Articles | Volume 7, issue 6
https://doi.org/10.5194/jbji-7-221-2022
© Author(s) 2022. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-7-221-2022
© Author(s) 2022. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
A desirability of outcome ranking (DOOR) for periprosthetic joint infection – a Delphi analysis
Brenton P. Johns
The Bone and Joint Institute, Royal Newcastle Centre, New Lambton
Heights, NSW, Australia
School of Medicine and Public Health, University of Newcastle, Callaghan, NSW,
Australia
David C. Dewar
The Bone and Joint Institute, Royal Newcastle Centre, New Lambton
Heights, NSW, Australia
School of Medicine and Public Health, University of Newcastle, Callaghan, NSW,
Australia
Mark R. Loewenthal
Department of Immunology and Infectious Diseases, Royal Newcastle
Centre, New Lambton Heights, NSW, Australia
School of Medicine and Public Health, University of Newcastle, Callaghan, NSW,
Australia
Laurens A. Manning
Medical School, University of Western Australia, Harry Perkins Research Institute, Fiona Stanley Hospital, Perth, WA, Australia
Amit Atrey
Division of Orthopaedics, St. Michael's Hospital, University of Toronto, Toronto, OT, Canada
Nipun Atri
Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Centre, Chicago, IL, USA
David G. Campbell
Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
Michael Dunbar
Department of Orthopaedics, Halifax Infirmary & Dalhusie University, Halifax, NS, Canada
Christopher Kandel
Division of Infectious Diseases, University Health Network, Toronto, Ontario, Canada
Amir Khoshbin
Division of Orthopaedics, St. Michael's Hospital, University of Toronto, Toronto, OT, Canada
Christopher W. Jones
Orthopaedic Research Foundation Western Australia and Curtin University, Perth, WA, Australia
Jaime Lora-Tamayo
Instituto de investigación, imas12 (CIBERINFEC), Hospital Universitario 12 de Octubre, Madrid, Spain
Catherine McDougall
Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
Department of Orthopaedics, The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia
Dirk Jan F. Moojen
Department of Orthopaedic and Trauma Surgery, Joint Research, OLVG, Amsterdam, the Netherlands
Jonathan Mulford
Department Orthopaedic Surgery, Launceston General Hospital, Launceston, TAS, Australia
David L. Paterson
Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
Trisha Peel
Department of Infectious Disease, Monash University and Alfred
Health, Melbourne, VIC, Australia
Michael Solomon
Department of Orthopaedics, Prince of Wales Hospital, Randwick, NSW, Australia
Simon W. Young
Department of Orthopaedic Surgery, University of Auckland, North Shore Hospital, Auckland, New Zealand
Joshua S. Davis
CORRESPONDING AUTHOR
Department of Immunology and Infectious Diseases, Royal Newcastle
Centre, New Lambton Heights, NSW, Australia
School of Medicine and Public Health, University of Newcastle, Callaghan, NSW,
Australia
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Cited
16 citations as recorded by crossref.
- Unlocking the DOOR—how to design, apply, analyse, and interpret desirability of outcome ranking endpoints in infectious diseases clinical trials S. Ong et al. https://doi.org/10.1016/j.cmi.2023.05.003
- How Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life? D. Cooper et al. https://doi.org/10.1097/CORR.0000000000003201
- Application of desirability of outcome ranking to the milking in non-vigorous infants trial A. Katheria et al. https://doi.org/10.1016/j.earlhumdev.2023.105928
- Opening the DOOR to a Novel Approach for Health Services Research C. Zogg & S. Murthy https://doi.org/10.1001/jamasurg.2024.2490
- Hierarchical Composite Endpoints Provide a Flexible Framework to Ensure Clinical Trials Measure Outcomes Important to All Stakeholders S. Ong et al. https://doi.org/10.1093/cid/ciag277
- Making Sense of Hierarchical Composite End Points in Randomized Clinical Trials—A Primer for Infectious Diseases Clinicians and Researchers S. Ong et al. https://doi.org/10.1093/cid/ciaf314
- Management and outcomes of culture-negative periprosthetic joint infection: a systematic review and meta-analysis F. Pourghazi et al. https://doi.org/10.5194/jbji-11-413-2026
- 2025 ICM: Monitoring and Declaring Success L. Manning et al. https://doi.org/10.1016/j.arth.2025.10.104
- Defining Success and Failure In Prosthetic Joint Infections: A Meta-epidemiologic Study Toward A Core Outcome Set F. Petri et al. https://doi.org/10.1093/ofid/ofag364
- CORR Insights®: How Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life? B. Ricciardi https://doi.org/10.1097/CORR.0000000000003271
- Consequences of Delaying Surgical Intervention in Patients With Native Joint Septic Arthritis T. Matsuo et al. https://doi.org/10.1093/ofid/ofaf662
- Design Characteristics and Recruitment Rates for Randomized Trials of Peri-Prosthetic Joint Infection Management: A Systematic Review L. Manning et al. https://doi.org/10.3390/antibiotics12101486
- Patient‐Centric Pragmatic Clinical Trials: Opening the DOOR S. Evans et al. https://doi.org/10.1002/sim.70328
- Beyond Accuracy: Methodological Advances for Assessing the Clinical Impact of Infectious Disease Diagnostics K. Claeys et al. https://doi.org/10.1093/ofid/ofaf489
- A patient-centric paradigm and tool for clinical research: the DOOR is open T. Hamasaki et al. https://doi.org/10.1128/aac.01478-25
- Comparison of surgical treatments for hip and knee periprosthetic joint infections using the desirability of outcome ranking in a prospective multicentre study B. Johns et al. https://doi.org/10.5194/jbji-10-73-2025
Latest update: 24 Jul 2026
Short summary
Treatments for prosthetic joint infections (PJIs) are often assessed using a
success or failureendpoint. Yet, this can fail to capture important outcomes for patients. A desirability of outcome ranking (DOOR) is a way of evaluating treatments in a more patient-focused form. This study found an outcome ranking using joint function, infection cure and quality of life. This helps to answer what are we trying to achieve for patients with PJI and how we measure the effectiveness of PJI treatments.
Treatments for prosthetic joint infections (PJIs) are often assessed using a
success or failure...