Journal of Orthopaedic Business最新文献

Markov Models for Cost-Effectiveness Analysis of Knee Arthroscopy: A Systematic Review 用于膝关节镜成本效益分析的马尔可夫模型：系统回顾

Journal of Orthopaedic Business Pub Date : 2024-01-01 DOI: 10.55576/job.v4i1.48

BS M. Bryant Transtrum, MD Benjamin Childs, MD Christopher Bacak, MD Alexis Sandler, MD John Scanaliato, MD Nata Parnes

{"title":"Markov Models for Cost-Effectiveness Analysis of Knee Arthroscopy: A Systematic Review","authors":"BS M. Bryant Transtrum, MD Benjamin Childs, MD Christopher Bacak, MD Alexis Sandler, MD John Scanaliato, MD Nata Parnes","doi":"10.55576/job.v4i1.48","DOIUrl":"https://doi.org/10.55576/job.v4i1.48","url":null,"abstract":"OBJECTIVES: The purpose of this study is to review the existing literature on the cost-effectiveness of knee arthroscopy procedures with the objective of assessing the variability in assumptions, methodologies and results across different Markov analyses. DESIGN: Systematic review of study designs involving a Markov model or probabilistic cost-effectiveness analysis specific to knee arthroscopy. MAIN OUTCOME MEASURES: Main outcome measures comprised estimates of cost-effectiveness, including incremental cost-effectiveness ratio (ICER) comparisons and cost per quality-adjusted life year (QALY) ratios. RESULTS: The initial search identified 474 studies, with 7 articles meeting the inclusion criteria after screening and review. The included studies exhibited heterogeneity in participant demographic, design, interventions, and outcomes. The majority of studies reported superior cost-effectiveness in favor of meniscus repair and against meniscectomy. Additional analyses included evidence favoring diagnostic needle arthroscopy to MRI; early drilling of osteochondral defects to nonoperative management; and early intervention to delayed treatment. CONCLUSION: This review demonstrated substantial variability in estimates of cost-effectiveness, methodologies, and outcomes within the literature on knee arthroscopy procedures. Despite the heterogeneity, several trends emerged indicating favorable cost-effectiveness for several arthroscopic procedures for knee pathology. However, disparities in methodology and the lack of standardized reporting guidelines pose limitations to generalization of these interpretations. Future research should focus on standardized methodologies and reporting, as well as long-term clinical and economical studies. This review underscores the need for larger data sets for assumptions made in Markov models used in assessing the cost-effectiveness of knee arthroscopy procedures. LEVEL OF EVIDENCE: IV; systematic review of level IV or higher evidence","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Increased OR Efficiency with Surgeon-Managed Orthopaedic Blocks 外科医生管理骨科手术区，提高手术室效率

Journal of Orthopaedic Business Pub Date : 2024-01-01 DOI: 10.55576/job.v4i1.51

Rebekah Kleinsmith, Kendra Kibble, Stephen A. Doxey, Brian Cunningham

{"title":"Increased OR Efficiency with Surgeon-Managed Orthopaedic Blocks","authors":"Rebekah Kleinsmith, Kendra Kibble, Stephen A. Doxey, Brian Cunningham","doi":"10.55576/job.v4i1.51","DOIUrl":"https://doi.org/10.55576/job.v4i1.51","url":null,"abstract":"Objectives: To analyze orthopaedic operative block time efficiency when scheduled by operating suite scheduling time versus dedicated group of orthopaedic surgeons and clinical leaders Design: Retrospective Review Setting: A Metropolitan Hospital Patients/Participants: All operative orthopaedic cases that took place between August 2018 and February 2023 in four dedicated orthopaedic operating rooms Intervention: Responsibility for OR schedule and block management was shifted into the hands of a dedicated group of orthopaedic surgeons and clinical leaders Main Outcome Measurements: Number of cases per day, operative time per day, number of after-hours cases, scheduled case length accuracy Results and Conclusions: On average, 13.4 ± 3.1 cases were done per day in the four orthopaedic ORs during the post-intervention (surgeon-scheduled) period compared to 11.3 ± 3.2 and 11.6 ± 2.8 in the pre-intervention and post-COVID periods, respectively (p < 0.001). Analysis of average percent deviation from scheduled time reveals a significantly lower average deviation during the post-intervention period (17.3 ± 19.3 %) when compared to the pre-intervention and post-COVID periods (18.7 ± 23.8% and 19.7 ± 24.0%, respectively; p = 0.003). Additionally, there was a greater than expected frequency of cases estimated accurately (within 10% of their actual operative time) during the post-intervention period (959, 45.1%; p<0.001). The present study demonstrates an average increase in the number of orthopaedic cases performed per day with subsequent decrease in proportion of after-hours case starts with surgeon responsibility for case scheduling. Key Words: Operating room efficiency; Surgical case scheduling; Orthopaedic surgery blocks Level of Evidence: Level IV","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"14 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of Medicaid and Medicare Reimbursement Variations for Common Orthopaedic Trauma Procedures 常见创伤骨科手术的医疗补助和医疗保险报销差异分析

Journal of Orthopaedic Business Pub Date : 2024-01-01 DOI: 10.55576/job.v4i1.50

BS M. Bryant Transtrum, MD Jeffrey Jones, MD Michael Eckhoff, MD Adam Adler, MD Rajiv Rajani

{"title":"Analysis of Medicaid and Medicare Reimbursement Variations for Common Orthopaedic Trauma Procedures","authors":"BS M. Bryant Transtrum, MD Jeffrey Jones, MD Michael Eckhoff, MD Adam Adler, MD Rajiv Rajani","doi":"10.55576/job.v4i1.50","DOIUrl":"https://doi.org/10.55576/job.v4i1.50","url":null,"abstract":"OBJECTIVES: Medicaid (MCD) reimbursement for surgery is determined by state governments and is subject to substantial variation in comparison to Medicare (MCR), which is determined by the federal government and invariable across the United States. This mismatch in reimbursement has previously been described as a component of the disparity in access to care in orthopaedics. While this variation has been previously quantified for general orthopaedics and orthopaedic hand surgery, no such analysis has been performed for orthopaedic trauma. This study aims to quantify the variation in MCD and MCR reimbursement for common orthopaedic trauma procedures. DESIGN: Billing data obtained from a Level I trauma center were retrospectively reviewed and the ten most commonly billed Current Procedural Terminology (CPT) codes were extracted. State and federal physician fee schedules were collected and assessed to determine MCD- and MCR-specific reimbursement rates, or relative value units (RVUs), for these ten procedures. An economic analysis was then conducted to evaluate the disparities between MCD and MCR reimbursement. MAIN OUTCOME MEASURES: MCD and MCR RVUs for each procedure were compared using dollar difference and coefficient of variation (CV). RESULTS: Our analysis showed considerable variance in MCD reimbursement rates between states. Additionally, we found that the majority of RVUs for MCD were higher than MCR for the evaluated trauma procedures. CONCLUSION: The variance in MCD reimbursement values may be driven by differences in the underlying characteristics of each systems’ patient population. This variance, particularly in bordering states, could represent a barrier to healthcare access for some populations.","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"60 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Orthopaedic Journal Clubs are More Effective with Variety and Debates 骨科期刊俱乐部的多样性和辩论更有效

Journal of Orthopaedic Business Pub Date : 2024-01-01 DOI: 10.55576/job.v4i1.49

Michael Polmear, John P. Scanaliato, Matthew Wells, Marc Nicholes, Alexis Sandler, Richard Purcell, Ahmed Thabet

{"title":"Orthopaedic Journal Clubs are More Effective with Variety and Debates","authors":"Michael Polmear, John P. Scanaliato, Matthew Wells, Marc Nicholes, Alexis Sandler, Richard Purcell, Ahmed Thabet","doi":"10.55576/job.v4i1.49","DOIUrl":"https://doi.org/10.55576/job.v4i1.49","url":null,"abstract":"Objective: To analyze the opinions of orthopaedic surgery faculty and residents on thecharacteristics that improve journal club effectiveness, engagement, and value. Design: Journal club series with 10 monthly meetings at a single ACGME orthopaedic surgeryresidency program during the 2022-2023 academic year with variable formats based onleadership style, themes, types and number of articles, and debates. Setting: Single ACGME orthopaedic surgery residency program. Participants: Sixteen faculty surgeons and 25 residents participated in the journal club seriesand 37 individuals completed the survey with 14 faculty surgeons and 23 residents. Intervention: A 12-question anonymous survey and free text section at the conclusion of theseries Main Outcome Measurements: Survey responses regarding effective attributes of journal clubmeetings, primarily use of debates and secondarily leadership style. Results: Faculty ranked a hybrid format (71%) with resident presentations and debates (86%)first. Residents were relatively more divided and overall ranked a hybrid format (52%) withattending presentations and debates (56%) first. Both faculty and residents ranked a debate orhybrid format among the top three formats (69 vs. 77%). Within the program, a debate or hybridformat was ranked first by 65% of respondents and among the top three formats by 74%.Conclusion: Faculty preferred that residents lead and present articles or debate topics whileapproximately half of residents preferred that faculty debate. The optimal journal club seriescombines multiple components and can be improved with variety, debates, and continuedopportunity for residents to demonstrate critical appraisal of how articles influence practice. Key Words: journal club, debate, ACGME, residency Level of Evidence: III, cohort","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"13 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relationship Between Age, Cost, and Patient Reported Outcomes in Primary ACLR: 原发性ACLR患者报告结果与年龄、费用的关系:

Journal of Orthopaedic Business Pub Date : 2023-07-03 DOI: 10.55576/job.v3i3.40

Arthur J. Only, Fernando A. Huyke-Hernández, Stephen A. Doxey, Logan Reitz, Brian P. Cunningham

{"title":"Relationship Between Age, Cost, and Patient Reported Outcomes in Primary ACLR:","authors":"Arthur J. Only, Fernando A. Huyke-Hernández, Stephen A. Doxey, Logan Reitz, Brian P. Cunningham","doi":"10.55576/job.v3i3.40","DOIUrl":"https://doi.org/10.55576/job.v3i3.40","url":null,"abstract":"Objectives:\u0000To evaluate how surgical trends, costs, and outcomes for anterior cruciate ligament reconstruction (ACLR) vary with patient age.\u0000Design:\u0000Retrospective Cohort Study\u0000Setting:\u0000Outpatient Ambulatory Surgery Center\u0000Patients:\u0000587 primary ACLR patients from 2009-2016. Inclusion criteria consisted of primary ACLR, complete preoperative and two-year post-operative patient reported outcome (PRO) data. Patients were excluded if they underwent non-operative management, multi-ligamentous repair, or sustained poly-trauma.\u0000Intervention:\u0000ACLR\u0000Main Outcome Measurements:\u0000ACLR failure/re-rupture, reoperation, cost of care, Knee Injury & Osteoarthritis Outcome Score (KOOS) and Single Assessment Numeric Evaluation (SANE).\u0000Results:\u0000Younger patients were prevalently female compared to older patients (p<0.0001). Graft use varied according to age, with older patients more commonly being treated with allograft (p<0.0001). There were equivalent rates of meniscal injuries (p=0.0855), but meniscal treatment differed for patients older than age 25. Older patients on average received more meniscectomies versus repairs (p=0.0009). Operative time was found to be lowest in patients 40 and older. Total implant, day-of-surgery, and two-year episode of care costs were significantly higher for older patients (respectively r=0.48, r=0.43, r=0.37; p<0.001). Re-rupture rates were similar among age groups, however younger patients underwent more reoperations (p=0.0349). While baseline and two-year KOOS and SANE differed across ages (p<0.032), two-year changes did not (p≥0.384).\u0000Conclusions:\u0000Patient characteristics, treatment techniques, costs, and PROs were found to vary according to patient age but change in PROs did not. These results provide information on how patient age and can influence value in the setting of ACLR.\u0000Keywords:\u0000Anterior Cruciate Ligament Reconstruction, KOOS, SANE, Cost, TDABC, Value-Based Care\u0000Level of Evidence:\u0000Level IV","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123806386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using the Scratch Collapse Test to Detect Clinical or Subclinical Peroneal Palsy in the Hospitalized Patient in Order to Prevent Falls 用划伤塌陷试验检测住院病人的临床或亚临床腓骨麻痹以预防跌倒

Journal of Orthopaedic Business Pub Date : 2023-04-01 DOI: 10.55576/job.v3i2.39

G. Gontre, M. Wells, Jessica Avila, Isaac Fernandez

{"title":"Using the Scratch Collapse Test to Detect Clinical or Subclinical Peroneal Palsy in the Hospitalized Patient in Order to Prevent Falls","authors":"G. Gontre, M. Wells, Jessica Avila, Isaac Fernandez","doi":"10.55576/job.v3i2.39","DOIUrl":"https://doi.org/10.55576/job.v3i2.39","url":null,"abstract":"INTRODUCTION: The scratch collapse test (SCT) is an examination tool that can be used to localize and confirm a variety of nerve conditions. The implications and clinical utility in an inpatient population has not been extensively studied. The purpose of this study was to evaluate the use of SCT in a subset of hospitalized patients in order to identify the presence of subclinical PNP and thereby prevent falls. \u0000 \u0000METHODS: Hospitalized adult trauma patients at a single, academic, level one trauma center were recruited for the study. Patients found to have a positive scratch collapse test of the peroneal nerve were randomized to either receive a short period of inpatient physical therapy or serve as a no-intervention control. \u0000 \u0000RESULTS: Overall 29 patients (70.7%) recorded a positive SCT. Of those, 6 (20.7%) patients recorded a post-discharge fall. There were 14 patients with a positive SCT in the physical therapy intervention group with 2 patients (14.3%) who recorded a fall. There were 15 patients with a positive SCT in the no intervention group with 4 patients (26.7%) who recorded a fall. \u0000 \u0000 CONCLUSION: In this study, the SCT was used to identify subclinical peroneal nerve palsy, which could potentially lead to increased falls. While larger sample sizes are required for an adequately powered study, the SCT may serve as an inexpensive, useful tool in predicting which patients could be vulnerable to a post hospital fall due to subclinical peroneal nerve palsy. ","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122912360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Schedule II Narcotics are often Unnecessary for Pain Control in Patients with Pelvic or Acetabular Fractures 对于骨盆或髋臼骨折患者，通常不需要麻醉药物来控制疼痛

Journal of Orthopaedic Business Pub Date : 2023-01-01 DOI: 10.55576/job.v3i1.28

Soumitra Lele, Benjamin R. Childs, Isaac Fernandez, Michael S Reich, M. Nguyen

{"title":"Schedule II Narcotics are often Unnecessary for Pain Control in Patients with Pelvic or Acetabular Fractures","authors":"Soumitra Lele, Benjamin R. Childs, Isaac Fernandez, Michael S Reich, M. Nguyen","doi":"10.55576/job.v3i1.28","DOIUrl":"https://doi.org/10.55576/job.v3i1.28","url":null,"abstract":"Objectives: Determine if patients with pelvic and acetabular fractures require scheduled II narcotics after discharge.\u0000 \u0000Design: Retrospective case series.\u0000 \u0000Setting: Level I Trauma Center\u0000 \u0000Patients: 124 consecutive patients with operatively managed pelvic (OTA 61B or C) and acetabular fractures (OTA 62A, 62B or C)\u0000 \u0000Intervention: A multimodal oral pain regimen was prescribed at discharge with schedule II narcotic only if needed for pain control.\u0000 \u0000Main Outcome: Primary outcomes were defined as the need for schedule II narcotic at discharge or in follow up.\u0000Measurements: Prescription of narcotic on follow up or return to ER for inadequate pain control. Visual Analog Pain Scale score.\u0000 \u0000Results: Ninety-two patients (74%) with adequate follow-up were included for the final analysis, including patients with 25 acetabular fractures, 50 pelvic fractures, and 17 combined injuries. Sixty-four patients (69.6%) were multiply-injured patients. Four (4.3%) patients were discharged with a Schedule II narcotic. Of the remaining patients (n=88), two (2.2%) required delayed prescription of a Schedule II narcotic after discharge and 5 (5.4%) presented to the ED for pain control. There were no readmissions for pain. Overall 81 of 92 (88.0%) patients had pain controlled without schedule II narcotics or ED presentation. The mean VAS pain score for all patients was 4.1±3.6 from 5 to 21 days, 3.2±3.4 at 22 to 60 days, and 2.7±3.3 at greater than 60 to 180 days after discharge, there was no significant difference between groups\u0000 \u0000Conclusion: Multimodal pain control regimens without schedule II narcotics in the immediate postoperative follow-up period can be effective in managing pain in the majority of patients with pelvic or acetabular fractures.\u0000 \u0000Level of Evidence: IV; case series\u0000 \u0000Keywords: narcotics, pain control, acetabular fractures, pelvic fractures","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122391983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost of Superior Capsular Reconstruction is Understudied: A Scoping Review 上囊重建的成本尚待研究:范围综述

Journal of Orthopaedic Business Pub Date : 2023-01-01 DOI: 10.55576/job.v3i1.30

Justin Evans, Shayli Schultz, Joshua Salisbury, Christopher Bacak, Mikel Tihista, K. Fitzpatrick, Reid Tompkins, Benjamin R. Childs, N. Parnes, A. Sandler

{"title":"Cost of Superior Capsular Reconstruction is Understudied: A Scoping Review","authors":"Justin Evans, Shayli Schultz, Joshua Salisbury, Christopher Bacak, Mikel Tihista, K. Fitzpatrick, Reid Tompkins, Benjamin R. Childs, N. Parnes, A. Sandler","doi":"10.55576/job.v3i1.30","DOIUrl":"https://doi.org/10.55576/job.v3i1.30","url":null,"abstract":"Background. Irreparable rotator cuff tears are challenging to treat; however, there are multiple options available for surgical management. In recent years, superior capsular reconstruction (SCR) has emerged as a promising option. \u0000Materials/Methods. A scoping review of studies reporting costs associated with SCR was performed. An initial search yielded 94 studies for screening, of which two studies were eligible for inclusion. \u0000Results. Estimated costs ranged from $5,642 to $20,837 US dollars (USD). The average cost estimate for SCR was ultimately determined to be $16,330.56 with adjustments for inflation. \u0000Conclusions. There is extremely limited data regarding the current cost of SCR. Regardless, much of the cost associated with the procedure appears to be driven by the costs of intraoperative factors including implants, specifically human dermal allograft and anchors, as well as operative time. Future research identifying specific costs pertinent to SCR will be invaluable in determining the role of this procedure in treating IRCTs as well as how to maximize cost-effectiveness in general.","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125158312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validity Evidence for a Low-Cost Shoulder Arthroscopy Partial Task Trainer (L-CASTT) 低成本肩关节镜部分任务训练器(L-CASTT)的有效性证据

Journal of Orthopaedic Business Pub Date : 2022-10-01 DOI: 10.55576/job.v2i4.22

Joshua Hansen, Corbin Lee, Bryson Hewins, Austin MacDonald, Austin Rasmussen, Kristen Bishop, E. Weissbrod, Robert Mcgill, J. Lopreiato, B. Franklin

{"title":"Validity Evidence for a Low-Cost Shoulder Arthroscopy Partial Task Trainer (L-CASTT)","authors":"Joshua Hansen, Corbin Lee, Bryson Hewins, Austin MacDonald, Austin Rasmussen, Kristen Bishop, E. Weissbrod, Robert Mcgill, J. Lopreiato, B. Franklin","doi":"10.55576/job.v2i4.22","DOIUrl":"https://doi.org/10.55576/job.v2i4.22","url":null,"abstract":"Objectives: To develop and validate a novel, low-cost shoulder arthroscopy partial task trainer. \u0000Study Design: Cross-sectional study\u0000Methods: A low-cost arthroscopy model was created to simulate navigation and triangulation skills in conjunction with ABOS-certified Orthopaedic surgeons' input. Each participant performed three trials of simulated labral repair and performance data was compared between experienced surgeons and novice medical students.\u0000Results: A total of 8 orthopaedic surgeons in the experienced group and 18 medical students in the novice group participated in the study. The average age of the experienced group was 43.1 years old, with 8.3 years of post-residency experience. The average age of the novice group was 24.3 years. The experienced group completed the simulation task faster than the novice group (16.6±7.6 vs. 96.4 ±102.2 seconds; p<0.001).\u0000Conclusion: The shoulder arthroscopy model demonstrated significant differences in performance between experienced orthopaedic surgeons and novices when used to assess a standardized basic arthroscopic technical skill. This low-cost trainer discriminates between varying skill levels and may be an effective option for simulation training of arthroscopic fundamentals to novice learners.\u0000Level of Evidence: III, Case Control\u0000Keywords: Arthroscopy, Simulation, Validity Evidence, Orthopaedics, Graduate Medical Education\u0000(J Ortho Business 2022; Volume 2, Issue 4:pages 1-4)","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"73 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120855842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Economic Process Behind Surgical Innovation 外科手术创新背后的经济过程

Journal of Orthopaedic Business Pub Date : 2022-10-01 DOI: 10.55576/job.v2i4.24

Daniel J. Cognetti, Jordan E. Handcox, K. Anderson, J. Aden, R. Hurley

{"title":"Economic Process Behind Surgical Innovation","authors":"Daniel J. Cognetti, Jordan E. Handcox, K. Anderson, J. Aden, R. Hurley","doi":"10.55576/job.v2i4.24","DOIUrl":"https://doi.org/10.55576/job.v2i4.24","url":null,"abstract":"Objective: To analyze trends in open and minimally invasive (MIS) sacroiliac joint fusion (SIJF) that coincide with changes in compensation models and Current Procedural Terminology (CPT) codes.\u0000Design: Database analysis\u0000Setting: American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Database\u0000Patients/Participants: Underwent SIJF, based on CPT codes, from 2007-2018\u0000Intervention: Open and MIS SIJF\u0000Main Outcome Measurements: Proportion of open versus MISJ SIJF, proportion of inpatient vs outpatient SIJF, relative value units\u0000Results: There were 744 total SIJFs performed. Open SIJFs totaled 683, while 65 MIS SIJFs were performed. The number of SIJFs increased yearly, apart from two years, with a similar trend noted when controlling for the number of NSQIP entries per year. From 2014-2018, MIS SIJF made up a significantly larger proportion of total SIJFs (p<0.0001) and the proportion of outpatient SIJFs increased over the entire study period (p=0.0002).\u0000Conclusions: SIJF is being increasingly utilized, coinciding with regulatory approval and the American Medical Association’s formal recognition of MIS SIJF. Related changes to coding and compensation serve as a model for the economic processes behind surgical innovation, highlighting the importance of surgeon advocacy along the way.\u0000Level of Evidence: III; Retrospective Cohort Study\u0000Keywords: Sacroiliac joint; arthrodesis; fusion; minimally invasive; NSQIP, economics, compensation, policy","PeriodicalId":152360,"journal":{"name":"Journal of Orthopaedic Business","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131538387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1