Osteoarthritis and Cartilage 23 (2015) 497
Letter to the Editor
More details on the database used in the study should be provided Dear Editor We read with great interest the study on “Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study” by Leung et al.1. This is because it reports more evidence for a constant biomechanical mechanism underlying BMI and KOA initiation and/or progression. However, we believe that due to the methodology of the study potentially underestimates of the number of total knee replacements performed by the patients in the study. This is because we would like to note the MediClaim System hospital discharge database2 utilized by the study does not record all hospital discharges from public and private hospitals. It is a system which records patients only if (1)he/she who wishes to pursue a financial healthcare claims, (2)meets the criteria through the Singapore government's healthcare financing system for procedures done by (3)accredited health practitioners and (4) accredited health institutions. Only after a patient passes through the stringent criteria can a patient claim for financial support for his treatment and be include on the Mediclaim System hospital discharge system. If a patient chooses not to pursue a claim through the system or do not have their procedures performed by an accredited health practitioner or institute, or does not meet the criteria set by the Ministry of Health in Singapore he/she would not be recorded by this database. Although we understand that the number of patients unaccounted for in this study through this aspects is likely to be small. We believe that clinicians will be better able to interpret and utilize the results from the study with this information. Author contributions Shunjie Chua and Jing Li came up with the idea for the manuscript. Shunjie Chua drafted the manuscript. Jing Li reviewed the manuscript. Shunjie Chua is responsible for the final integrity of the manuscript.
Funding None. Conflict of interest No conflict of interest declared
Acknowledgments We wish to acknowledge Jeff Ming Xuan Chua for his support. There no funding associated with the preparation of the manuscript.
References 1. Leung YY, Jr JCA, Noviani M, Ang LW, Wang R, Yuan JM, et al. Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study. 2. Application e MediClaim [Internet]. 10/11/2014. Available from: https://www.mediclaim.moh.gov.sg/mmae/overview.aspx. S.J. Chua* Duke NUS Graduate Medical School, Singapore J. Li Department of Rheumatology, Jiangsu University Affiliated Hospital, China *
Address correspondence and reprint requests to: S.J. Chua, Duke NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore. Tel: 65-90115031. E-mail address: [email protected] (S.J. Chua).
DOIs of original article: http://dx.doi.org/10.1016/j.joca.2014.12.006, http://dx.doi. org/10.1016/j.joca.2014.11.024. http://dx.doi.org/10.1016/j.joca.2014.11.025 1063-4584/© 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
11 November 2014
Letter to the Editor
More details on the database used in the study should be provided Dear Editor We read with great interest the study on “Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study” by Leung et al.1. This is because it reports more evidence for a constant biomechanical mechanism underlying BMI and KOA initiation and/or progression. However, we believe that due to the methodology of the study potentially underestimates of the number of total knee replacements performed by the patients in the study. This is because we would like to note the MediClaim System hospital discharge database2 utilized by the study does not record all hospital discharges from public and private hospitals. It is a system which records patients only if (1)he/she who wishes to pursue a financial healthcare claims, (2)meets the criteria through the Singapore government's healthcare financing system for procedures done by (3)accredited health practitioners and (4) accredited health institutions. Only after a patient passes through the stringent criteria can a patient claim for financial support for his treatment and be include on the Mediclaim System hospital discharge system. If a patient chooses not to pursue a claim through the system or do not have their procedures performed by an accredited health practitioner or institute, or does not meet the criteria set by the Ministry of Health in Singapore he/she would not be recorded by this database. Although we understand that the number of patients unaccounted for in this study through this aspects is likely to be small. We believe that clinicians will be better able to interpret and utilize the results from the study with this information. Author contributions Shunjie Chua and Jing Li came up with the idea for the manuscript. Shunjie Chua drafted the manuscript. Jing Li reviewed the manuscript. Shunjie Chua is responsible for the final integrity of the manuscript.
Funding None. Conflict of interest No conflict of interest declared
Acknowledgments We wish to acknowledge Jeff Ming Xuan Chua for his support. There no funding associated with the preparation of the manuscript.
References 1. Leung YY, Jr JCA, Noviani M, Ang LW, Wang R, Yuan JM, et al. Association between body mass index and risk of total knee replacement, the Singapore Chinese Health Study. 2. Application e MediClaim [Internet]. 10/11/2014. Available from: https://www.mediclaim.moh.gov.sg/mmae/overview.aspx. S.J. Chua* Duke NUS Graduate Medical School, Singapore J. Li Department of Rheumatology, Jiangsu University Affiliated Hospital, China *
Address correspondence and reprint requests to: S.J. Chua, Duke NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore. Tel: 65-90115031. E-mail address: [email protected] (S.J. Chua).
DOIs of original article: http://dx.doi.org/10.1016/j.joca.2014.12.006, http://dx.doi. org/10.1016/j.joca.2014.11.024. http://dx.doi.org/10.1016/j.joca.2014.11.025 1063-4584/© 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
11 November 2014
