Today's News

Friday, March 2, 2001

Patient-demand matching may be invalid method

Patient-demand matching may be an invalid method of determining implant utilization if there is a statistically significant increase in demand level activities in low-demand patients postoperatively, as demonstrated in a study in scientific exhibit 31.

Jack M. Bert, MD, St. Paul, Minn., reported that 44 total arthroplasty patients were enrolled in a prospective, randomized, multicenter study. Prior to surgery, all patients were categorized as either low- or medium/high-demand patients using a modification of the Lahey Clinic Implant Standardization Program.

This included the patient's age and weight at the time of surgery, ASA Health Index and the patient's preoperative and expected postoperative activity level. The questionnaire form asked whether the patient could perform any of the 54 low-, medium- and high-demand activities listed and compared preoperative to three- and four-year postoperative data.

Of the 44 patients, 31 were classified as low demand prior to surgery. For this cohort, there was no change from preoperative to three- to four-year postoperative in the number of low demand activities marked. For the same cohort, at three- and four-year postoperatively, there was an average increase of two in the number of medium/high demand activities marked.

Preoperatively, 13 patients were classified as medium/high-demand. For this cohort, there were no significant changes in activities preoperative to one-year postoperative.

Based on this review at three- and four-year postoperatively, the low-demand patients may significantly increase the number of medium/high-demand activities in which they participate.

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2001 Academy News March 2 Index C

Last modified 15/February/2001 by IS