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Joint replacement: Which joints and when?
Joint replacement: Which joints and when? Paul Dieppe Ex-rheumatologist and health services researcher (no longer Bristol)
Which Joints? ,[object Object],[object Object],[object Object],[object Object]
Which Joints? ,[object Object],[object Object],[object Object],[object Object]
Our research ,[object Object],[object Object]
When should you consider having a joint replacement?
When should you consider having a joint replacement? ,[object Object]
[object Object]
NHS Provision ,[object Object],[object Object],[object Object]
Where and by whom? ,[object Object],[object Object],[object Object]
NHS Provision ,[object Object]
The pathway to joint replacement and how decisions are made
People in the Community The GP Orthopaedic Surgeon Surgery
People in the Community The GP Orthopaedic Surgeon Surgery Don’t seek help Give up seeking help
Views of people not seeking help or giving up after seeing a GP ,[object Object]
Views of people not seeking help or giving up after seeing a GP ,[object Object],[object Object]
Views of people not seeking help or giving up after seeing a GP ,[object Object],[object Object],[object Object]
Views of people not seeking help or giving up after seeing a GP ,[object Object],[object Object],[object Object],[object Object]
Views of GPs ,[object Object]
Views of GPs ,[object Object],[object Object]
Views of GPs ,[object Object],[object Object],[object Object]
Views of GPs ,[object Object],[object Object],[object Object],[object Object]
Views of GPs ,[object Object],[object Object],[object Object],[object Object],[object Object]
People in the Community The GP Orthopaedic Surgeon Surgery ?
The views and behaviours of orthopaedic surgeons ,[object Object]
The views and behaviours of orthopaedic surgeons ,[object Object],[object Object]
So - when should you consider having a joint replacement?
So - when should you consider having a joint replacement? ,[object Object],[object Object]
What do YOU think? (!) ,[object Object]
What do YOU think? (!) ,[object Object],[object Object]
What do YOU think? (!) ,[object Object],[object Object],[object Object]
What do YOU think? (!) ,[object Object],[object Object],[object Object],[object Object]
What do YOU think? (!) ,[object Object],[object Object],[object Object],[object Object],[object Object]
So how can we make the system better and ‘fairer’?
[object Object]
[object Object]
CAPACITY TO BENEFIT (Likely gain -v- likely risk) DISEASE INTERVENTION Risk of the disease (do nothing?) How serious the case (pt circumstances) Likely gain (demographics, Co-morbidity) Alternatives (consequences)
2) Local appropriateness criteria
Appropriateness Criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Appropriateness Criteria ,[object Object],[object Object]
Thank You

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Paul Dieppe

  • 1. Joint replacement: Which joints and when?
  • 2. Joint replacement: Which joints and when? Paul Dieppe Ex-rheumatologist and health services researcher (no longer Bristol)
  • 3.
  • 4.
  • 5.
  • 6. When should you consider having a joint replacement?
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. The pathway to joint replacement and how decisions are made
  • 13. People in the Community The GP Orthopaedic Surgeon Surgery
  • 14. People in the Community The GP Orthopaedic Surgeon Surgery Don’t seek help Give up seeking help
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24. People in the Community The GP Orthopaedic Surgeon Surgery ?
  • 25.
  • 26.
  • 27. So - when should you consider having a joint replacement?
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34. So how can we make the system better and ‘fairer’?
  • 35.
  • 36.
  • 37. CAPACITY TO BENEFIT (Likely gain -v- likely risk) DISEASE INTERVENTION Risk of the disease (do nothing?) How serious the case (pt circumstances) Likely gain (demographics, Co-morbidity) Alternatives (consequences)
  • 39.
  • 40.