Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 14, 2021
Date Accepted: Oct 4, 2021
Patient-reported outcomes tool to triage total hip arthroplasty patients to hospital or video consultation
ABSTRACT
Background:
The digital transformation in health care has been accelerated by COVID-19 pandemic. Video consultation became the alternative for hospital consultation. It is unknown how to select patients suitable for video consultation.
Objective:
To develop a tool based on patient-reported outcomes (PROs) to triage total hip arthroplasty (THA) patients to hospital or video consultation.
Methods:
A pilot study with expert panels and a retrospective cohort with prospective collected data of 1228 THA patients was executed. Primary outcome was a PROs triage tool to allocate THA patients to hospital or video consultation 6 weeks postoperatively. Expert panels defined criteria and selected arranging patient-reported outcome measures (PROMs) questions including thresholds. Data was divided in a training and a test cohort. Distribution, floor effect, correlation, responsiveness, PROs patient journey, and homogeneity of the selected questions were investigated in the training cohort. Test cohort was applied to provide an unbiased evaluation of the final triage tool.
Results:
Expert panels selected moderate or severe pain and using two crutches as triage tool criteria. PROMs questions included in the final triage tool were NRS pain during activity, EQ-5D-3L 1 and 4, and OHS 6, 8 and 12. Of the training cohort (n=703), 201 (29%) patients needed hospital consultation equal to 150 (32%) of the test cohort (n=463) (P=.190).
Conclusions:
A PROs triage tool based on moderate or severe pain and using two crutches was developed. Around 70% of THA patients could safely have a video consultation and 30% need hospital consultation 6 weeks postoperatively. This tool is promising in selecting patients for video consultation while using an existing PROMs infrastructure.
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