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Cost-Effectiveness of Web-Based Follow Ups

This study has been completed.
The Physicians' Services Incorporated Foundation
Information provided by (Responsible Party):
Dianne Bryant, University of Western Ontario, Canada Identifier:
First received: March 1, 2010
Last updated: February 6, 2013
Last verified: February 2013

Complications following total joint arthroplasty are rare, and the majority of follow-up visits are routine. The technology now exists to conduct annual follow-up assessments without having to physically see the patient.

This study will investigate the cost-effectiveness of web-based follow-up assessments compared to standard in-clinic follow-ups. We will also assess patient satisfaction, preference, and the validity of the web-based follow up assessments. Patients coming up to their 1 year follow-up or greater will be randomized to either the web-based group or the usual care group.

Web-based patients will complete all questionnaires using an online database system, and have their x-ray taken at their local radiology facility. The surgeon will review radiographs online. If there are any concerns with the x-ray or responses to questionnaires, arrangements will be made for the patient to be seen at the clinic. Patients in the Usual Care group will come into the clinic for their follow-up assessment and have their x-ray taken at University Hospital as usual.

Online assessment could significantly decrease wait times in orthopaedic clinics, as well as increase availability for OR time and new consultations. This approach could also potentially reduce patient burden by decreasing travel distances, financial burden and time requirements.

Condition Intervention
Osteoarthritis in the Knee Joint Osteoarthritis in the Hip Joint Other: in-person Other: web-based

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Cost-Effectiveness of Web-Based Follow Up Following Total Joint Arthroplasty

Resource links provided by NLM:

Further study details as provided by Dianne Bryant, University of Western Ontario, Canada:

Primary Outcome Measures:
  • Cost-effectiveness [ Time Frame: one year ]

Secondary Outcome Measures:
  • Harris Hip Score [ Time Frame: one year ]
  • Western Ontario and McMaster Osteoarthritis Index (WOMAC) [ Time Frame: one year ]
  • SF-12 [ Time Frame: one year ]
  • Adverse events [ Time Frame: one year ]

Enrollment: 260
Study Start Date: February 2010
Study Completion Date: March 2011
Primary Completion Date: March 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: web-based
The patient will undergo xrays at the closest PACs enabled imaging centre and will login and answer questions online. The surgeon will review the images and patient responses and determine whether the patient needs to be seen more urgently or a per routine.
Other: web-based
Patients who are at least 2 years following knee or hip replacement will complete a questionnaire online and routine x-rays at a PACS enabled imaging center. The patient's surgeon will receive an email from the database summarizing the patient's responses to key questions and will review the x-rays. The surgeon will determine whether the patient needs to be seen in-person.
Active Comparator: in-person
Patients will attend their follow-up appointments in-person as per usual
Other: in-person
Follow-up appointments will be completed in-person as per usual


Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • patients who have had a primary total hip or total knee arthroplasty

Exclusion Criteria:

  • patients with osteolysis, or previous complications from their joint replacement
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01079572

Canada, Ontario
London Health Sciences Centre - University Hospital
London, Ontario, Canada, N6G 1H1
Sponsors and Collaborators
University of Western Ontario, Canada
The Physicians' Services Incorporated Foundation
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Dianne Bryant, Associate Professor, University of Western Ontario, Canada Identifier: NCT01079572     History of Changes
Other Study ID Numbers: PSI-2010-01
Study First Received: March 1, 2010
Last Updated: February 6, 2013

Keywords provided by Dianne Bryant, University of Western Ontario, Canada:
electronic follow-up

Additional relevant MeSH terms:
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases processed this record on September 19, 2017