the clinical view, but it offers a very different input into the appropriateness discourse, more closely aligned with appropriateness of setting, which refers to cost-effectiveness considerations.

Indexed as

Administrative PersonnelHealth PolicyArthroplasty, ReplacementCanadaCost-Benefit AnalysisHealth Services MisuseHumansInterviews as TopicMedical Overuse

Identifiers

PMID27027795
PMCPMC4817968

What OpenQuestion holds

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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.