Impact of a national guideline on use of knee arthroscopy: An interrupted time-series analysis. Kiadaliri, A., Bergkvist, D., Dahlberg, L. E., & Englund, M. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 31(9):G113–G118, November, 2019.
Impact of a national guideline on use of knee arthroscopy: An interrupted time-series analysis [link]Paper  doi  abstract   bibtex   
OBJECTIVE: To assess the impact of the Swedish health authority recommendation against the use of knee arthroscopy in patients aged ≥40 years with knee osteoarthritis (OA). DESIGN: Interrupted time series analysis. SETTING: Public health care in Skåne region. PARTICIPANTS: Patients aged ≥40 years who underwent knee arthroscopy from January 2010 to December 2015. INTERVENTION(S): National guideline's recommendation against the use of knee arthroscopy in patients with knee OA. MAIN OUTCOME MEASURE(S): 1) proportion of patients aged ≥40 years with a main diagnosis of Knee OA and/or degenerative meniscal lesions (DML) who underwent knee arthroscopy, and 2) overall knee arthroscopy rate per 100,000 Skåne population aged ≥40 years. RESULTS: A total of 6,155 knee arthroscopy were performed among people aged ≥40 years during study period. Of 42,044 patients with Knee OA/DML, 3,728 had knee arthroscopy. The recommendation was associated with reductions in the use of knee arthroscopy and two years after the recommendation, there was a reduction of 28.6% (95% CI: 9.3, 47.8) and 34.7% (23.9, 45.4) in proportion of Knee OA/DML patients with knee arthroscopy and the overall knee arthroscopy rate, respectively, relative to that expected if pre-recommendation trend continued. Our sensitivity analysis showed that the use of total knee replacement was stable over the study period. CONCLUSION: The national recommendation was associated with reduction in use of knee arthroscopy in public health care in southern Sweden. However, still 4.5% of these patients underwent knee arthroscopy in 2015 implying that more efforts are required to achieve the recommended target.
@article{kiadaliri_impact_2019,
	title = {Impact of a national guideline on use of knee arthroscopy: {An} interrupted time-series analysis},
	volume = {31},
	issn = {1464-3677},
	shorttitle = {Impact of a national guideline on use of knee arthroscopy},
	url = {https://doi.org/10.1093/intqhc/mzz089},
	doi = {10.1093/intqhc/mzz089},
	abstract = {OBJECTIVE: To assess the impact of the Swedish health authority recommendation against the use of knee arthroscopy in patients aged ≥40 years with knee osteoarthritis (OA).
DESIGN: Interrupted time series analysis.
SETTING: Public health care in Skåne region.
PARTICIPANTS: Patients aged ≥40 years who underwent knee arthroscopy from January 2010 to December 2015.
INTERVENTION(S): National guideline's recommendation against the use of knee arthroscopy in patients with knee OA.
MAIN OUTCOME MEASURE(S): 1) proportion of patients aged ≥40 years with a main diagnosis of Knee OA and/or degenerative meniscal lesions (DML) who underwent knee arthroscopy, and 2) overall knee arthroscopy rate per 100,000 Skåne population aged ≥40 years.
RESULTS: A total of 6,155 knee arthroscopy were performed among people aged ≥40 years during study period. Of 42,044 patients with Knee OA/DML, 3,728 had knee arthroscopy. The recommendation was associated with reductions in the use of knee arthroscopy and two years after the recommendation, there was a reduction of 28.6\% (95\% CI: 9.3, 47.8) and 34.7\% (23.9, 45.4) in proportion of Knee OA/DML patients with knee arthroscopy and the overall knee arthroscopy rate, respectively, relative to that expected if pre-recommendation trend continued. Our sensitivity analysis showed that the use of total knee replacement was stable over the study period.
CONCLUSION: The national recommendation was associated with reduction in use of knee arthroscopy in public health care in southern Sweden. However, still 4.5\% of these patients underwent knee arthroscopy in 2015 implying that more efforts are required to achieve the recommended target.},
	language = {eng},
	number = {9},
	journal = {International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care},
	author = {Kiadaliri, Ali and Bergkvist, Dan and Dahlberg, Leif E. and Englund, Martin},
	month = nov,
	year = {2019},
	pmid = {31725873},
	pmcid = {PMC7076349},
	keywords = {Adult, Arthroplasty, Replacement, Knee, Arthroplasty, Replacement, Knee/statistics \& numerical data, Arthroscopy, Arthroscopy/*statistics \& numerical data, Guidelines as Topic, Humans, Interrupted Time Series Analysis, Knee Joint, Knee Joint/*surgery, Meniscus, Meniscus/pathology/surgery, Middle Aged, Osteoarthritis, Knee, Osteoarthritis, Knee/*surgery, Sweden, degenerative knee disease, interrupted time series, knee arthroscopy},
	pages = {G113--G118},
}

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