Novel Strategies for Personalized Clinical Decisions in Knee Arthroplasty

University of Colorado Denver (CU Denver)

Status: Completed

Conditions: Total Knee Replacement

Treatments: Other: Clinical decision support (CDS) tool

Study type: Observational

Funder types: Other

Identifiers

NCT05900453

18-1246

Details and patient eligibility

About

This study will compare the postoperative recovery of two patient cohorts who attended outpatient physical therapy at two clinics in the Greenville, South Carolina area. The Usual Care cohort received care according to each clinic's pre-existing care guidelines. The CDS Cohort received care informed by a new clinical decision support (CDS) tool.

Full description

In this cohort study, the investigators will use regression to examine whether CDS tool exposure was associated with patient outcomes after total knee replacement. Linear mixed effect models will be used for continuous outcomes that have multiple assessment points per patient. For count outcomes (e.g., visit utilization), the investigators will use Poisson/negative binomial regression or linear regression with appropriate outcome transformations.

Enrollment: 675 patients

Sex: All

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient underwent TKA for primary knee osteoarthritis
• Patient underwent postoperative TKA rehabilitation at one of the two participating physical therapy clinics in the Greenville, SC area

Exclusion criteria

• Patients < 40 years old
• Patients whose total episode of care length in outpatient physical therapy was < 21 days
• Patients who attended < 3 outpatient physical therapy visits throughout their episode of care
• Outcomes collected > 6 months after surgery (except for visit utilization, which can include data up to 1 year after surgery)
• Patients who were not exposed to the CDS tool, but were treated by a clinician who was trained to use the CDS tool

Trial design

675 participants in 2 patient groups

Usual Care TKA rehabilitation

Description:

This cohort of patients received Usual Care TKA rehabilitation at two outpatient physical therapy clinics in the Greenville, South Carolina, USA area. These patients received treatment guided by their clinician's professional judgment and the clinic's best practice guidelines for TKA.

CDS tool TKA rehabilitation

Description:

This cohort of patients received TKA rehabilitation at the same two outpatient physical therapy clinics in the Greenville, South Carolina, USA area. These patients also received treatment guided by their clinician's professional judgement and the clinic's best practice guidelines. Additionally, this cohort of patients was exposed to the CDS tool (i.e., clinicians used the tool to view personalized information about the patient at least once during the patient's episode of care).

Treatment:

Other: Clinical decision support (CDS) tool