{"id":"https://openalex.org/W2902625890","doi":"https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0324.r1","title":"Outcome-based commissioning of knee arthroplasty in the NHS: system error in a national monitoring programme and the unintended consequences on achieving the Best Practice Tariff","display_name":"Outcome-based commissioning of knee arthroplasty in the NHS: system error in a national monitoring programme and the unintended consequences on achieving the Best Practice Tariff","publication_year":2018,"publication_date":"2018-11-30","ids":{"openalex":"https://openalex.org/W2902625890","doi":"https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0324.r1","mag":"2902625890","pmid":"https://pubmed.ncbi.nlm.nih.gov/30499320"},"language":"en","primary_location":{"id":"doi:10.1302/0301-620x.100b12.bjj-2018-0324.r1","doi":"https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0324.r1","is_oa":false,"landing_page_url":"https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0324.r1","pdf_url":null,"source":{"id":"https://openalex.org/S4210239958","display_name":"The Bone & Joint Journal","issn_l":"2049-4394","issn":["2049-4394","2049-4408"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311815","host_organization_name":"British Editorial Society of Bone & Joint Surgery","host_organization_lineage":["https://openalex.org/P4310311815"],"host_organization_lineage_names":["British Editorial Society of Bone & Joint Surgery"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The Bone &amp; Joint Journal","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5041102578","display_name":"Robert Middleton","orcid":"https://orcid.org/0000-0002-0427-1727","observed_orcids":["https://orcid.org/0000-0002-0427-1727","https://orcid.org/0009-0007-4840-9031"]},"institutions":[{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"R. Middleton","raw_affiliation_strings":["Botnar Research Centre, Oxford, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Botnar Research Centre, Oxford, UK","institution_ids":["https://openalex.org/I40120149"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101840877","display_name":"Hannah A Wilson","orcid":"https://orcid.org/0000-0002-9351-1592","observed_orcids":["https://orcid.org/0000-0002-9351-1592"]},"institutions":[{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"H. A. Wilson","raw_affiliation_strings":["Botnar Research Centre, Oxford, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Botnar Research Centre, Oxford, UK","institution_ids":["https://openalex.org/I40120149"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5030106343","display_name":"Abtin Alvand","orcid":"https://orcid.org/0000-0001-6069-978X","observed_orcids":["https://orcid.org/0000-0001-6069-978X"]},"institutions":[{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"A. Alvand","raw_affiliation_strings":["Botnar Research Centre, Oxford, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Botnar Research Centre, Oxford, UK","institution_ids":["https://openalex.org/I40120149"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5083135142","display_name":"Simon G. F. Abram","orcid":"https://orcid.org/0000-0002-4452-6499","observed_orcids":["https://orcid.org/0000-0002-4452-6499"]},"institutions":[{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"S. G. F. Abram","raw_affiliation_strings":["Botnar Research Centre, Oxford, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Botnar Research Centre, Oxford, UK","institution_ids":["https://openalex.org/I40120149"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5040308850","display_name":"Nicholas Bottomley","orcid":"https://orcid.org/0000-0001-8441-630X","observed_orcids":["https://orcid.org/0000-0001-8441-630X"]},"institutions":[{"id":"https://openalex.org/I2801809904","display_name":"Nuffield Orthopaedic Centre","ror":"https://ror.org/0036ate90","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801809904","https://openalex.org/I4210147381"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"N. Bottomley","raw_affiliation_strings":["Nuffield Orthopaedic Centre, Oxford, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Nuffield Orthopaedic Centre, Oxford, UK","institution_ids":["https://openalex.org/I2801809904"]}]},{"author_position":"middle","author":{"id":null,"display_name":"W. Jackson","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801809904","display_name":"Nuffield Orthopaedic Centre","ror":"https://ror.org/0036ate90","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801809904","https://openalex.org/I4210147381"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"W. Jackson","raw_affiliation_strings":["Nuffield Orthopaedic Centre, Oxford, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Nuffield Orthopaedic Centre, Oxford, UK","institution_ids":["https://openalex.org/I2801809904"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5005098926","display_name":"Andrew James Price","orcid":"https://orcid.org/0000-0002-4258-5866","observed_orcids":["https://orcid.org/0000-0002-4258-5866"]},"institutions":[{"id":"https://openalex.org/I40120149","display_name":"University of Oxford","ror":"https://ror.org/052gg0110","country_code":"GB","type":"education","lineage":["https://openalex.org/I40120149"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"A. Price","raw_affiliation_strings":["Botnar Research Centre, Oxford, UK"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Botnar Research Centre, Oxford, UK","institution_ids":["https://openalex.org/I40120149"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":2.3133,"has_fulltext":false,"cited_by_count":11,"citation_normalized_percentile":{"value":0.86678551,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":97},"biblio":{"volume":"100-B","issue":"12","first_page":"1572","last_page":"1578"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10562","display_name":"Total Knee Arthroplasty Outcomes","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10562","display_name":"Total Knee Arthroplasty Outcomes","score":0.9970999956130981,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10442","display_name":"Knee injuries and reconstruction techniques","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/patient-reported-outcome-measures","display_name":"patient-reported outcome measures","score":0.8270000219345093},{"id":"https://openalex.org/keywords/unicompartmental-knee-arthroplasty","display_name":"unicompartmental knee arthroplasty","score":0.968999981880188},{"id":"https://openalex.org/keywords/total-knee-arthroplasty","display_name":"total knee arthroplasty","score":0.9860000014305115},{"id":"https://openalex.org/keywords/oxford-knee-score","display_name":"Oxford Knee Score","score":0.9879999756813049},{"id":"https://openalex.org/keywords/national-health-service","display_name":"National Health Service","score":0.33000001311302185},{"id":"https://openalex.org/keywords/data-coding-errors","display_name":"data coding errors","score":0.4399999976158142},{"id":"https://openalex.org/keywords/administrative-data","display_name":"administrative data","score":0.6079999804496765}],"concepts":[{"id":"https://openalex.org/C2778829800","wikidata":"https://www.wikidata.org/wiki/Q7884755","display_name":"Unicompartmental knee arthroplasty","level":4,"score":0.8851295709609985},{"id":"https://openalex.org/C2780463824","wikidata":"https://www.wikidata.org/wiki/Q7115567","display_name":"Oxford knee score","level":4,"score":0.856002926826477},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7042640447616577},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.528738260269165},{"id":"https://openalex.org/C3017871827","wikidata":"https://www.wikidata.org/wiki/Q1693864","display_name":"Total knee arthroplasty","level":2,"score":0.5047239065170288},{"id":"https://openalex.org/C2778336525","wikidata":"https://www.wikidata.org/wiki/Q708178","display_name":"Arthroplasty","level":2,"score":0.46032989025115967},{"id":"https://openalex.org/C2777596629","wikidata":"https://www.wikidata.org/wiki/Q10858520","display_name":"Inclusion and exclusion criteria","level":3,"score":0.45981794595718384},{"id":"https://openalex.org/C2776164576","wikidata":"https://www.wikidata.org/wiki/Q62736","display_name":"Osteoarthritis","level":3,"score":0.24681460857391357},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.22716182470321655},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.0},{"id":"https://openalex.org/C204787440","wikidata":"https://www.wikidata.org/wiki/Q188504","display_name":"Alternative medicine","level":2,"score":0.0}],"mesh":[{"descriptor_ui":"D000071066","descriptor_name":"Patient Reported Outcome Measures","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004739","descriptor_name":"England","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005500","descriptor_name":"Follow-Up Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012042","descriptor_name":"Registries","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D012189","descriptor_name":"Retrospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013222","descriptor_name":"State Medicine","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D017063","descriptor_name":"Outcome Assessment, Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D019645","descriptor_name":"Arthroplasty, Replacement, Knee","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D020370","descriptor_name":"Osteoarthritis, Knee","qualifier_ui":"Q000601","qualifier_name":"surgery","is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1302/0301-620x.100b12.bjj-2018-0324.r1","doi":"https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0324.r1","is_oa":false,"landing_page_url":"https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0324.r1","pdf_url":null,"source":{"id":"https://openalex.org/S4210239958","display_name":"The Bone & Joint Journal","issn_l":"2049-4394","issn":["2049-4394","2049-4408"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-a","doyens","jufo-3","ki-jl-2","medline","norway-2","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311815","host_organization_name":"British Editorial Society of Bone & Joint Surgery","host_organization_lineage":["https://openalex.org/P4310311815"],"host_organization_lineage_names":["British Editorial Society of Bone & Joint Surgery"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The Bone &amp; Joint Journal","raw_type":"journal-article"},{"id":"pmid:30499320","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/30499320","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The bone & joint journal","raw_type":"Journal Article"},{"id":"pmh:oai:research-information.bris.ac.uk:openaire_cris_publications/09edb697-1ee4-4384-bbd0-639bdffae6e1","doi":null,"is_oa":false,"landing_page_url":"https://research-information.bris.ac.uk/en/publications/09edb697-1ee4-4384-bbd0-639bdffae6e1","pdf_url":null,"source":{"id":"https://openalex.org/S4306400895","display_name":"Bristol Research (University of Bristol)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I36234482","host_organization_name":"University of Bristol","host_organization_lineage":["https://openalex.org/I36234482"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Middleton, R, Wilson, H A, Alvand, A, Abram, S G F, Bottomley, N, Jackson, W & Price, A 2018, 'Outcome-based commissioning of knee arthroplasty in the NHS : SYSTEM ERROR IN A NATIONAL MONITORING PROGRAMME AND THE UNINTENDED CONSEQUENCES ON ACHIEVING THE BEST PRACTICE TARIFF', Bone and Joint Journal, vol. 100B, no. 12, pp. 1572-1578. https://doi.org/10.1302/0301-620x.100b12.bjj-2018-0324.r1","raw_type":"info:eu-repo/semantics/article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.9391000270843506,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[{"id":"https://openalex.org/G1043955966","display_name":null,"funder_award_id":"CL-2014-13-007","funder_id":"https://openalex.org/F4320319990","funder_display_name":"National Institute for Health and Care Research"}],"funders":[{"id":"https://openalex.org/F4320319990","display_name":"National Institute for Health and Care Research","ror":"https://ror.org/0187kwz08"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":13,"referenced_works":["https://openalex.org/W2019627320","https://openalex.org/W2049699480","https://openalex.org/W2050372920","https://openalex.org/W2074272730","https://openalex.org/W2139990021","https://openalex.org/W2141932718","https://openalex.org/W2148306825","https://openalex.org/W2160916700","https://openalex.org/W2249783060","https://openalex.org/W2494727417","https://openalex.org/W2525767011","https://openalex.org/W2625325905","https://openalex.org/W4213231055"],"related_works":["https://openalex.org/W3080160228","https://openalex.org/W7162945481","https://openalex.org/W4405994680","https://openalex.org/W4306851316","https://openalex.org/W1943924423","https://openalex.org/W4403692301","https://openalex.org/W4321612954","https://openalex.org/W3202208649","https://openalex.org/W4408031412","https://openalex.org/W7117900905"],"abstract_inverted_index":{"AIMS:":[0],"Our":[1],"unit":[2],"was":[3,98,106],"identified":[4],"as":[5],"a":[6,23,28,177],"negative":[7],"outlier":[8],"in":[9,53,93,146],"the":[10,43,51,62,94,115,124,173,203],"national":[11,95],"patient-reported":[12],"outcome":[13],"measures":[14],"(PROMs)":[15],"programme,":[16],"which":[17],"has":[18],"significant":[19],"funding":[20],"implications.":[21],"As":[22],"centre":[24],"that":[25,180,202],"carries":[26],"out":[27],"high":[29],"volume":[30],"of":[31,64,90,123,132,143,169],"unicompartmental":[32],"knee":[33,74,165],"arthroplasty":[34],"(UKA),":[35],"our":[36,150],"objectives":[37],"were:":[38],"1)":[39],"to":[40,60,85,157,208],"determine":[41,61],"whether":[42],"PROMs":[44,80,96,117,139,147,174],"programme":[45,97,140,175],"included":[46],"primary":[47,66,73,128,144,164],"UKA":[48,67,91,109,129,170],"when":[49,184],"calculating":[50],"gain":[52,105,152,187],"Oxford":[54],"Knee":[55],"Score":[56],"(OKS);":[57],"and":[58,110,112,135],"2)":[59],"impact":[63],"excluding":[65],"on":[68,195],"calculated":[69,107],"OKS":[70,104,151,186],"gains":[71],"for":[72,108,119,127,161,163],"arthroplasty.":[75,166],"MATERIALS":[76],"AND":[77],"METHODS:":[78],"National":[79],"data":[81],"from":[82,138,153,172],"England":[83],"(2012":[84],"2016)":[86],"were":[87],"analyzed.":[88],"Inclusion":[89,142],"cases":[92],"determined":[99],"using":[100],"clinical":[101],"codes.":[102],"Local":[103],"TKA":[111],"compared":[113],"with":[114],"published":[116],"results":[118],"2012/13.":[120],"RESULTS:":[121],"Use":[122],"recommended":[125],"codes":[126],"excluded":[130],"99.6%":[131],"UKAs":[133,145],"locally":[134],"97%":[136],"nationally":[137],"analysis.":[141],"analysis":[148],"improved":[149],"15.1":[154],"(below":[155],"average)":[156,160],"16.3":[158],"(above":[159],"2012/13":[162],"CONCLUSION:":[167],"Exclusion":[168],"patients":[171],"is":[176,200,206],"nationwide":[178],"issue":[179],"potentially":[181],"introduces":[182],"bias":[183],"comparing":[185],"between":[188],"centres.":[189],"Where":[190],"commissioning":[191],"decisions":[192],"are":[193],"based":[194],"routinely":[196],"collected":[197],"data,":[198],"it":[199],"imperative":[201],"underlying":[204],"methodology":[205],"appropriate":[207],"generate":[209],"valid":[210],"results.":[211]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2022,"cited_by_count":1},{"year":2021,"cited_by_count":4},{"year":2020,"cited_by_count":2},{"year":2019,"cited_by_count":3}],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2018-12-11T00:00:00"}
