Table 2.
Summary of automated risk calculators used in the total joints literature
| Calculator | Link | Procedure | Main outcome | Evaluation metrics | Author comments |
|---|---|---|---|---|---|
| Total-Knee Arthroplasty Revision Probability Calculator [13] | https://jordanbstarr.shinyapps.io/TKARevCalc/ | Primary TKA | Revision TKA |
Mean absolute error (1 year): 0.1% Mean absolute error (5 years): 3.6% |
Generalizability: developed from VA database Has not been externally validated |
| PJI Calculator [11] | https://apps.apple.com/us/app/pji-calculator/id1435025720 | Surgical Treatment for PJI | Treatment success as defined by Delphi criteria* | AUC: 0.69 | Several modifiable risk factors were identified |
| PJI Risk Calculator | https://icmphilly.com/ortho-applications/prosthetic-joint-infection-pji-risk-calculator/ | Primary or revision TKA or THA |
PJI Antibiotic-resistant PJI S. aureus PJI |
AUC**: 0.83, 0.84 AUC**: 0.86, 0.83 AUC**: 0.86, 0.73 |
Contains detailed surgical variables Strong AUC value Generalizability: externally validated at a high-volume institution, may not be applicable at low-volume institutions |
| Total Knee Replacement Surgery - Risk IQ tool [27] | https://www.healthgrades.com/risk-iq/total-knee-replacement-surgery | Primary TKA | Complications up to 14 days postoperatively | AUC: 0.61 |
Lower observed complication rate than predicted complication rate Generalizability: developed from Medicare patients |
| American Joint Replacement Registry (AJRR) Total Joint Replacement Risk Calculator [10] | https://teamwork.aaos.org/ajrr/SitePages/Risk%20Calculator.aspx | Primary TKA or THA |
Mortality within 90 days PJI within 2 years |
AUC: 0.62 |
AJRR calculator is inaccurate in predicting outcomes of Veterans AJRR calculator has poor discrimination and calibration AJRR calculator likely lacks a statistical model AJRR should undergo external validation |
| NSQIP-SRC [28–30] | http://riskcalculator.facs.org/RiskCalculator/ | TKA or THA | Specific complications within 30 days | AUC for each complication: < 0.80 | Risk estimates were associated with actual event occurrence |
|
PJI within 30 days PJI within 90 days |
AUC: 0.74 AUC: 0.71 |
NSQIP-SRC is designed to predict SSI, not PJI Calculator may overestimate risk of PJI |
|||
| WIthin 90 days: discharge to SNF/rehab, DVT, readmission, PJI, return to OR |
AUC, SNF/rehab: 0.72 AUC, all other complications: < 0.70 |
Fair predictor of discharge to SNF/rehab Limited use in predicting other complications Accurate predictor of hospital length of stay |
*Delphi criteria for surgical PJI treatment success: (1) infection eradication characterized by a healed wound without pain or infection recurrence caused by the same organism strain, (2) no subsequent surgical intervention for infection after reimplantation surgery, and (3) no occurrence of PJI related mortality
**AUC values include interval AUC first, followed by AUC value from external validation