From the Case Western Reserve University School of Medicine, Cleveland, OH (Brown), the University of Iowa Orthopedics and Sports Medicine, Iowa City, IA (Dr. Westermann), the University of Washington Orthopaedics and Sports Medicine, Seattle, WA (Dr. Hagen), the Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH (Dr. Rosneck and Dr. Spindler), the Cleveland Clinic Sports Health, Cleveland Clinic, Cleveland, OH (Mr. Strnad, Dr. Rosneck, and Dr. Spindler), and the Columbia University Vagelos College of Physicians and Surgeons, New York, NY (Dr. Lynch).
J Am Acad Orthop Surg. 2019 Nov 15;27(22):e1009-e1015. doi: 10.5435/JAAOS-D-18-00550.
The purpose of this study is to compare the utility and validity of the OrthoMiDaS (Orthopaedic Minimal Data Set) Episode of Care (OME) database with the current benchmark for recording procedural details, the operative note (OpNote), with regard to disease severity and risk factors for hip arthroscopy cases.
A convenience sample of the first 100 hip arthroscopy cases for labral tears done at our institution between February and August 2015 were selected for this study. Surgeons recorded procedural details within OME after each case. An individual blinded to the OME data performed a chart review of the OpNote and/or implant log and recorded the information in a separate REDCap database.
OME demonstrated higher completion rates than the OpNote for important procedural details such as previous left and right hip surgery (P < 0.001), anchor type (P = 0.008), and labrum tear clockface variables (P < 0.001 for both). In addition, OME exhibited "near-perfect" agreement with the OpNote for several important procedural details such as surgical limb (Kappa = 1.000), suture configuration (Kappa = 0.982), repair type (Kappa = 0.947), tear clockface: from (Kappa = 0.949), and tear clockface: to (Kappa = 0.885). On average, surgeons took 117 seconds to complete data entry within OME.
The findings of this study validate the ability of OME to accurately and consistently capture important procedural details pertaining to arthroscopic hip surgery. Through the use of OME, high-quality standardized information can be captured and used to advance the field of hip arthroscopy by determining the clinically useful predictors of patient-reported outcome measures.
本研究旨在比较 OrthoMiDaS(骨科最小数据集)治疗单元(OME)数据库与当前记录手术细节的基准——手术记录(OpNote)在髋关节镜检查病例的疾病严重程度和风险因素方面的效用和有效性。
本研究选取了 2015 年 2 月至 8 月我院前 100 例髋关节镜检查治疗盂唇撕裂的病例作为方便样本。手术医生在每个病例后在 OME 中记录手术细节。一名对 OME 数据不知情的研究人员对 OpNote 和/或植入物日志进行病历回顾,并将信息记录在单独的 REDCap 数据库中。
OME 在记录手术细节方面的完成率高于 OpNote,重要的手术细节包括既往左、右侧髋关节手术(P < 0.001)、锚定类型(P = 0.008)和盂唇撕裂时钟面变量(两者均 P < 0.001)。此外,OME 在一些重要的手术细节方面与 OpNote 表现出“近乎完美”的一致性,如手术肢体(Kappa = 1.000)、缝线结构(Kappa = 0.982)、修复类型(Kappa = 0.947)、撕裂时钟面:起点(Kappa = 0.949)和撕裂时钟面:终点(Kappa = 0.885)。平均而言,手术医生完成 OME 内的数据录入需要 117 秒。
本研究的结果验证了 OME 准确和一致地捕获与髋关节镜手术相关的重要手术细节的能力。通过使用 OME,可以捕获高质量的标准化信息,并通过确定患者报告的结果测量的临床有用预测因子来推进髋关节镜领域的发展。