The Paradox of Patient-Reported Outcome Measures: Should We Prioritize 'Feeling Better' or 'Feeling Good' After Total Knee Arthroplasty?
| العنوان: | The Paradox of Patient-Reported Outcome Measures: Should We Prioritize 'Feeling Better' or 'Feeling Good' After Total Knee Arthroplasty? |
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| المؤلفون: | Graham S. Goh, Colin M. Baker, Saad Tarabichi, Sean C. Clark, Matthew S. Austin, Jess H. Lonner |
| المصدر: | The Journal of Arthroplasty. 37:1751-1758 |
| بيانات النشر: | Elsevier BV, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Treatment Outcome, Minimal Clinically Important Difference, Humans, Orthopedics and Sports Medicine, Patient Reported Outcome Measures, Registries, Osteoarthritis, Knee, Arthroplasty, Replacement, Knee |
| الوصف: | The use of preoperative patient-reported outcome measure (PROM) thresholds for patient selection in arthroplasty care has been questioned recently. This study aimed to identify factors affecting achievement of the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) after total knee arthroplasty (TKA) and determine the overlap between the two outcomes.We identified 1,239 primary, unilateral TKAs performed at a single institution in 2015-2019. PROMs including the Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) and 12-item Short Form Health Survey (SF-12) were collected preoperatively and 1-year postoperatively. The likelihood of attaining PASS as per attainment of MCID was assessed. A multivariable regression was used to identify predictors of MCID and PASS.In total, 71.3% achieved MCID and 75.5% achieved PASS for KOOS-JR. Only 7.7% achieved MCID but not PASS, whereas almost twice this number did not achieve MCID but did achieve PASS (11.9%). Poorer preoperative KOOS-JR (OR 0.925), better SF-12 physical (OR 1.025), and mental (OR 1.027) were associated with MCID attainment. In contrast, better preoperative KOOS-JR (OR 1.030) and SF-12 mental (OR 1.025) were associated with PASS attainment. Age, gender, race, ethnicity, body mass index, Charlson index, American Society of Anesthesiologists classification, and smoking status were not significant predictors.Preoperative PROMs were associated with achieving MCID and PASS after TKA, albeit some positively and some negatively. In the era of value-based care, clinicians should not only strive to help patients "feel better" but also ensure that patients "feel good" after surgery. This study does not support the use of PROMs in prioritizing access to care. |
| تدمد: | 0883-5403 2015-2019 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d81066b0b4b36d1aad071ded8dbe4f2a https://doi.org/10.1016/j.arth.2022.04.017 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....d81066b0b4b36d1aad071ded8dbe4f2a |
| قاعدة البيانات: | OpenAIRE |
Full Text via ClinicalKey | تدمد: | 08835403 20152019 |
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