Patients prefer In-Office Needle Arthroscopy (IONA) over traditional surgical arthroscopy
Notice bibliographique
Résumé
Purpose: In-Office Needle Arthroscopy (IONA) is an emerging technology that has been primarily studied as a diagnostic tool. Recent evidence shows that it is a cost-effective alternative to hospital- and community-based MRI with comparable accuracy. Although exciting for surgeons and administrators, little is known about patients' perceptions of IONA. Level IV evidence shows that patients with claustrophobia or contra-indications to sedation prefer IONA to MRI for diagnostic purposes. However, no study to date has examined patients' preferences regarding IONA and traditional surgical arthroscopy. Therefore, this study was conceived with the purpose of gathering patients' perspectives on IONA as an alternative to traditional surgical arthroscopy through semi-structured interviews. A secondary outcome was to determine the real-life financial impact with respect to profit and cost of introducing IONA at an academic mid-sized Canadian hospital. Method: All patients undergoing arthroscopic non-ligamentous knee surgery within a three-month period at a mid-sized academic hospital were approached for this study. A trained researcher conducted telephone interviews regarding patient experience with the entire surgical process, including diagnosis and treatment, suffering an injury, referral for MRI and sports surgeon, and booking arthroscopic surgery. Participants were provided information on IONA, including risks and benefits as an alternative to traditional arthroscopy, and were asked about their likelihood of choosing IONA as an alternative to their treatment pathway. Thematic and quantitative analysis was conducted based on interview results, with quantitative analysis conducted using a 5-point Likert scale. Financial analysis was conducted by observing the propensity to choose IONA via patients' response to the 5-point Likert scale and then modeled for cost effectiveness. Results: Twenty-one patients were interviewed. The mean age was 32.3 (SD: 9.8) years old with 12 (57.1 %) females. Mean time from surgery to interview was 10.2 weeks (SD: 11.4). In general, patients' perceptions of IONA were favorable. When asked how likely they would have been to opt for IONA over traditional arthroscopy, the mean response was "very likely" (4.10 [1.26]). The mean likelihood for males to select IONA was higher than females (4.78 versus 3.58). Common reasons for wanting IONA were to speed up the time between injury and surgery (n = 9), avoiding a general anesthetic/intubation and associated complications (n = 7), and avoiding the fear/anxiety of surgery (n = 6). Most patients listed the lack of primary data on the effectiveness, pain, revision rate, and PROMs as the primary hesitation (n = 6). Financial analysis revealed that IONA would reduce costs by $21,832.66 (p < 0.0001), resulting in an increase in profit of $21,468.80 (p < 0.0001). Conclusion: The most significant finding in this study is that IONA may be preferable by patients in a publicly funded healthcare system with limitations to operating room access. Patients believe that IONA can accelerate the diagnosis and treatment of meniscal injuries, allowing patients to avoid surgery via the traditional route of the operating room. Furthermore, it is shown to be a cost-effective alternative to MRI with similar diagnostic accuracy at a mid-sized Canadian institution.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».