Cochrane and MAGIC partnership: results from musculoskeletal pilot project on arthroscopic surgery for degenerative knee disease

Session: 

Oral session: Innovative solutions to challenges of evidence production (3)

Date: 

Monday 17 September 2018 - 14:00 to 14:20

Location: 

Carrick 1

All authors in correct order:

O'Connor D1, Johnston R2, Brignardello-Petersen R3, O Vandvik P4, Agoritsas T5, van de Velde S4, Phillips S6, Buchbinder R2
1 Cochrane EPOC and Musculoskeletal, Monash University, Australia
2 Cochrane Musculoskeletal, Monash University, Australia
3 McMaster University & Universidad de Chile, Canada & Chile
4 MAGIC & Norwegian Institute of Public Health, Norway
5 McMaster University & University of Geneva, Canada & Switzerland
6 Therapeutic Guidelines Limited, Australia
Presenting author and contact person

Presenting author:

Denise O'Connor

Contact person:

Denise O'Connor
Abstract text
Background: Cochrane Musculoskeletal and MAGIC are working on pilot projects to explore jointly innovations in sharing work and data to harmonise flow from musculoskeletal reviews to guidelines and decision support systems. Arthroscopic surgery for degenerative knee disease is a low-value treatment practice where large variation exists and research translation is urgently needed.

Objectives: To describe our experiences and progress with a Cochrane Musculoskeletal-MAGIC partnership pilot project on arthroscopic surgery for degenerative knee disease.

Methods: In 2017 Cochrane Musculoskeletal contributed to a BMJ Rapid Recommendation (and related BMJ Open Rapid Review) on knee arthroscopy for degenerative knee disease. A strong recommendation against the use of arthroscopy in nearly all patients with degenerative knee disease was made. Cochrane Musculoskeletal recently converted the rapid review to a Cochrane Review incorporating new evidence. MAGICapp and SHARE-IT were used to create a decision aid (de-implementation tool) to disseminate this evidence to people with knee osteoarthritis considering arthroscopic surgery. The content of the decision aid was informed by qualitative interviews with consumers and health professionals about their information needs and preferences for a knee arthroscopy decision aid. The decision aid is being piloted with Australian consumers and clinicians. Methods to integrate it with Australian primary care electronic health record (EHR) management software are being explored. The decision aid for knee arthroscopy will be evaluated in a randomised trial in Australian primary care. Therapeutic Guidelines will update their guideline recommendation if needed.

Results: We will present the results within the Evidence Ecosystem (Figure 1), including: barriers and facilitators for evidence synthesis, development of the decision aid in MAGICapp, and plans for implementation and evaluation.

Conclusions: The Evidence Ecosystem for musculoskeletal conditions, as illustrated by this case study in knee arthroscopy for degenerative knee disease, provides opportunities for closing the loop between synthesised evidence and improved care.

Patient or healthcare consumer involvement: The information needs and preferences of consumers were used to inform the content of the decision aid.

Attachments: 

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Relevance to patients and consumers: 

This research describes the efficient creation and implementation of a systematic review and decision aid for arthroscopic surgery for knee osteoarthritis; a commonly used but 'low-value' healthcare practice. Healthcare consumers were interviewed about their information needs and preferences for the decision aid and this informed the content of the tool.