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Designing a strategy to implement cost-effective blood transfusion management in elective hip and knee arthroplasties: A study protocol

Overview of attention for article published in Implementation Science, June 2012
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (59th percentile)

Mentioned by

2 tweeters


18 Dimensions

Readers on

65 Mendeley
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Designing a strategy to implement cost-effective blood transfusion management in elective hip and knee arthroplasties: A study protocol
Published in
Implementation Science, June 2012
DOI 10.1186/1748-5908-7-58
Pubmed ID

Veronique MA Voorn, Perla J Marang-van de Mheen, Cynthia So-Osman, Thea PM Vliet Vlieland, Ankie WMM Koopman-van Gemert, Rob GHH Nelissen, Leti van Bodegom-Vos


Total hip and knee arthroplasties are two of the most commonly performed procedures in orthopedic surgery. Different blood-saving measures (BSMs) are used to reduce the often-needed allogenic blood transfusions in these procedures. A recent large randomized controlled trial showed it is not cost effective to use the BSMs of erythropoietin and perioperative autologous blood salvage in elective primary hip and knee arthroplasties. Despite dissemination of these study results, medical professionals keep using these BSMs. To actually change practice, an implementation strategy is needed that is based on a good understanding of target groups and settings and the psychological constructs that predict behavior of medical professionals. However, detailed insight into these issuses is lacking. Therefore, this study aims to explore which groups of professionals should be targeted at which settings, as well as relevant barriers and facilitators that should be taken into account in the strategy to implement evidence-based, cost-effective blood transfusion management and to de-implement BSMs. The study consists of three phases. First, a questionnaire survey among all Dutch orthopedic hospital departments and independent treatment centers (n = 99) will be conducted to analyze current blood management practice. Second, semistructured interviews will be held among 10 orthopedic surgeons and 10 anesthesiologists to identify barriers and facilitators that are relevant for the uptake of cost-effective blood transfusion management. Interview questions will be based on the Theoretical Domains Interview framework. The interviews will be followed by a questionnaire survey among 800 medical professionals in orthopedics and anesthesiology (400 professionals per discipline) in which the identified barriers and facilitators will be ranked by frequency and importance. Finally, an implementation strategy will be developed based on the results from the previous phases, using principles of intervention mapping and an expert panel. The developed strategy for cost-effective blood transfusion management by de-implementing BSMs is likely to reduce costs for elective hip and knee arthroplasties. In addition, this study will lead to generalized knowledge regarding relevant factors for the de-implementation of non-cost-effective interventions and insight in the differences between implementation and de-implementation strategies.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 65 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 3%
United Kingdom 1 2%
Spain 1 2%
Netherlands 1 2%
Unknown 60 92%

Demographic breakdown

Readers by professional status Count As %
Other 8 12%
Student > Ph. D. Student 7 11%
Researcher 7 11%
Student > Master 7 11%
Student > Doctoral Student 6 9%
Other 15 23%
Unknown 15 23%
Readers by discipline Count As %
Medicine and Dentistry 26 40%
Nursing and Health Professions 5 8%
Psychology 5 8%
Business, Management and Accounting 4 6%
Agricultural and Biological Sciences 2 3%
Other 7 11%
Unknown 16 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 July 2012.
All research outputs
of 4,506,407 outputs
Outputs from Implementation Science
of 752 outputs
Outputs of similar age
of 75,178 outputs
Outputs of similar age from Implementation Science
of 31 outputs
Altmetric has tracked 4,506,407 research outputs across all sources so far. This one has received more attention than most of these and is in the 52nd percentile.
So far Altmetric has tracked 752 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.3. This one is in the 16th percentile – i.e., 16% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 75,178 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 59% of its contemporaries.
We're also able to compare this research output to 31 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.