Who gets referred for knee or hip replacement? A theoretical model of the potential impact of evidence-based referral thresholds using data from a retrospective review of clinic records from an English musculoskeletal referral hub.
Helen A DakinPeter EibichAlastair M GrayJames SmithKaren L BarkerDavid BeardAndrew James Pricenull nullPublished in: BMJ open (2020)
Musculoskeletal hubs currently consider OKS/OHS and other factors when making decisions about referral to secondary care for joint replacement. Those referred typically have low OHS/OKS, and introducing evidence-based OKS/OHS thresholds would prevent few inappropriate (high-functioning, low-pain) referrals. However, our findings suggest that some patients not currently referred could benefit from arthroplasty based on OKS/OHS. More research is required to explore other important patient characteristics currently influencing hub decisions.
Keyphrases
- primary care
- end stage renal disease
- healthcare
- ejection fraction
- chronic kidney disease
- newly diagnosed
- chronic pain
- total knee arthroplasty
- palliative care
- case report
- peritoneal dialysis
- network analysis
- quality improvement
- electronic health record
- patient reported outcomes
- knee osteoarthritis
- big data
- spinal cord injury
- total hip arthroplasty
- bioinformatics analysis
- anterior cruciate ligament