Evidence map›Paper›PMID 32750091›Full record

ArticlePloS one2020

Dynamic early identification of hip replacement implants with high revision rates. Study based on the NJR data from UK during 2004-2012.

Alexander Begun, Alexander J MacGregor, Dmitri Pchejetski, Elena Kulinskaya

Abstract read
In one paragraph

Article in PloS one, 2020. 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

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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

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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.

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4 · The record

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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

4 authors.

Alexander BegunSchool of Computing Sciences, University of East Anglia, Norwich, United Kingdom.
Alexander J MacGregorNorwich Medical School, University of East Anglia, Norwich, United Kingdom.
Dmitri PchejetskiNorwich Medical School, University of East Anglia, Norwich, United Kingdom.
Elena KulinskayaSchool of Computing Sciences, University of East Anglia, Norwich, United Kingdom.ORCID 0000-0002-9843-1663

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHip replacement and hip resurfacing are common surgical procedures with an estimated risk of revision of 4% over 10 year period. Approximately 58% of hip replacements will last 25 years. Some implants have higher revision rates and early identification of poorly performing hip replacement implant brands and cup/head brand combinations is vital.

aimsDevelopment of a dynamic monitoring method for the revision rates of hip implants.

methodsData on the outcomes following the hip replacement surgery between 2004 and 2012 was obtained from the National Joint Register (NJR) in the UK. A novel dynamic algorithm based on the CUmulative SUM (CUSUM) methodology with adjustment for casemix and random frailty for an operating unit was developed and implemented to monitor the revision rates over time. The Benjamini-Hochberg FDR method was used to adjust for multiple testing of numerous hip replacement implant brands and cup/ head combinations at each time point.

resultsThree poorly performing cup brands and two cup/ head brand combinations have been detected. Wright Medical UK Ltd Conserve Plus Resurfacing Cup (cup o), DePuy ASR Resurfacing Cup (cup e), and Endo Plus (UK) Limited EP-Fit Plus Polyethylene cup (cup g) showed stable multiple alarms over the period of a year or longer. An addition of a random frailty term did not change the list of underperforming components. The model with added random effect was more conservative, showing less and more delayed alarms.

conclusionsOur new algorithm is an efficient method for early detection of poorly performing components in hip replacement surgery. It can also be used for similar tasks of dynamic quality monitoring in healthcare.

Indexed as

Prosthesis DesignProsthesis FailureAgedAged, 80 and overArthroplasty, Replacement, HipFemaleHip ProsthesisHumansMaleMiddle AgedRegistriesReoperationUnited Kingdom

Identifiers

PMID32750091
PMCPMC7402470

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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.