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Title: Electronic patient centred outcomes in orthopaedic surgery
Author: Hurst, Simon
ISNI:       0000 0004 7228 8015
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2016
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This thesis primarily reports on the national pilot of an electronic patient reported outcomes (ePRO) system for orthopaedic patients. Also reported on within the pilot is a new electronic patient centred outcome measure (ePCO) with focus on activity participation, and aspiration. At the time of publishing the pilot remains the largest of its kind within the speciality, and the first of its kind with respect to ePCOs. A background with historical perspective is provided for the use of outcomes in orthopaedic surgery, including a discussion surrounding current practices, and controversies. The engineering principles behind the construction of an ePCO/PCO system are also explained, along with the current regulatory guidelines governing them in Europe and the United States. The development and piloting of three individual software platforms are explained, evaluated, and discussed. This includes in the appendix a discussion on their wider context within industry, and within an increasingly technological able society. The final platform (Software C) is piloted in a large cohort both nationally, and internationally. Results from the pilot are presented and discussed in terms of the software usability, the ability for PROs to be successfully digitalised to ePROs within the software, and patient’s opinion of the technology. Objective outcome data obtained from a instrumented treadmill is used as an adjunct to the analysis of the impact of ePROs collected during the pilot, and also helping to address the validation parameters for the ePCO. Finally, the PCO is reported on. This includes the principles providing its conception, and foundation. It is tested using parameters for outcome score validation in both an initial paper-based pilot study, and in a national pilot using a modified digitalised format of the PCO.
Supervisor: Cobb, Justin ; Reilly, Peter Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral