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Subject: search.filters.subject.Benchmarking

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    Benchmarking total knee replacement constructs using noninferiority analysis: the New Zealand joint registry study
    (BioMed Central Ltd, 2021-08-23) Wyatt MC; Frampton CF; Whitehouse MR; Deere KC; Sayers A; Kieser D
    BACKGROUND: The aim of this study was to compare the relative performance of total knee replacement constructs and discern if there is variability in performance in currently commonly used prostheses in the New Zealand Joint Registry (NZJR) using a noninferiority analysis. METHODS: All patients who underwent a primary total knee replacement (TKR) registered in the NZJR between 1st January 1999 to June 2020 were identified. Using a noninferiority analysis, the performance of total knee replacement prostheses were compared with the best performing contemporary construct. Construct all-cause revision rate was estimated using the 1-Kaplan Meier survival function method to estimate net failure. The difference in all-cause revision rates between the contemporary benchmark and all other constructs was tested. RESULTS: In total 110 183 TKR were recorded and 25 constructs (102 717 procedures) had > 500 procedures at risk at 3 years post-primary of which 5 were inferior by at least 20 % relative risk of which, one was inferior by at least 100 % relative risk. 14 constructs were identified with > 500 procedures at risk at 10 years with 5 inferior by at least 20 %, of which 2 were inferior by > 100 % relative risk. CONCLUSIONS: We discerned that there is great variability in construct performance and at all time points, greater than 25 % of constructs are inferior to the best performing construct by at least 20 %. These results can help inform patients, clinicians and health care funders when considering TKR surgery.
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    Benchmarking total hip replacement constructs using noninferiority analysis: the New Zealand joint registry study.
    (BioMed Central Ltd, 2021) Wyatt M; Frampton C; Whitehouse M; Deere K; Sayers A; Kieser D
    BACKGROUND: The aim of this study was to compare the relative performance of total hip replacement constructs and discern if there is substantial variability in performance in currently commonly used prostheses in the New Zealand Joint Registry (NZJR) using a noninferiority analysis. METHODS: All patients who underwent a primary total hip replacement (THR) registered in the NZJR between 1st January 1999 to June 2020 were identified. Using a noninferiority analysis, the performance of hip prostheses were compared with the best performing contemporary construct. Construct failure was estimated using the 1-Kaplan Meier survival function method to estimate net failure. The difference in failure between the contemporary benchmark and other constructs was examined. RESULTS: In total 135,432 THR were recorded comprising 1035 different THR constructs. Notably 328 constructs were used just once. Forty-eight constructs (62,251 THR) had > 500 procedures at risk at 3 years post-primary of which 28 were inferior by at least 20% relative risk of which, 10 were inferior by at least 100% relative risk. Sixteen constructs were identified with > 500 procedures at risk at 10 years with 9 inferior by at least 20%, of which one was inferior by > 100% relative risk. There were fewer constructs noninferior to the best practice benchmark when we performed analysis by gender. In females at 10 years, from 5 constructs with > 500 constructs at risk, 2 were inferior at the 20% margin. In males at 10 years, there were only 2 eligible constructs of which one was inferior at the 20% margin. CONCLUSIONS: We discerned that there is substantial variability in construct performance and at most time points, just over half of constructs are inferior to the best performing construct by at least 20%. These results can facilitate informed decision-making when considering THR surgery.
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    The characteristics of successful benchmarking implementation : guidelines for a national strategy for promoting benchmarking
    (Massey University, 2014) Abbas, Ahmed
    The MPhil research project presented in this thesis forms the first part of an intended PhD research project. The purpose of the PhD will be to develop a framework to increase the uptake of benchmarking on a national level whilst the aim of the MPhil is to examine the state of benchmarking globally. More specifically, the study objective is to measure and understand the perceived effectiveness, awareness, current and future uptake of benchmarking. The study also explores best practice benchmarking characteristics such as duration of the projects, motivations of benchmarking projects and main benefits of benchmarking. An on-line questionnaire was used to collect data. The questionnaire was translated into five languages and promoted mainly by the Global Benchmarking Network, (GBN) a network of benchmarking centres representing 21 countries. The data was then analysed using SPSS statistical package. The questionnaire consists of seven sections: (1) Organisation’s profile, (2) Use of improvement technique, (3) General questions on benchmarking, (4) Best practice benchmarking projects planning phase, (5) Best practice benchmarking projects research and analysis phase, (6) Best practice benchmarking projects implementation phase, and finally (7) Best practice benchmarking projects evaluation phase. The analysis suggests that informal and performance benchmarking is being used by a majority of organisations while best practice benchmarking is lagging behind them. Benchmarking awareness, effectiveness and future uptake compares favourably with other popular improvement techniques.