Evidence map›Paper›PMID 36640180›Full record

ArticleInternational orthopaedics2023

Quality indicators in primary elective total hip and knee arthroplasty.

Scott Kim, Justin Cottrell, James Waddell, Eric Bohm, Sam Adie, Sarah Ward, Jennifer Leighton, Earl Bogoch, David Backstein, Michael Dunbar and 4 more

Abstract read
PubMed Publisher
In one paragraph

Article in International orthopaedics, 2023. 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
0.9field-weighted citation impact, top 27% of its field
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, 3 citations in OpenAlex.

  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

14 authors at 7 institutions in 2 countries.

Scott KimUniversity of Toronto Division of Orthopaedics, 149 College St Room 508-A, Toronto, ON, M5T 1P5, Canada. Scott.Kim@mail.utoronto.ca.ORCID 0000-0002-8837-743X
Justin CottrellDepartment of Otolaryngology, University of Toronto, 600 University Ave #401, Toronto, ON, M5G 1X5, Canada.
James WaddellUniversity of Toronto Division of Orthopaedics, 149 College St Room 508-A, Toronto, ON, M5T 1P5, Canada.
Eric BohmUniversity of Manitoba, 1155 Concorida Ave #301, Winnipeg, MB, R2K 4L5, Canada.
Sam AdieSt. George and Sutherland Clinical School, University of New South Wales, Clinical Sciences Building, Short Street St George Hospital, Kogarah, NSW, 2217, Australia.
Sarah WardUniversity of Toronto Division of Orthopaedics, 149 College St Room 508-A, Toronto, ON, M5T 1P5, Canada.
Jennifer LeightonDalhousie University, QEII Health Sciences Centre, Halifax Infirmary, 1796 Summer St, 4th Floor, Halifax, NS, B3H 3A6, Canada.
Earl BogochUniversity of Toronto Division of Orthopaedics, 149 College St Room 508-A, Toronto, ON, M5T 1P5, Canada.
David BacksteinUniversity of Toronto Division of Orthopaedics, 149 College St Room 508-A, Toronto, ON, M5T 1P5, Canada.
Michael DunbarDalhousie University, QEII Health Sciences Centre, Halifax Infirmary, 1796 Summer St, 4th Floor, Halifax, NS, B3H 3A6, Canada.
Bassam MasriUniversity of British Columbia, 2775 Laurel St, Vancouver, BC, V5Z 1M9, Canada.
Michael ZywielUniversity of Toronto Division of Orthopaedics, 149 College St Room 508-A, Toronto, ON, M5T 1P5, Canada.
Eric MonteiroDepartment of Otolaryngology, University of Toronto, 600 University Ave #401, Toronto, ON, M5G 1X5, Canada.
Jesse Isaac WolfstadtUniversity of Toronto Division of Orthopaedics, 149 College St Room 508-A, Toronto, ON, M5T 1P5, Canada.
University of Toronto · CADalhousie University · CASt. Michael's Hospital · CASutherland Hospital · AUUniversity Health Network · CAUniversity of British Columbia Hospital · CAUniversity of Manitoba · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTotal hip arthroplasty (THA) and total knee arthroplasty (TKA) represent a significant portion of healthcare spending and are high-priority for quality improvement initiatives. This study aims to develop quality indicators (QIs) in the care of primary elective THA and TKA patients. These QIs serve a number of purposes including documentation of the quality of care, objective comparisons of institutions/providers, facilitating pay-for-performance initiatives, and supporting accountability, regulation, and accreditation.

methodsA guideline-based approach, initially described by Kötter et al., was utilized. Eight clinical practice guidelines (CPGs) were evaluated for candidate indicators (CIs). CIs with high-quality evidence and consensus statements were extracted. Eighteen additional CIs were included from previous work that evaluated quality improvement databases. Each CI and supporting evidence was submitted for independent review by an expert panel. The RAND Corporation-University of California, Los Angeles (RAND/UCLA) appropriateness methodology was utilized and items were rated based on validity, reliability, and feasibility of measurement. After two rounds of ratings and ranking, a final ranked list of QIs was obtained.

resultsFifty-six CIs were identified from the literature and CPGs or proposed by the expert panel. Two rounds of voting resulted in 12 total QIs that were deemed appropriate measures of high-quality care. The final 12 QIs were ranked by order of importance: use of peri-operative tranexamic acid, infusion of prophylactic antibiotics prior to inflation of tourniquet, appropriate post-operative venous thromboembolic prophylaxis, complication rate, rate of secondary procedure, readmission rate, early mobilization, average change of pre- to one year post-operative functional status, use of multimodal analgesia, use of neuraxial anesthesia, use of peri-articular injection in TKA, and use of pre-operative PO analgesia.

conclusionThis study is an expert opinion based on parameters observed in modern and high-quality academic settings. Twelve QIs are proposed to assess the quality of care in the peri-operative management of primary elective THA and TKA patients.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeHumansPain ManagementQuality Indicators, Health CareReimbursement, IncentiveReproducibility of ResultsQuality indicatorTHATKA

Identifiers

PMID36640180
OpenAlexW4316035032

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.