Advanced decision-making using patient-reported outcome measures in total joint replacement. 2020

Prakash Jayakumar, and Kevin J Bozic
Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, Texas.

Up to one-third of total joint replacement (TJR) procedures may be performed inappropriately in a subset of patients who remain dissatisfied with their outcomes, stressing the importance of shared decision-making. Patient-reported outcome measures capture physical, emotional, and social aspects of health and wellbeing from the patient's perspective. Powerful computer systems capable of performing highly sophisticated analysis using different types of data, including patient-derived data, such as patient-reported outcomes, may eliminate guess work, generating impactful metrics to better inform the decision-making process. We have created a shared decision-making tool which generates personalized predictions of risks and benefits from TJR based on patient-reported outcomes as well as clinical and demographic data. We present the protocol for a randomized controlled trial designed to assess the impact of this tool on decision quality, level of shared decision-making, and patient and process outcomes. We also discuss current concepts in this field and highlight opportunities leveraging patient-reported data and artificial intelligence for decision support across the care continuum.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071066 Patient Reported Outcome Measures Assessment of the quality and effectiveness of health care as measured and directly reported by the patient. Patient Reported Outcome Measure,Patient-Reported Outcome,Patient-Reported Outcomes,Patient Reported Outcome,Patient Reported Outcomes,Outcome, Patient Reported,Outcome, Patient-Reported
D019643 Arthroplasty, Replacement Partial or total replacement of a skeletal joint. Joint Prosthesis Implantation,Arthroplasties, Replacement,Joint Replacement,Replacement Arthroplasties,Replacement Arthroplasty,Total Joint Replacement,Implantation, Joint Prosthesis,Implantations, Joint Prosthesis,Joint Prosthesis Implantations,Joint Replacement, Total,Joint Replacements,Joint Replacements, Total,Prosthesis Implantation, Joint,Prosthesis Implantations, Joint,Replacement, Joint,Replacement, Total Joint,Replacements, Joint,Replacements, Total Joint,Total Joint Replacements
D020000 Decision Support Systems, Clinical Computer-based information systems used to integrate clinical and patient information and provide support for decision-making in patient care. Clinical Decision Support System,Clinical Decision Support Systems,Clinical Decision Support,Decision Support, Clinical,Clinical Decision Supports,Decision Supports, Clinical,Support, Clinical Decision,Supports, Clinical Decision

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