The NJR continues to support ODEP and its work ~ this section is authored by the Orthopaedic Data Evaluation Panel
The 2013/14 year has been a busy year for ODEP who, like the NJR, celebrated a tenth anniversary. It is an important milestone for many of the reasons noted below but importantly, ODEP is now responsible for Beyond Compliance.
Available registry data for the benchmarking process
When NICE set up ODEP*, they introduced the concept of 10-year benchmarks. Up until now, judgements against benchmarks, particularly 10-year, have relied upon the following data:
- Statistical methodology
- Data from other registries
- Reports in journals and
- Orthopaedic meetings
With the registry now holding 10 years of data, it is going to be much easier for companies to complete their ODEP submissions for the 10A and 10A* benchmarks.
A recent refining of the benchmarks now means that a whole cohort of implants/patients has to pass through each benchmark for the accreditation to be achieved. Other changes to the system include:
- The 10A*benchmark where there is a 5% revision rate or less at 10 years
- A pre-entry*benchmark has been introduced for those implants which are being introduced through beyond compliance
- To obtain the 3 year, 5 year and 7 year benchmarks the initial cohort has to be 150, 250 and 350 patients respectively, all through the time period
ODEP and NICE
NICE have recently revised their “Guidance on the selection of prostheses of primary total hip replacement” (NICE Technology Appraisal Guidance 2) and have asked ODEP to implement it. ODEP has always judged the acetabular component and the femoral component of a hip replacement separately, whereas NICE have indicated that they would prefer the assessment of hip replacements as one unit.
ODEP has encouraged NICE to continue with the ODEP method of assessing stems and cups separately. The NICE proposal would have excluded all cases of mix and match where the manufacturer of the stem is different from the manufacturer of the acetabular component. Currently, some of the best results in hip replacement involve the use of components from more than one manufacturer. We are pleased that this proposal has been accepted.
ODEP ratings for knee implants
ODEP is now reporting on knees and the first output will be in the autumn of 2014. We are very grateful for BASK (British Association of Surgery for the Knee) for all their input and particularly the help that Mr Tim Wilton, Mr Colin Esler and Mr Richard Parkinson have given.
Knee implants will be judged as single units. However, as many of the main brands have been changing some of the options within the brand ‘family’, we are regularly drilling further down into these attributes so that a separate benchmark can be awarded to each. This also allows reporting of how many of each particular variation are used. Many surgeons, manufacturers and organisations have requested an ODEP output for knees and work is underway. We thank our colleagues for their patience in these early days of development.
Sharing ODEP progress and practice
ODEP has made numerous presentations over the past year to societies, manufacturers and other organisations. We were delighted to be allowed to present to the manufacturers at the March American Academy of Orthopaedic Surgeons meeting in New Orleans.
Thanks must be shared all members of the ODEP panel who give their time for this valuable process, most of them being unpaid for their work. You can find out more about the panel membership at www.odep.org.uk.
*No current affiliation