Advanced Levels of Clinical Inquiry and Systematic Reviews.

Scenario: You work for the contracting department for a national payer that is working to convert its provider contracts to value-based arrangements. Your team is approaching large physician groups for recontracting. Develop a 12-15-slide presentation with speaker notes to show the value of converting to a value-based arrangement:Advanced Levels of Clinical Inquiry and Systematic Reviews.

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Explain value-based care.
Explain how value-based care differs from a fee-for-service or a capitated approach.
Describe why adopting a value-based purchasing arrangement would be financially advantageous for the physician groups and to the health plan.
Include at least three references, including your textbook.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.Advanced Levels of Clinical Inquiry and Systematic Reviews.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.Advanced Levels of Clinical Inquiry and Systematic Reviews.

Advanced Levels of Clinical Inquiry and Systematic ReviewsNameInstitutionDate
Introduction
Assess topic: The effectiveness of the Prolonged Use of the Continuous Passive Motion (CPM), as an Adjunct to Physiotherapy after Total Knee Arthroplasty (TKA).
Explore development of PICOT question.
Evaluate the various research levels and the articles selected.
General results from the research process.
Clinical Issue of Interest
The effectiveness of the Prolonged Use of the Continuous Passive Motion (CPM), as an Adjunct to Physiotherapy after Total Knee Arthroplasty (TKA).
TKA is knee replacement surgery for those with knee damage.
CPM is therapy using machine for joint motion.
Developing PICOT Question
PICOT Question: – What is the effectiveness of the Prolonged Use of the Continuous Passive Motion (CPM), as an Adjunct to Physiotherapy after Total Knee Arthroplasty (TKA)?
CPM is an alternative to physiotherapy in helping the patients move the joints.Advanced Levels of Clinical Inquiry and Systematic Reviews.
CPM mostly used on knee joints.
Goal is to assess whether they are an effective supplementary for patients with TKA to enhance patient outcomes.
Level I Research Database
Cochrane Database of Systematic Reviews database.
Used CPM as search term.
Yielded 5 relevant sources.
Harvey et al. (2014) article selected.
Contends that effectiveness of CPM as treatment is unclear.

Level II Research Database
Used critically appraised topics.
Used the National Guideline Clearinghouse database
Used total knee replacement as key term.
Yielded 27 relevant results.
Evidence supports that CPM after TKA does not improve patient outcomes.
Initializing rehabilitation measures early helps improve patient outcomes.
Level III and IV Research Databases
Level III Critically- Appraised Individual Articles
Used evidence-based nursing database and total knee replacement as search term.
Erduran et al. (2017) contend that AROM is better than CPM for TKA in reducing pain severity.
Level IV- Randomized Controlled Trial
Used search term CPM or early mobilization and total knee replacement.
Boese et al. (2014) contend that CPM is not beneficial especially in early mobility after TKA.Advanced Levels of Clinical Inquiry and Systematic Reviews.
Conclusion
Topic: The effectiveness of the Prolonged Use of the Continuous Passive Motion (CPM), as an Adjunct to Physiotherapy after Total Knee Arthroplasty (TKA).
Level I research contends that effectiveness of CPM as treatment is unclear.
Level II research from National Guideline Clearinghouse database has evidence that CPM after TKA does not improve patient outcomes.
Level III research contend that AROM is better than CPM for TKA in reducing pain severity.
Level IV research shows that CPM is not beneficial especially in early mobility after TKA.

References
Boese, C. K., Weis, M., Phillips, T., Lawton-Peters, S., Gallo, T., & Centeno, L. (2014). The Efficacy of Continuous Passive Motion After Total Knee Arthroplasty: A Comparison of Three Protocols. The Journal of Arthroplasty, 29(6), 1158–1162. https://doi.org/10.1016/j.arth.2013.12.005
Erduran, M., Eymir, M., & Ünver, B. (2017). AB0806 The effect of repetitive active range of motion versus continuous passive motion on early functional outcomes after primary total knee replacement. Abstracts Accepted for Publication. https://doi.org/10.1136/annrheumdis-2017-eular.5851
Harvey, L. A., Brosseau, L., & Herbert, R. D. (2014). Continuous passive motion following total knee arthroplasty in people with arthritis. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd004260.pub3
National Guideline Clearinghouse (NGC). Guideline summary: American Academy of Orthopedic Surgeons clinical practice guideline on surgical management of osteoarthritis of the knee. In: National Guideline Clearinghouse (NGC). Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2015 Dec 04.Advanced Levels of Clinical Inquiry and Systematic Reviews.

´Advanced Levels of Clinical Inquiry and Systematic Reviews
Name
Institution
Date

´Introduction

´Assess topic: The effectiveness of the Prolonged Use of the Continuous Passive Motion (CPM), as an Adjunct to Physiotherapy after Total Knee Arthroplasty (TKA).

´Explore development of PICOT question.

´Evaluate the various research levels and the articles selected.Advanced Levels of Clinical Inquiry and Systematic Reviews.

´General results from the research process.

´Clinical Issue of Interest

´The effectiveness of the Prolonged Use of the Continuous Passive Motion (CPM), as an Adjunct to Physiotherapy after Total Knee Arthroplasty (TKA).

´TKA is knee replacement surgery for those with knee damage.

´CPM is therapy using machine for joint motion.

´Developing PICOT Question

´PICOT Question: – What is the effectiveness of the Prolonged Use of the Continuous Passive Motion (CPM), as an Adjunct to Physiotherapy after Total Knee Arthroplasty (TKA)?

´CPM is an alternative to physiotherapy in helping the patients move the joints.

´CPM mostly used on knee joints.

´Goal is to assess whether they are an effective supplementary for patients with TKA to enhance patient outcomes.Advanced Levels of Clinical Inquiry and Systematic Reviews.

´Level I Research Database

´Cochrane Database of Systematic Reviews database.

´Used CPM as search term.

´Yielded 5 relevant sources.

´Harvey et al. (2014) article selected.

´Contends that effectiveness of CPM as treatment is unclear.

´

´Level II Research Database

´Used critically appraised topics.

´Used the National Guideline Clearinghouse database

´Used total knee replacement as key term.

´Yielded 27 relevant results.

´Evidence supports that CPM after TKA does not improve patient outcomes.

´Initializing rehabilitation measures early helps improve patient outcomes.

´Level III and IV Research Databases

´Level III Critically- Appraised Individual Articles

´Used evidence-based nursing database and total knee replacement as search term.Advanced Levels of Clinical Inquiry and Systematic Reviews.

´Erduran et al. (2017) contend that AROM is better than CPM for TKA in reducing pain severity.

´Level IV- Randomized Controlled Trial

´Used search term CPM or early mobilization and total knee replacement.

´Boese et al. (2014) contend that CPM is not beneficial especially in early mobility after TKA.

´Conclusion

´Topic: The effectiveness of the Prolonged Use of the Continuous Passive Motion (CPM), as an Adjunct to Physiotherapy after Total Knee Arthroplasty (TKA).

´Level I research contends that effectiveness of CPM as treatment is unclear.

´Level II research from National Guideline Clearinghouse database has evidence that CPM after TKA does not improve patient outcomes.

´Level III research contend that AROM is better than CPM for TKA in reducing pain severity.

´Level IV research shows that CPM is not beneficial especially in early mobility after TKA.Advanced Levels of Clinical Inquiry and Systematic Reviews.

´

´References

´Boese, C. K., Weis, M., Phillips, T., Lawton-Peters, S., Gallo, T., & Centeno, L. (2014). The Efficacy of Continuous Passive Motion After Total Knee Arthroplasty: A Comparison of Three Protocols. The Journal of Arthroplasty, 29(6), 1158–1162. ´Erduran, M., Eymir, M., & Ünver, B. (2017). AB0806 The effect of repetitive active range of motion versus continuous passive motion on early functional outcomes after primary total knee replacement. Abstracts Accepted for Publication.

´Harvey, L. A., Brosseau, L., & Herbert, R. D. (2014). Continuous passive motion following total knee arthroplasty in people with arthritis. Cochrane Database of Systematic Reviews.

´National Guideline Clearinghouse (NGC). Guideline summary: American Academy of Orthopedic   Surgeons clinical practice guideline on surgical management of osteoarthritis of the knee. In:   National Guideline Clearinghouse (NGC). Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); 2015 Dec 04.

Advanced Levels of Clinical Inquiry and Systematic Reviews.