Merrill Robert K, Ibrahim John M, Machi Anthony S, Raphael James S
Department of Orthopedic Surgery, Albert Einstein Medical Center, 5501 Old York Road, Philadelphia, PA, 19141, USA.
Curr Rev Musculoskelet Med. 2020 Jun;13(3):298-308. doi: 10.1007/s12178-020-09632-0.
To discuss the automated risk calculators that have been developed and evaluated in orthopedic surgery.
Identifying predictors of adverse outcomes following orthopedic surgery is vital in the decision-making process for surgeons and patients. Recently, automated risk calculators have been developed to quantify patient-specific preoperative risk associated with certain orthopedic procedures. Automated risk calculators may provide the orthopedic surgeon with a valuable tool for clinical decision-making, informed consent, and the shared decision-making process with the patient. Understanding how an automated risk calculator was developed is arguably as important as the performance of the calculator. Additionally, conveying and interpreting the results of these risk calculators with the patient and its influence on surgical decision-making are paramount. The most abundant research on automated risk calculators has been conducted in the spine, total hip and knee arthroplasty, and trauma literature. Currently, many risk calculators show promise, but much research is still needed to improve them. We recommend they be used only as adjuncts to clinical decision-making. Understanding how a calculator was developed, and accurate communication of results to the patient, is paramount.
讨论在骨科手术中已开发并评估的自动风险计算器。
识别骨科手术后不良结局的预测因素对外科医生和患者的决策过程至关重要。最近,已开发出自动风险计算器来量化与某些骨科手术相关的患者特异性术前风险。自动风险计算器可为骨科医生提供用于临床决策、知情同意以及与患者共同决策过程的宝贵工具。了解自动风险计算器的开发方式与计算器的性能同样重要。此外,向患者传达和解释这些风险计算器的结果及其对手术决策的影响至关重要。关于自动风险计算器的研究在脊柱、全髋关节和膝关节置换术以及创伤文献方面最为丰富。目前,许多风险计算器显示出前景,但仍需要大量研究来改进它们。我们建议仅将它们用作临床决策的辅助工具。了解计算器的开发方式以及向患者准确传达结果至关重要。