Part I: Topics of Interest Related to Revision Total Knee Arthroplasty   |    
Why We Should Collect Outcomes Data
Marc F. Swiontkowski, MD
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Corresponding author: Marc F. Swiontkowski, MD
Department of Orthopaedic Surgery, University of Minnesota, 420 Delaware Street S.E., MMC 492, Minneapolis, MN 55455. E-mail address: swion001@tc.umn.edu

The author did not receive grants or outside funding in support of his research or preparation of this manuscript. He did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the author is affiliated or associated.

J Bone Joint Surg Am, 2002 Jan 01;85(suppl 1):S14-S15
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The failure of efforts in the 1990s to create large databases on orthopaedic practice outcomes requires us once again to critically address outcomes research in orthopaedics. The MODEMS program established by the American Academy of Orthopaedic Surgeons and subspecialty societies demonstrated that the vast majority of orthopaedic surgeons in the United States are not motivated to collect outcomes data 1. Those surgeons who did collect the data quickly found that the process was cumbersome and expensive because of the need for specialized software and increased staff time. These additional expenses were impossible to justify, given the increasing pressure on practices to be more cost-efficient. More importantly, without addressing specific and clinically relevant issues, the data-collection activities were not sustainable. During the postmortem on these failed programs, two oversights became clear. First, the expectation that the process should create a financial profit for sponsoring organizations was unrealistic. Outcomes research on this scale is a lengthy procedure, typically consuming resources over an eight to ten-year period. This significant time commitment should have been noted and accepted from the outset. Second, and more importantly, the orthopaedic surgery community should have focused the outcomes efforts on those issues that were most likely to produce clinically useful information. The selection of outcome measures should have been guided by the orthopaedic community-at-large to solidify its "buy-in" into the process as well as to ensure clinically useful information.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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