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首页> 外文期刊>Journal of Health Services Research & Policy >MOBILE and the provision of total joint replacement
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MOBILE and the provision of total joint replacement

机译：并提供全部关节置换

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Modern joint replacements have been available for 45 years, but we still do not have clear indications for these interventions, and we do not know how to optimize the outcome for patients who agree to have them done. The MOBILE programme has been investigating these issues in relation to primary total hip and knee joint replacements, using mixed methods research. nnThere have been five main strands:nnEpidemiological investigations to find out who is receiving total hip and knee replacements in the National Health Service (NHS). This has shown that there are extensive variations in different regions of the UK, with inequalities and probable inequities in the provision of these operations; nnEpidemiological work to ascertain the population-based needs for the operations, showing under-provision of knee joint replacements, and a relative reluctance of both patients and GPs to consider knee surgery; nnQuantitative and qualitative research into the views of patients, health care professionals and the public on the indications for, and prioritization of, total hip and knee joint replacements. This has shown lack of agreement within or between professional groups, as well as a mismatch between the views of patients and the public, and those of professionals; nnTheoretical and experimental work on patient-related outcome measures, and the development of new instruments to assess both pain and function in people with osteoarthritis, based on the International Classification of Function, as well as a new integrated model of function; nnCohort studies of patients undergoing hip or knee joint replacements to find out what the determinants of good and bad outcomes are. These studies have emphasized the huge variation in disease severity at the time of surgery. nnThe challenge now is to use and implement our findings for maximum patient benefit.
机译：现代关节置换术已有45年的历史了，但是对于这些干预措施我们仍然没有明确的适应症，而且我们不知道如何为同意这样做的患者优化治疗效果。 MOBILE计划已使用混合方法研究了与主要的全髋和膝关节置换有关的这些问题。 nn有五个主要方面：nn流行病学调查，以找出谁在国家卫生局（NHS）中接受全部髋关节和膝关节置换术。这表明英国不同地区之间存在很大差异，在提供这些业务方面存在不平等和可能的不平等； nn流行病学工作，以确定基于人群的手术需求，显示膝关节置换术的准备不足，并且患者和GP都不愿考虑进行膝关节手术； nn对患者，卫生保健专业人员和公众就完全髋和膝关节置换的适应症和优先次序的观点进行定量和定性研究。这表明在专业团体内部或专业团体之间缺乏共识，以及患者和公众以及专业人士的观点不一致； nn关于患者相关结局指标的理论和实验工作，并开发了基于国际功能分类以及新的综合功能模型评估骨关节炎患者疼痛和功能的新工具； nn对接受髋关节或膝关节置换术的患者进行的队列研究，以找出决定好坏的因素。这些研究强调了手术时疾病严重程度的巨大差异。 nn现在的挑战是使用和实施我们的发现，以最大程度地提高患者受益。

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