Treating end stage osteoarthritis - System redesign targeting appropriateness, cost-effectiveness, safety and efficiency

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Severe osteoarthritis is a significant cause of disability that can be treated by joint replacement. Indiscriminate and overuse can lead to harm and waste that can account for 20% of all costs. I will lead a multidisciplinary research team to answer the question of appropriateness, decision-making, alternatives to surgery and health economic impact to develop a model of care based on safety and cost-effectiveness. This work will give valuable lessons into managing other chronic diseases.