WCWL - Hip/Knee Joint Replacement

The WCWL panel on hip and knee replacement surgery developed and tested a set of standardized clinical criteria for setting priorities among patients awaiting hip and knee replacement surgery. The criteria were applied to 406 patients in four provinces. Regression analysis was used to determine the set of criteria weights that collectively best predicted clinicians’ overall urgency ratings. Inter-rater and test-retest reliability was assessed using six videotaped patient interviews, scored by orthopaedic surgeons, related professionals, and general practitioners. The priority criteria accounted for over two-thirds of the observed variance in overall urgency ratings (adj.R2 = 67.6%). The panel modified the criteria and weights based on the empirical findings and clinical judgment. The reliability of the priority criteria for the hip and knee replacement tool was among the strongest of the five instruments developed in the WCWL project. The panel considered the criteria easy to use and reasonably reflective of expert surgical judgment regarding clinical urgency for hip and knee replacement.