This study looks at rates of a shoulder surgery (arthroscopic subacromial decompression) and at the characteristics of the people undergoing these procedures in the UK over time. A large UK clinical trial (Can Shoulder Arthoscopy Work; CSAW1) has shown that this surgery is unlikely to be effective, and we are interested in examining the trends in its use before and after that trial. We aim to determine whether the conduct and completion of the trial has impacted clinical practice. We are also interested in documenting the characteristics of patients undergoing surgery and how these have changed over time.
This is a descriptive study examining temporal trends in arthroscopic subacromial decompression (ASAD) for subacromial pain. We want to determine whether there has been a change in clinical practice in response to the conduct (from 2012 to 2015) and publication (in 2017) of a large UK trial finding that subacromial decompression is unlikely to be effective.
OBJECTIVES
1. Temporal analysis of incidence rates of ASAD
2. Temporal analysis of characteristics of patients undergoing ASAD
METHODS
Data sources: CPRD GOLD. We are replicating this study in similar primary care databases internationally, and are not requesting HES linkage for comparability.
Participants: Incidence rates: all CPRD patients; patient characteristics: patients undergoing ASAD
Outcomes: ASAD
Measurements: Counts of subacromial decompression surgery and all patient characteristics listed in “covariates” (Section M)
Statistics: Incidence rates will be calculated as the proportion of the population registered in any contributing practice in a given calendar year who undergo ASAD for the first time in their records in that same year. Stratified rates will be obtained by sex and age groups.
Temporal trends in ASAD incidence rates and characteristics patients undergoing the procedure.
Daniel Prieto-Alhambra - Chief Investigator - University of Oxford
James Smith - Corresponding Applicant - University of Oxford