Evidence map›Paper›PMID 36917319›Full record

ArticleOrthopadie (Heidelberg, Germany)2023

[Three-year revision rate of certified centres for joint replacement according to EndoCert : Risk-adjusted analysis of outcome quality and comparison with other quality assurance systems].

Katrin Osmanski-Zenk, Annett Klinder, Jürgen Malzahn, Holger Haas, Gabriela von Lewinski, Bernd Kladny, Wolfram Mittelmeier

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Article in Orthopadie (Heidelberg, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors.

Katrin Osmanski-ZenkOrthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Doberaner Straße 142, 18057, Rostock, Deutschland. katrin.osmanski-zenk@med.uni-rostock.de.
Annett KlinderOrthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Doberaner Straße 142, 18057, Rostock, Deutschland.
Jürgen MalzahnAOK-Bundesverband, Rosenthaler Str. 31, 10178, Berlin, Deutschland.
Holger HaasZentrum für Orthopädie, Unfallchirurgie und Sportmedizin, Gemeinschaftskrankenhaus Bonn, 53113, Bonn, Deutschland.
Gabriela von LewinskiKlinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.
Bernd KladnyFachklinik Herzogenaurach, 91074, Herzogenaurach, Deutschland.
Wolfram MittelmeierOrthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Doberaner Straße 142, 18057, Rostock, Deutschland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe EndoCert initiative does not yet allow a long-term assessment of outcome quality. The assessment cannot be achieved without cooperation with the German arthroplasty registry (EPRD) and other quality assurance infrastructure, such as the quality assurance system of the nationwide healthcare insurance data for inpatient hospital treatment (QSR) by the German local healthcare fund (AOK). Therefore, the quality of care of all certified centres for joint replacement (EPZ) after primary hip and knee arthroplasty was to be examined for the first time. These data were subsequently compared to the data of the EPRD. MATERIALS AND

methodsIn EPZ that provided care to at least one AOK-insured patient in 2016, the risk-adjusted 3‑year revision rate and the SMR-value (standardised mortality or morbidity ratio), which is the quotient of the observed and expected revision rate, were analysed as markers for the quality of care. Annual hospital volume, type of centre and audit results were examined as possible influencing factors.

resultsIn the group comparison, significant differences (p = 0.042) for the SMR value of the 3‑year revision rate were demonstrated for hip arthroplasty with regard to the EPZ type. The annual number of primary hip arthroplasties, however, did not influence the 3‑year revision rate. For knee arthroplasties, no effect of the defined categories on the 3‑year revision rate and its SMR value was observed. The comparison of our 3‑year revision rates with those of the EPRD showed similar results for the hip but indicated significant differences for the knee.

conclusionWe did not observe a correlation between quality of care and annual hospital volume in certified EPZ. However, different quality assurance procedures can lead to different results with respect to the outcome quality. Therefore, a considerably improved interaction of the German quality systems must be achieved. Participation in the EPRD is not sufficient for this. Rather, a complete report of all arthroplasties must be required, at least with the achievement of a minimum reporting rate per participating hospital. Uniform inclusion and exclusion criteria should be defined.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeHospitalizationHumansKnee JointRegistriesAnnual hospital volumeCertificationQuality assurance, healthcareRegistriesTotal hip arthroplastyTotal knee arthroplasty

Identifiers

PMID36917319

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