Imperial College London
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Mr. Gareth G. Jones

Faculty of Medicine, Department of Surgery & Cancer

Clinical Senior Lecturer in Orthopaedic Surgery
 
 
 
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Contact

 

+44 (0)20 7594 5465g.g.jones

 
 
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Location

 

203Sir Michael Uren HubWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Stanley:2023:10.1177/20552076231152177,
author = {Stanley, A and Edwards, T and Jaere, M and Lex, J and Jones, G},
doi = {10.1177/20552076231152177},
journal = {Digital Health},
pages = {1--9},
title = {An automated, web-based triage tool may optimise referral pathways in elective orthopaedic surgery: a proof-of-concept study},
url = {http://dx.doi.org/10.1177/20552076231152177},
volume = {9},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - IntroductionKnee pain is caused by various pathologies, making evaluation in primary-care challenging. Subsequently, an over-reliance on imaging, such as radiographs and MRI exists. Electronic-triage tools represent an innovative solution to this problem. The aims of this study were to establish the magnitude of unnecessary knee imaging prior to orthopaedic surgeon referral, and ascertain whether an e-triage tool outperforms existing clinical pathways to recommend correct imaging.MethodsPatients ≥18 years presenting with knee pain treated with arthroscopy or arthroplasty at a single academic hospital between 2015 and 2020 were retrospectively identified. The timing and appropriateness of imaging were assessed according to national guidelines, and classified as ‘necessary’, ‘unnecessary’ or ‘required MRI’. Based on an eDelphi consensus study, a symptom-based e-triage tool was developed and piloted to preliminarily diagnose five common knee pathologies and suggest appropriate imaging.Results1462 patients were identified. 17.2% (n = 132) of arthroplasty patients received an ‘unnecessary MRI’, 27.6% (n = 192) of arthroscopy patients did not have a ‘necessary MRI’, requiring follow-up. Forty-one patients trialled the e-triage pilot (mean age: 58.4 years, 58.5% female). Preliminary diagnoses were available for 33 patients. The e-triage tool correctly identified three of the four knee pathologies (one pathology did not present). 79.2% (n = 19) of participants would use the tool again.ConclusionA substantial number of knee pain patients receive incorrect imaging, incurring delays and unnecessary costs. A symptom-based e-triage tool was developed, with promising performance and user feedback. With refinement using larger datasets, this tool has the potential to improve wait-times, referral quality and reduce cost.
AU  - Stanley,A
AU  - Edwards,T
AU  - Jaere,M
AU  - Lex,J
AU  - Jones,G
DO  - 10.1177/20552076231152177
EP  - 9
PY  - 2023///
SN  - 2055-2076
SP  - 1
TI  - An automated, web-based triage tool may optimise referral pathways in elective orthopaedic surgery: a proof-of-concept study
T2  - Digital Health
UR  - http://dx.doi.org/10.1177/20552076231152177
UR  - https://journals.sagepub.com/doi/10.1177/20552076231152177
UR  - http://hdl.handle.net/10044/1/102704
VL  - 9
ER  -
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