Each surgeon has the possibility, and the responsibility, to keep track of his or her surgical outcomes. This is for the purpose of determining what is working in the practice. This link explains more about this point. Because many failures in arthroplasty happen more than five-years after surgery, it is important to continue long-term care.
Three of the key elements of an effective/informative/practical outcome system are (1) capturing the highest possible percentage of patients treated, (2) being able to present the results to patients in terms that patients and surgeons understand, and (3) having a system that is validated and universally applicable so that data can be compared among centers.
#1 requires minimizing exclusion bias. Many scales, including the UCLA score, the Constant Score, and the Shoulder Arthroplasty Smart Score, require patients to return to their doctor for measurement of ranges (and sometimes strength). Not only does it expose patients to inter-observer variability as well as risking observer bias, there is also the possibility of patients being excluded from the office if they are not able to return.
Continue reading…
