Patient Satisfaction
Conditions
Keywords
Wearable Sensors, Machine Learning, Satisfaction, Expectations, Total Knee Arthroplasty
Brief summary
More than 70,000 total knee replacement procedures are performed annually in Canada, representing a growth of 17% over the past 5 years, with further increases anticipated due to an aging population. While total knee replacement offers improved quality of life for patients and is cost effective for the healthcare system, 20% of patients routinely report dissatisfaction with the procedure. Patient dissatisfaction has been strongly linked to unmet expectations of outcomes after the surgery, especially with respect to physical activity. Counselling patients on appropriate expectations has been suggested as a means to improve satisfaction. Recently, our group has developed a tool to predict the functional ability of an individual patient after total knee replacement. This tool employs machine learning to classify patients as more likely to maintain or improve function, based on a functional test performed in clinic while wearing a sensor system around each knee. Implementing this tool in clinic pre-operatively could assist in setting appropriate expectations for each patient. Our primary objective is to compare patient satisfaction scores at one year after total knee replacement in patients who were informed of their specific expected functional outcome compared to patients who were not informed of their predicted functional outcome. We hypothesize that patients who are given an informed expectation will have higher satisfaction scores. This in turn may decrease health system costs associated with additional clinic visits from dissatisfied patients.
Interventions
OTHERPatient-Specific Prediction of Functional Outcome
Information sheet that describes whether a patient is more likely to improve on or maintain their current preoperative function.
OTHERStandard Pre-Operative Total Knee Arthroplasty Information
Standard of care information that is routinely provided at patient preadmission appointments.
Sponsors
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Caregiver, Investigator)
Masking description
Members of the care team and investigator will be blinded from knowing which study arm the patient is in and what their predicted functional ability is, to ensure standard of care is not influenced in any way.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with osteoarthritis scheduled to undergo primary total knee arthroplasty
Exclusion criteria
* prior knee surgery * inflammatory arthritis * neuromuscular disorder that impairs gait * scheduled for bilateral total knee arthroplasty * Cannot read, write, or speak English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Satisfaction | Pre-operation, 3-months, and 1-year post-operation | Patients will complete the Knee Society Score (KSS) questionnaire. The primary outcome of interest from the KSS is the satisfaction section. There are five questions related to satisfaction, each with five options ranging from very dissatisfied (0 points) to very satisfied (8 points). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cost Effectiveness | At 2-weeks, 6-weeks, 3-months, and 1-year post-operation | Patient-reported cost diary |
Other
| Measure | Time frame | Description |
|---|---|---|
| Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP) | Pre-operation and 1-year post-operation | Patient-reported questionnaire to assess experience with constant and intermittent pain. |
| Patient Global Assessment (PGA) | Pre-operation and 1-year post-operation | Patient-reported scale question to measure global disease activity on a range of 0 (doing very well) to 10 (doing very poorly) |
| Local Knee Inflammation | Pre-operation and 1-year post-operation (imaging). Intra-operative (tissue biopsies) | Imaging and tissue biopsies to grade level of inflammation of the knee |
| EuroQuol 5D (EQ-5D) | Pre-operation and 1-year post-operation | Patient-reported questionnaire to assess health-related quality of life and is used for economic analysis. |
| UCLA Activity Score | Pre-operation and 1-year post-operation | Patient-reported questionnaire to assess activity from range of 1 (completely wholly inactive) to 10 (regularly participates in impact sports). |
| Global Rating of Change Scale (GROC) | Pre-operation and 1-year post-operation | Patient-reported questionnaire to assess self-perceived improvement. |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) | Pre-operation and 1-year post-operation | Patient-reported questionnaire to assess pain, stiffness, and function. |
Countries
Canada
Outcome results
None listed