Cost-Effectiveness of Web-Based Follow Ups

Study Overview
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Brief Summary
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Complications following total joint arthroplasty are rare, and the majority of follow-up visits are routine. The technology now exists to conduct annual follow-up assessments without having to physically see the patient. This study will investigate the cost-effectiveness of web-based follow-up assessments compared to standard in-clinic follow-ups. We will also assess patient satisfaction, preference, and the validity of the web-based follow up assessments. Patients coming up to their 1 year follow-up or greater will be randomized to either the web-based group or the usual care group. Web-based patients will complete all questionnaires using an online database system, and have their x-ray taken at their local radiology facility. The surgeon will review radiographs online. If there are any concerns with the x-ray or responses to questionnaires, arrangements will be made for the patient to be seen at the clinic. Patients in the Usual Care group will come into the clinic for their follow-up assessment and have their x-ray taken at University Hospital as usual. Online assessment could significantly decrease wait times in orthopaedic clinics, as well as increase availability for OR time and new consultations. This approach could also potentially reduce patient burden by decreasing travel distances, financial burden and time requirements.

Official Title
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Cost-Effectiveness of Web-Based Follow Up Following Total Joint Arthroplasty

Conditions
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Osteoarthritis in the Knee Joint, Osteoarthritis in the Hip Joint

Intervention / Treatment
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* Other: in-person
* Other: web-based


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients who have had a primary total hip or total knee arthroplasty Exclusion Criteria: patients with osteolysis, or previous complications from their joint replacement
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: web-based<br>The patient will undergo xrays at the closest PACs enabled imaging centre and will login and answer questions online. The surgeon will review the images and patient responses and determine whether the patient needs to be seen more urgently or a per routine. | Other: web-based<br>* Patients who are at least 2 years following knee or hip replacement will complete a questionnaire online and routine x-rays at a PACS enabled imaging center. The patient's surgeon will receive an email from the database summarizing the patient's responses to key questions and will review the x-rays. The surgeon will determine whether the patient needs to be seen in-person.<br>|
| Active Comparator: in-person<br>Patients will attend their follow-up appointments in-person as per usual | Other: in-person<br>* Follow-up appointments will be completed in-person as per usual<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cost-effectiveness |  | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Harris Hip Score |  | one year | 
| Western Ontario and McMaster Osteoarthritis Index (WOMAC) |  | one year | 
| SF-12 |  | one year | 
| Adverse events |  | one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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web-based, osteoarthritis, arthroplasty, electronic follow-up