Estimating an Individual's Probability of Revision Surgery After Knee Replacement: A Comparison of Modeling Approaches Using a National Dataset.

Estimating an Individual's Probability of Revision Surgery After Knee Replacement: A Comparison of Modeling Approaches Using a National Dataset. Am J Epidemiol. 2018 Jun 11;: Authors: Aram P, Trela-Larsen L, Sayers A, Hills AF, Blom AW, McCloskey EV, Kadirkamanathan V, Wilkinson JM Abstract Tools that provide personalized risk prediction of the outcomes after surgical procedures help patients to make preference-based decisions amongst the available treatment options. However, it is unclear which modeling approach provides the most accurate risk estimation. We constructed and compared several parametric and non-parametric models for predicting prosthesis survivorship after knee replacement surgery for osteoarthritis. We used 430,455 patient-procedure episodes between April 2003 and September 2015 from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. The flexible parametric survival and random survival forest models most accurately captured the observed probability of remaining event-free. The concordance index for the flexible parametric model was the highest (0.705; 95% confidence interval: 0.702, 0.707) for total knee replacement, 0.639 (95% confidence interval: 0.634, 0.643) for unicondylar knee replacement and 0.589 (95% confidence interval: 0.586, 0.592) for patellofemoral replacement. The observed-to-predicted ratios for both the flexible parametric and the random survival forest approaches i...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research