Wilson Ian, Bohm Eric, Lübbeke Anne, Lyman Stephen, Overgaard Søren, Rolfson Ola, W-Dahl Annette, Wilkinson Mark, Dunbar Michael
Concordia Joint Replacement Group, Winnipeg, Manitoba, Canada.
Canadian Joint Replacement Registry, University of Manitoba, Concordia Joint Replacement Group, Winnipeg, Manitoba, Canada.
EFORT Open Rev. 2019 Jun 3;4(6):357-367. doi: 10.1302/2058-5241.4.180080. eCollection 2019 Jun.
Total joint arthroplasty is performed to decreased pain, restore function and productivity and improve quality of life.One-year implant survivorship following surgery is nearly 100%; however, self-reported satisfaction is 80% after total knee arthroplasty and 90% after total hip arthroplasty.Patient-reported outcomes (PROs) are produced by patients reporting on their own health status directly without interpretation from a surgeon or other medical professional; a PRO measure (PROM) is a tool, often a questionnaire, that measures different aspects of patient-related outcomes.Generic PROs are related to a patient's general health and quality of life, whereas a specific PRO is focused on a particular disease, symptom or anatomical region.While revision surgery is the traditional endpoint of registries, it is blunt and likely insufficient as a measure of success; PROMs address this shortcoming by expanding beyond survival and measuring outcomes that are relevant to patients - relief of pain, restoration of function and improvement in quality of life.PROMs are increasing in use in many national and regional orthopaedic arthroplasty registries.PROMs data can provide important information on value-based care, support quality assurance and improvement initiatives, help refine surgical indications and may improve shared decision-making and surgical timing.There are several practical considerations that need to be considered when implementing PROMs collection, as the undertaking itself may be expensive, a burden to the patient, as well as being time and labour intensive. Cite this article: 2019;4 DOI: 10.1302/2058-5241.4.180080.
全关节置换术的目的是减轻疼痛、恢复功能和生产力并改善生活质量。术后一年植入物的存活率接近100%;然而,全膝关节置换术后自我报告的满意度为80%,全髋关节置换术后为90%。患者报告结局(PROs)是由患者直接报告自己的健康状况而无需外科医生或其他医疗专业人员的解读产生的;PRO测量工具(PROM)是一种工具,通常是一份问卷,用于测量与患者相关结局的不同方面。一般PROs与患者的总体健康和生活质量相关,而特定PRO则专注于特定疾病、症状或解剖区域。虽然翻修手术是登记处的传统终点,但它比较生硬,作为成功的衡量标准可能并不充分;PROMs通过超越存活率并测量与患者相关的结局——疼痛缓解、功能恢复和生活质量改善——来解决这一缺点。PROMs在许多国家和地区的骨科关节置换登记处的使用正在增加。PROMs数据可以提供有关基于价值的医疗、支持质量保证和改进计划、帮助完善手术适应症以及可能改善共同决策和手术时机的重要信息。在实施PROMs收集时需要考虑几个实际问题,因为这项工作本身可能成本高昂,给患者带来负担,而且耗费时间和人力。引用本文:2019;4 DOI: 10.1302/2058-5241.4.180080。