{"id":479,"date":"2023-03-14T10:52:02","date_gmt":"2023-03-14T14:52:02","guid":{"rendered":"https:\/\/journal.aoao.org\/?p=479"},"modified":"2023-03-14T10:57:38","modified_gmt":"2023-03-14T14:57:38","slug":"a-comparison-of-nasa-task-load-index-in-primary-and-revision-total-hip-arthroplasty","status":"publish","type":"post","link":"https:\/\/journal.aoao.org\/?p=479","title":{"rendered":"A Comparison of NASA Task Load Index in Primary and Revision Total Hip Arthroplasty<\/strong>"},"content":{"rendered":"\n

1<\/sup>Panwar K, 2<\/sup>Huish E, 1<\/sup>Law J, 3<\/sup>Staples J, 4<\/sup>Eisemon E, 5<\/sup>Lum Z
1<\/sup>Doctors Medical Center, Modesto, California, USA; 2<\/sup>San Joaquin General Hospital, Stockton, California, USA; 3<\/sup>Memorial Medical Center, Modesto, California, USA; 4<\/sup>Kaiser Permanente Oakland, Oakland, CA, USA; 5<\/sup>UC Davis Medical Center, Weston, Florida, USA<\/p>\n\n\n\n

Introduction<\/strong>
Perceived surgeon workload of performing total hip arthroplasty (THA) is poorly understood and variable in nature. The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) survey was developed to quantify subjective experiences following aviation and has been applied to various healthcare fields. Our purpose is to: 1) quantify the workload endured by surgeons who are performing primary and revision THA and 2) compare these values in relationship to their Center for Medicare & Medicaid Services (CMS) compensation.<\/p>\n\n\n\n

Methods <\/strong>
A prospective observational cohort of 5 fellowship-trained adult reconstruction surgeons completed NASA-TLX surveys following conclusion of primary THA (CPT 27130 and 27132) and revision THA (CPT 27134, 27137, and 27138). Survey consists of obtaining self-reported scores on 6 domains: mental demand, physical demand, temporal demand, performance, effort, and frustration. All domains were graded on a 20-point scale (0=lowest, 20=highest). Reference tasks and descriptions were included in order to improve interobserver reliability (figure 1). Final workload scores (0 to 20 points) involved a weighted average of all 6 domains. We excluded from analysis any cases with intraoperative complication. Operative time, surgical indication, patient age, sex, body mass index, and American Society of Anesthesiologist category were recorded. Final NASA-TLX workloads were compared to 2021 CMS data for work relative value units. Statistical analysis was performed using SPSS.<\/p>\n\n\n\n

Results <\/strong>
55 surveys (38 primaries and 17 revisions) were completed averaging 7.6 primaries and 3.4 revisions per surgeon. All 6 NASA-TLX domains were significantly higher in revision than primary THA (p<.003, table 1). Revision THA represented a 106% increased workload compared to primary THA (p<0.001), primary 5.26 (CI 0-10.96) vs. revision 10.85 (CI 6.29-15.41). Subgroup analysis was unable to reveal difference in workload based upon indication for primary THA (p=0.332) or revision THA (p=.353). Operative time was higher in revision versus primary THA – 150 vs 115 minutes respectively (p=0.001). Post-hoc power analysis demonstrated likelihood of &#946;-error <.001. Based upon 2021 CMS data, revision THA is compensated 25% lower than actual workload.<\/p>\n\n\n\n

Conclusion<\/strong>
Revision THA places a significant workload upon surgeons and is disproportionately compensated by CMS.<\/p>\n\n\n\n

Image 1<\/a> | Image 2<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

1Panwar K, 2Huish E, 1Law J, 3Staples J, 4Eisemon E, 5Lum Z1Doctors Medical Center, Modesto, California, USA; 2San Joaquin General Hospital, Stockton, California, USA; 3Memorial Medical Center, Modesto, California, USA; 4Kaiser Permanente Oakland, Oakland, CA, USA; 5UC Davis Medical Center, Weston, Florida, USA IntroductionPerceived surgeon workload of performing total hip arthroplasty (THA) is poorly understood and variable in nature. The National Aeronautics and Space […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[40,50],"class_list":["post-479","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-abstracts","tag-april-2023"],"yoast_head":"\nA Comparison of NASA Task Load Index in Primary and Revision Total Hip Arthroplasty - AOAO Journal<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/journal.aoao.org\/?p=479\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A Comparison of NASA Task Load Index in Primary and Revision Total Hip Arthroplasty - AOAO Journal\" \/>\n<meta property=\"og:description\" content=\"1Panwar K, 2Huish E, 1Law J, 3Staples J, 4Eisemon E, 5Lum Z1Doctors Medical Center, Modesto, California, USA; 2San Joaquin General Hospital, Stockton, California, USA; 3Memorial Medical Center, Modesto, California, USA; 4Kaiser Permanente Oakland, Oakland, CA, USA; 5UC Davis Medical Center, Weston, Florida, USA IntroductionPerceived surgeon workload of performing total hip arthroplasty (THA) is poorly understood and variable in nature. 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