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Dates: Ongoing collaboration since 2013
Funding: NIHR Health Technology Assessment (HTA)
Collaborators: Nuffield Department of Orthopaedics, University of Bristol, University of Exeter
Information: Helen Dakin, Alastair Gray, Peter Eibich

There is currently widespread regional variation in the way that GPs decide which patients with hip or knee pain should be referred to secondary care and in how decisions about whether to conduct hip or knee replacement are made in secondary care. Uncertainty around which patients benefit from knee or hip replacement means that some patients are referred inappropriately for surgery while others who could benefit miss out.

This project aims to develop an evidence-based tool (ACHE) for GPs and/or hospitals to use to identify patients who are highly likely to benefit from hip or knee replacement surgery and guide those unlikely to benefit to other treatment options.

This project will review current clinical tools for assessing patients before joint replacement and analyse existing datasets to identify which tool best predicts outcomes and estimate thresholds that identify which patients are candidates for surgery. As part of this project, HERC researchers will extend our previous work on knee replacement to assess which tool best predicts incremental costs and QALYs of joint replacement and estimate health economic thresholds for each tool at which joint replacement ceases to be cost-effective.

For more information: