Monitoring Quality of Care for Joint Replacements: Assessing Alternative Statistical Methods to Accurately Estimate Time to Revision

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atmire.migration.oldid2972
dc.contributor.advisorMarshall, Deborah
dc.contributor.authorLacny, Sarah Lynn
dc.date.accessioned2015-02-04T17:17:56Z
dc.date.embargolift2017-02-03T17:17:56Z
dc.date.issued2015-02-04
dc.date.submitted2015en
dc.description.abstractWith increased longevity and as younger, more physically active patients are receiving joint replacements, it has become increasingly important to measure the failure rate for joint replacements using the cumulative incidence of revision. The most commonly applied survival analysis technique, the Kaplan-Meier (KM) method, does not account for competing risks (i.e., patient deaths) and consequently overestimates the cumulative incidence. This thesis examines alternative methods for estimating the cumulative incidence of revision using population-based cohorts of hip and knee replacements performed in Alberta and Sweden. In comparing the KM method to the cumulative incidence function, which accounts for competing risks, the KM method overestimated the cumulative incidence at each time point. The magnitude of overestimation increased with follow-up time and higher mortality rates. Application of three regression models demonstrated competing risks models require careful interpretation. Competing risks methods are recommended to accurately estimate revision rates for healthcare planning purposes.en_US
dc.description.embargoterms2 yearsen_US
dc.identifier.citationLacny, S. L. (2015). Monitoring Quality of Care for Joint Replacements: Assessing Alternative Statistical Methods to Accurately Estimate Time to Revision (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/27000en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/27000
dc.identifier.urihttp://hdl.handle.net/11023/2083
dc.language.isoeng
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectHealth Care Management
dc.subject.classificationArthroplasty, Replacement, Hipen_US
dc.subject.classificationArthroplasty, Replacement, Kneeen_US
dc.subject.classificationArthroplasty, Revisionen_US
dc.subject.classificationSurvival Analysisen_US
dc.subject.classificationKaplan-Meier Estimateen_US
dc.subject.classificationCompeting Risksen_US
dc.subject.classificationCumulative Incidenceen_US
dc.titleMonitoring Quality of Care for Joint Replacements: Assessing Alternative Statistical Methods to Accurately Estimate Time to Revision
dc.typemaster thesis
thesis.degree.disciplineCommunity Health Sciences
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameMaster of Science (MSc)
ucalgary.item.requestcopytrue
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