Machine Learning and Primary Total Knee Arthroplasty: Patient Forecasting for a Patient-Specific Payment Model

The Journal of Arthroplasty
Sergio M NavarroPrem N Ramkumar

Abstract

Value-based and patient-specific care represent 2 critical areas of focus that have yet to be fully reconciled by today's bundled care model. Using a predictive naïve Bayesian model, the objectives of this study were (1) to develop a machine-learning algorithm using preoperative big data to predict length of stay (LOS) and inpatient costs after primary total knee arthroplasty (TKA) and (2) to propose a tiered patient-specific payment model that reflects patient complexity for reimbursement. Using 141,446 patients undergoing primary TKA from an administrative database from 2009 to 2016, a Bayesian model was created and trained to forecast LOS and cost. Algorithm performance was determined using the area under the receiver operating characteristic curve and the percent accuracy. A proposed risk-based patient-specific payment model was derived based on outputs. The machine-learning algorithm required age, race, gender, and comorbidity scores ("risk of illness" and "risk of morbidity") to demonstrate a high degree of validity with an area under the receiver operating characteristic curve of 0.7822 and 0.7382 for LOS and cost. As patient complexity increased, cost add-ons increased in tiers of 3%, 10%, and 15% for moderate, major, a...Continue Reading

Associated Clinical Trials

Citations

Feb 8, 2019·Journal of Orthopaedic Trauma·Jaret M KarnutaPrem N Ramkumar
Jan 30, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Prakash Jayakumar, Kevin J Bozic
Oct 31, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Dustin R BironAlan H Daniels
Sep 24, 2020·Journal of Neuro-oncology·Adham M KhalafallahDebraj Mukherjee
Jan 27, 2020·Current Reviews in Musculoskeletal Medicine·J Matthew HelmPrem N Ramkumar
Apr 8, 2020·Indian Journal of Orthopaedics·Murali PoduvalAniruddha Sinha
Jan 9, 2021·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Michael MurphyNicholas Brown
Sep 2, 2020·Journal of Shoulder and Elbow Surgery·Varun ArvindPaul J Cagle
Jan 19, 2021·Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association·Kyle N KunzeShane J Nho
Dec 17, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Eric C MakhniPrem N Ramkumar
Oct 19, 2020·The Journal of Arthroplasty·Tanmaya D Sambare, Kevin J Bozic
Dec 15, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Malcolm R DeBaunMichael J Gardner
Feb 18, 2021·Clinical Orthopaedics and Related Research·Michael P Murphy, Nicholas M Brown
Apr 27, 2021·The American Journal of Sports Medicine·Prem N RamkumarRiley J Williams
Dec 21, 2021·The Journal of the American Academy of Orthopaedic Surgeons·Christine M EtzelAlan H Daniels
Jan 11, 2022·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Florian HinterwimmerRüdiger von Eisenhart-Rothe

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

American Journal of Physical Medicine & Rehabilitation
Kevin R VincentAlan P Alfano
British Journal of Anaesthesia
C C JørgensenLundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group
© 2022 Meta ULC. All rights reserved