Abstract
BackgroundThe digital transformation in health care has been accelerated by the COVID-19 pandemic. Video consultation has become the alternative for hospital consultation. It remains unknown how to select patients suitable for video consultation.ObjectiveThis study aimed to develop a tool based on patient-reported outcomes (PROs) to triage total hip arthroplasty (THA) patients to hospital or video consultation.MethodsA pilot study with expert panels and a retrospective cohort with prospectively collected data from 1228 THA patients was executed. The primary outcome was a PRO triage tool to allocate THA patients to hospital or video consultation 6 weeks postoperatively. Expert panels defined the criteria and selected the patient-reported outcome measure (PROM) questions including thresholds. Data were divided into training and test cohorts. Distribution, floor effect, correlation, responsiveness, PRO patient journey, and homogeneity of the selected questions were investigated in the training cohort. The test cohort was used to provide an unbiased evaluation of the final triage tool.ResultsThe expert panels selected moderate or severe pain and using 2 crutches as the triage tool criteria. PROM questions included in the final triage tool were numeric rating scale (NRS) pain during activity, 3-level version of the EuroQol 5 dimensions (EQ-5D-3L) questions 1 and 4, and Oxford Hip Score (OHS) questions 6, 8, and 12. Of the training cohort, 201 (201/703, 28.6%) patients needed a hospital consultation, which was statistically equal to the 150 (150/463, 32.4%) patients in the test cohort who needed a hospital consultation (P=.19).ConclusionsA PRO triage tool based on moderate or severe pain and using 2 crutches was developed. Around 70% of THA patients could safely have a video consultation, and 30% needed a hospital consultation 6 weeks postoperatively. This tool is promising for selecting patients for video consultation while using an existing PROM infrastructure.
Highlights
The digital transformation in health care has been accelerated by the COVID-19 pandemic
The final triage tool was applied in the test cohort to provide an unbiased evaluation of the final tool fitted on the training dataset
This study aimed to develop a tool based on patient-reported outcomes (PROs) collected using an existing patient-reported outcome measure (PROM) infrastructure to triage total hip arthroplasty (THA) patients to hospital or video consultation 6 weeks postoperatively
Summary
The digital transformation in health care has been accelerated by the COVID-19 pandemic. Objective: This study aimed to develop a tool based on patient-reported outcomes (PROs) to triage total hip arthroplasty (THA) patients to hospital or video consultation. The primary outcome was a PRO triage tool to allocate THA patients to hospital or video consultation 6 weeks postoperatively. Expert panels defined the criteria and selected the patient-reported outcome measure (PROM) questions including thresholds. Results: The expert panels selected moderate or severe pain and using 2 crutches as the triage tool criteria. Around 70% of THA patients could safely have a video consultation, and 30% needed a hospital consultation 6 weeks postoperatively. This tool is promising for selecting patients for video consultation while using an existing PROM infrastructure
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