Yves Henrotin1, Cedric Tits2, Jérôme Paul2, Pierre Gramme2, Thibault Helleputte2, Alberto Migliore3, Pascal Richette4, Xavier Chevalier5, Jordi Monfort6, Demirhan Diracoglu7, Hervé Bard8, Jörg Jerosch9, Dominique Baron10, Raman Raghu11, Thierry Conrozier12. 1. Musculoskeletal Innovative Research Lab, Arthropole Liège, Center for Interdisciplinary Research on Medicines, Institute of Pathology, University of Liège, Liège, Belgium. 2. DNAlytics, Louvain-la-Neuve, Belgium. 3. U.O.S. of Rheumatology, Ospedale San Pietro Fatebenefratelli, Rome, Italy. 4. Université Paris Diderot, UFR médicale, Hôpital Lariboisière, Paris, France. 5. Department of Rheumatology, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France. 6. Servei de Reumatologia, Hospital del Mar, Barcelona, Spain. 7. Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. 8. Cabinet Medical Vaudoyer, Paris, France. 9. Department of Orthopedic, Johanna Etienne Hospital, Neuss, Germany. 10. Centre de Réadaptation Fonctionnelle de Lannion-Trestel, Trévou-Tréguignec, France. 11. Academic Department of Orthopaedics, Hull and East Yorkshire NHS Trust Castle Hill Hospital, Cottingham, UK. 12. Hospital North Franche-Comté, Trévenans, France.
Abstract
OBJECTIVES: This work studied if and how current clinical practice agrees with European Viscosupplementation Consensus Group (EUROVISCO) recommendations and how this agreement might be different according to physician's specialization. In addition, this work aimed to identify key decision factors that practitioners consider in their decision to retreat or not a patient with hyaluronic acid viscosupplementation. METHODS: Practitioners have been invited by e-mail to participate in an online exercise on viscosupplementation retreatment. They received a fictional patient case at random among a set of predefined fictional cases. The platform asked the practitioner if he/she would retreat the patient with viscosupplementation or not. To take a decision, the practitioner could select questions among a list of predefined questions. Among them, some were related to criteria used in the EUROVISCO decision tree and others served as confounding factors. RESULTS: A total of 506 practitioners participated to the exercise, of which 399 gave their decision about the case assigned to them by the platform. The observed agreement between practitioner decisions and EUROVISCO recommendations was 58.89 ± 4.95% (95% confidence interval [CI]). Overall, the decision to retreat was taken in 47.87% of the cases, while the EUROVISCO guidelines follow-up would have led to 55.89% retreatment for the same cases (P = 0.03). CONCLUSIONS: In current practice, physicians tended to reinject their patients less than recommended, although EUROVISCO guidelines for viscosupplementation retreatment consider decision criteria that clearly correspond to those of practitioners in real life. These include the patients' willingness to be treated or the patients' perception of the effectiveness of the treatment.
OBJECTIVES: This work studied if and how current clinical practice agrees with European Viscosupplementation Consensus Group (EUROVISCO) recommendations and how this agreement might be different according to physician's specialization. In addition, this work aimed to identify key decision factors that practitioners consider in their decision to retreat or not a patient with hyaluronic acid viscosupplementation. METHODS: Practitioners have been invited by e-mail to participate in an online exercise on viscosupplementation retreatment. They received a fictional patient case at random among a set of predefined fictional cases. The platform asked the practitioner if he/she would retreat the patient with viscosupplementation or not. To take a decision, the practitioner could select questions among a list of predefined questions. Among them, some were related to criteria used in the EUROVISCO decision tree and others served as confounding factors. RESULTS: A total of 506 practitioners participated to the exercise, of which 399 gave their decision about the case assigned to them by the platform. The observed agreement between practitioner decisions and EUROVISCO recommendations was 58.89 ± 4.95% (95% confidence interval [CI]). Overall, the decision to retreat was taken in 47.87% of the cases, while the EUROVISCO guidelines follow-up would have led to 55.89% retreatment for the same cases (P = 0.03). CONCLUSIONS: In current practice, physicians tended to reinject their patients less than recommended, although EUROVISCO guidelines for viscosupplementation retreatment consider decision criteria that clearly correspond to those of practitioners in real life. These include the patients' willingness to be treated or the patients' perception of the effectiveness of the treatment.
Authors: K M Jordan; N K Arden; M Doherty; B Bannwarth; J W J Bijlsma; P Dieppe; K Gunther; H Hauselmann; G Herrero-Beaumont; P Kaklamanis; S Lohmander; B Leeb; M Lequesne; B Mazieres; E Martin-Mola; K Pavelka; A Pendleton; L Punzi; U Serni; B Swoboda; G Verbruggen; I Zimmerman-Gorska; M Dougados Journal: Ann Rheum Dis Date: 2003-12 Impact factor: 19.103
Authors: R R Bannuru; M C Osani; E E Vaysbrot; N K Arden; K Bennell; S M A Bierma-Zeinstra; V B Kraus; L S Lohmander; J H Abbott; M Bhandari; F J Blanco; R Espinosa; I K Haugen; J Lin; L A Mandl; E Moilanen; N Nakamura; L Snyder-Mackler; T Trojian; M Underwood; T E McAlindon Journal: Osteoarthritis Cartilage Date: 2019-07-03 Impact factor: 6.576