Current Status and Future Prospects for Shared Decision Making before and after Total Knee Replacement Surgery—A Scoping Review
Abstract
:1. Introduction
- What is known regarding the decisional needs and preferences of patients considering, preparing for and recovering from elective primary TKR surgery?
- To what extent does existing SDM research in TKR surgery incorporate Team talk, Option talk and Decision talk, as used in the model of Elwyn et al., (2017) of SDM?
- To what extent are the needs and preferences of patients, as found by answering RQ1, acknowledged in existing SDM research on TKR surgery?
2. Materials and Methods
2.1. Search Strategy, Identification of Relevant Studies
2.2. Study Selection
2.3. Methodological Assessment
2.4. Data Extraction
2.5. Data Analysis
3. Results
Methodological Assessment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Search strategy in PubMed, 3-4-2020 | ||
# | Query | Results |
1 | Search “Arthroplasty, Replacement, Knee” [Mesh]. OR “Knee Prosthesis” [Mesh]. OR TKA [tiab]. OR TKR [tiab]. OR ((“Knee Joint” [Mesh]. OR “Knee” [Mesh]. OR “Joints’ [Mesh]. OR knee [tiab]. OR knees [tiab]. OR joint [tiab].) AND (“Arthroplasty, Replacement” [Mesh]. OR replacement [tiab]. OR arthroplast*[tiab].)) | 68,431 |
2 | Search shared decision*[tiab]. OR sharing decision*[tiab]. OR informed decision*[tiab]. OR informed choice*[tiab]. OR decision aid*[tiab]. OR ((share*[ti]. OR sharing*[ti]. OR informed*[ti].) and (decision*[ti]. OR deciding*[ti]. OR choice*[ti].)) | 20,463 |
3 | Search decision making[mh:noexp]. OR decision support techniques[mh:noexp]. OR decision support systems, clinical[mh]. OR choice behaviour[mh:noexp]. OR decision making*[tiab]. OR decision support*[tiab]. OR patient treatment choice*[tiab]. OR choice behaviour*[tiab]. OR ((decision*[ti]. OR choice*[ti].) and (making*[ti]. OR support*[ti]. OR behaviour*[ti].)) | 246,445 |
4 | Search patient participation[mh]. OR patient participation*[tiab]. OR consumer participation*[tiab]. OR patient involvement*[tiab]. OR consumer involvement*[tiab]. OR ((patient*[ti]. OR consumer*[ti].) and (involvement*[ti]. OR involving*[ti]. OR participation*[ti]. OR participating*[ti].)) | 36,313 |
5 | Search professional-patient relations[mh]. OR ((nurses[mh]. OR physicians[mh]. OR nurse*[ti]. OR physician*[ti]. OR clinician*[ti]. OR doctor*[ti]. OR general practitioner*[ti]. OR gps[ti]. OR health care professional*[ti]. OR healthcare professional*[ti]. OR health care provider*[ti]. OR healthcare provider*[ti]. OR resident*[ti].) AND (patients[mh]. OR patient*[ti]. OR consumer*[ti]. OR people*[ti].)) | 178,246 |
6 | Search #2 OR #3 OR #4 OR #5 | 440,656 |
7 | Search #1 AND #6 | 1078 |
Search strategy in Embase.com, 3-4-2020 | ||
# | Query | Results |
1 | ’knee arthroplasty’/exp OR ’knee arthroplasty’ OR ’knee prosthesis’/exp OR ’knee prosthesis’ OR tka:ab,ti OR tkr:ab,ti OR ((’joint’/exp OR ’joint’ OR knee:ab,ti OR knees:ab,ti OR joint:ab,ti) AND (’arthroplasty’/exp OR ’arthroplasty’ OR replacement*:ab,ti OR arthroplast*:ab,ti)) | 108,758 |
2 | ’shared decision’:ti,ab OR ’sharing decision’:ti,ab OR ’informed decision’:ti,ab OR ’informed choice’:ti,ab OR ’decision aid’:ti,ab OR ((share*:ti OR sharing*:ti OR informed*:ti) AND (decision*:ti OR deciding*:ti OR choice*:ti)) | 19,773 |
3 | (’clinical decision making’/exp OR ’decision making’/exp OR ’decision support system’/exp OR ’ethical decision making’/exp OR ’family decision making’/exp OR ’medical decision making’/exp OR ’patient decision making’/exp OR ’decision making’:ti,ab OR ’patient treatment choice*’:ti,ab) AND ’decision support’:ti,ab OR ’choice behaviour’:ti,ab OR ((decision*:ti OR choice*:ti) AND (making*:ti OR support*:ti OR behaviour*:ti)) | 49,342 |
4 | ’patient participation’/exp OR ’patient participation’:ti,ab OR ’consumer participation’:ti,ab OR ’patient involvement’:ti,ab OR ’consumer involvement’:ti,ab OR ((patient*:ti OR consumer*:ti) AND (involvement*:ti OR involving*:ti OR participation*:ti OR participating*:ti)) | 41,253 |
5 | ’doctor patient relation’/exp OR ’nurse patient relationship’/exp OR ((’nurse’/exp OR ’physician’/exp OR nurse*:ti OR physician*:ti OR clinician*:ti OR doctor*:ti OR ’general practitioners’:ti OR gps:ti OR ’health care professionals’:ti OR ’healthcare professionals’:ti OR ’health care providers’:ti OR ’healthcare providers’:ti OR resident*:ti) AND (’patient’/exp OR patient*:ti OR consumer*:ti OR people*:ti)) | 483,044 |
6 | #2 OR #3 OR #4 OR #5 | 570,786 |
7 | #1 AND #6 | 3326 |
8 | #1 AND #6 NOT ([conference abstract]. /lim OR [conference paper]. /lim OR [conference review]. /lim) | 1287 |
Search strategy of The Cochrane Library,3-4-2020 | ||
# | Query | Results |
1 | ((tka OR tkr OR ((knee OR knees OR joint) AND (replacement* OR arthroplast*)))):ti,ab,kw | 9806 |
2 | ((Professional-Patient NEXT Relation* OR Nurse-Patient NEXT Relation* OR Physician-Patient NEXT Relation*)):ti,ab,kw | 2570 |
3 | (((Nurse* OR Physician* OR Clinician* OR Doctor* OR General NEXT Practitioner* OR GPs OR Health NEXT Care NEXT Professional* OR Healthcare NEXT Professional* OR Health NEXT Care NEXT Provider* OR Healthcare NEXT Provider* OR Resident*) AND (Patient* OR Consumer* OR People*))):ti | 3310 |
4 | #2 OR #3 | 5517 |
5 | ((Patient NEXT Participation* OR Consumer NEXT Participation* OR Patient NEXT Involvement* OR Consumer NEXT Involvement*)):ti,ab,kw | 2814 |
6 | (((Patient* or Consumer*) and (Involvement* or Involving* or Participation* or Participating*))):ti | 1042 |
7 | #5 and #6 | 3653 |
8 | ((Decision NEXT Making* or Decision NEXT Support* or “Choice Behaviour”)):ti,ab,kw | 15,200 |
9 | (((Decision* or Choice*) AND (Making* or Support* or Behaviour*))):ti | 2492 |
10 | #8 OR #9 | 15,782 |
11 | ((Shared NEXT Decision* or Sharing NEXT Decision* or Informed NEXT Decision* or Informed NEXT Choice* or Decision NEXT Aid*)):ti,ab,kw | 2997 |
12 | (((Share* or Sharing* or Informed*) AND (Decision* or Deciding* or Choice*))):ti | 610 |
13 | #11 OR #12 | 3029 |
14 | #4 OR #7 OR #10 OR #13 | 23,842 |
15 | #1 AND #14 in Cochrane Reviews | 1 |
16 | #1 AND #14 in Trials (CENTRAL) | 118 |
Search strategy in CINAHL via EBSCOhost,3-4-2020 | ||
# | Query | Results |
1 | ((MH “Knee"OR MH “Joints”) AND (MH “Surgery, Operative” OR TI surgery OR AB surgery)) OR TI((knee OR knees OR joint) N2 (surgery OR replacement* OR transplant* OR repair* OR operation OR reduction OR orthopedic* OR orthopaedic* OR arthroplast* OR arthroscop*)) OR AB((knee OR knees OR joint) N2 (surgery OR replacement* OR transplant* OR repair* OR operation OR reduction OR orthopedic* OR orthopaedic* OR arthroplast* OR arthroscop*)) | 25,623 |
2 | AB Shared Decision* OR TI Shared Decision* OR AB Sharing Decision* OR TI Sharing Decision* OR AB Informed Decision* OR TI Informed Decision* OR AB Informed Choice* OR TI Informed Choice* OR AB Decision Aid* OR TI Decision Aid* OR ((TI Share* OR TI Sharing OR TI Informed*) AND (TI Decision* OR TI Deciding* OR TI Choice*)) | 12,643 |
3 | MH “Decision Making+” OR MW Decision Support OR AB Decision Making* OR TI Decision Making* OR AB Decision Support* OR TI Decision Support* OR AB Choice Behaviour* OR TI Choice Behaviour* OR ((TI Decision* OR TI Choice*) AND (TI Making* OR TI Support* OR TI Behaviour*)) | 172,216 |
4 | MH Consumer Participation OR AB Patient Participation* OR TI Patient Participation* OR AB Consumer Participation* OR TI Consumer Participation* OR AB Patient Involvement* OR TI Patient Involvement* OR AB Consumer Involvement* OR TI Consumer Involvement* OR ((TI Patient* OR TI Consumer*) AND (TI Participating* OR TI Participation* OR TI Involving* OR TI Involvement*)) | 25,804 |
5 | MH Professional Patient Relations OR MH Nurse Patient Relations OR MH Physician Patient Relations OR ((MH Nurses+ OR MH Physicians+ OR TI Nurse* OR TI Physician* OR TI Clinician* OR TI Doctor* OR TI General Practitioner* OR TI GPs OR TI Health Care Professional* OR TI Healthcare Professional* OR TI Health Care Provider* OR TI Healthcare Provider* OR TI Resident*) AND (MH Patients+ OR TI Patient* OR TI Consumer* OR TI People*)) | 75,617 |
6 | S2 OR S3 OR S4 OR S5 | 263,970 |
7 | S1 AND S6 | 883 |
Search strategy in PsycINFO via EBSCOhost,3-4-2020 | ||
# | Query | Results |
1 | ((DE “Knee” OR DE “Joints (Anatomy)”) AND (DE “Surgery” OR TI surgery OR AB surgery)) | 362 |
2 | TI((knee OR knees OR joint) N2 (surgery OR replacement* OR transplant* OR repair* OR operation OR reduction OR orthopedic* OR orthopaedic* OR arthroplast* OR arthroscop*)) | 386 |
3 | AB((knee OR knees OR joint) N2 (surgery OR replacement* OR transplant* OR repair* OR operation OR reduction OR orthopedic* OR orthopaedic* OR arthroplast* OR arthroscop*)) | 829 |
4 | #1 OR #2 OR #3 | 913 |
5 | AB Shared Decision* OR TI Shared Decision* OR AB Sharing Decision* OR TI Sharing Decision* OR AB Informed Decision* OR TI Informed Decision* OR AB Informed Choice* OR TI Informed Choice* OR AB Decision Aid* OR TI Decision Aid* OR ((TI Share* OR TI Sharing OR TI Informed*) AND (TI Decision* OR TI Deciding* OR TI Choice*)) | 11,393 |
6 | (DE “Decision Making” OR DE “Choice Behavior” OR DE “Group Decision Making” OR DE “Management Decision Making” OR DE “Choice Shift”) OR AB Decision Making* OR TI Decision Making* OR AB Decision Support* OR TI Decision Support* OR AB Choice Behaviour* OR TI Choice Behaviour* OR ((TI Decision* OR TI Choice*) AND (TI Making* OR TI Support* OR TI Behaviour*)) | 156,714 |
7 | DE “Client Participation” OR AB Patient Participation* OR TI Patient Participation* OR AB Consumer Participation* OR TI Consumer Participation* OR AB Patient Involvement* OR TI Patient Involvement* OR AB Consumer Involvement* OR TI Consumer Involvement* OR ((TI Patient* OR TI Consumer*) AND (TI Participating* OR TI Participation* OR TI Involving* OR TI Involvement*)) | 9690 |
8 | DE “Therapeutic Processes” OR ((DE “Nurses” OR DE “Psychiatric Nurses” OR DE “Public Health Service Nurses” OR DE “School Nurses” OR DE “Physicians” OR DE “Family Physicians” OR DE “General Practitioners” OR DE “Gynecologists” OR DE “Internists” OR DE “Neurologists” OR DE “Obstetricians” OR DE “Pathologists” OR DE “Pediatricians” OR DE “Psychiatrists” OR DE “surgeons” OR TI Nurse* OR TI Physician* OR TI Clinician* OR TI Doctor* OR TI General Practitioner* OR TI GPs OR TI Health Care Professional* OR TI Healthcare Professional* OR TI Health Care Provider* OR TI Healthcare Provider* OR TI Resident*) AND (DE “Patients” OR DE “Geriatric Patients” OR DE “Hospitalized Patients” OR DE “Medical Patients” OR DE “Outpatients” OR DE “Psychiatric Patients” OR DE “Surgical Patients” OR DE “Terminally ill Patients” OR TI Patient* OR TI Consumer* OR TI People*)) | 40,604 |
9 | #5 OR #6 OR #7 OR #8 | 204,754 |
10 | #4 AND #9 | 93 |
Section/Topic | # | Checklist Item | Reported on Page # |
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TITLE | |||
Title | 1 | Identify the report as a systematic review, meta-analysis or both. | 1 (stated as scoping review) |
ABSTRACT | |||
Structured summary | 2 | Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number. | 2 |
INTRODUCTION | |||
Rationale | 3 | Describe the rationale for the review in the context of what is already known. | 3 |
Objectives | 4 | Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes and study design (PICOS). | 4 |
METHODS | |||
Protocol and registration | 5 | Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number. | n/a scoping reviews cannot be registered |
Eligibility criteria | 6 | Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale. | 5 |
Information sources | 7 | Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched. | 5 |
Search | 8 | Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated. | 5 & additional file #1 |
Study selection | 9 | State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis). | 5-6 (figure 1) |
Data collection process | 10 | Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators. | 6 & 7 |
Data items | 11 | List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made. | 6 |
Risk of bias in individual studies | 12 | Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level) and how this information is to be used in any data synthesis. | 6 |
Summary measures | 13 | State the principal summary measures (e.g., risk ratio, difference in means). | n/a |
Synthesis of results | 14 | Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis. | 6&7 |
Risk of bias across studies | 15 | Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies). | n/a |
Additional analyses | 16 | Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified. | 6&7 |
RESULTS | |||
Study selection | 17 | Give numbers of studies screened, assessed for eligibility and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram. | 6 (figure 1) & 8 |
Study characteristics | 18 | For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations. | 8 (tables 1 and 2) |
Risk of bias within studies | 19 | Present data on risk of bias of each study and, if available, any outcome level assessment (see item 12). | 8 & 9 + additional file 2 |
Results of individual studies | 20 | For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot. | tables 1 and 2 |
Synthesis of results | 21 | Present results of each meta-analysis done, including confidence intervals and measures of consistency. | 9-12 |
Risk of bias across studies | 22 | Present results of any assessment of risk of bias across studies (see Item 15). | n/a |
Additional analysis | 23 | Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item 16].). | n/a |
DISCUSSION | |||
Summary of evidence | 24 | Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users and policy makers). | 12-14 |
Limitations | 25 | Discuss limitations at study and outcome level (e.g., risk of bias) and at review-level (e.g., incomplete retrieval of identified research, reporting bias). | 14 |
Conclusions | 26 | Provide a general interpretation of the results in the context of other evidence and implications for future research. | 15 |
FUNDING | |||
Funding | 27 | Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review. | 16 |
Assessment of Rigor of the Qualitative Studies | ||||||||||
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CASP 1 | CASP 2 | CASP 3 | CASP 4 | CASP 5 | CASP 6 | CASP 7 | CASP 8 | CASP 9 | CASP 10 | |
Al Taiar, 2013 [40] | yes | yes | yes | no | yes | no | ? | yes | no | no |
Barlow, 2016 [39] | yes | yes | yes | yes | yes | no | no | yes | yes | yes |
Kesternich, 2016 [41] | yes | yes | yes | yes | no | no | ? | no | yes | yes |
Kroll, 2007 [42] | yes | yes | yes | yes | yes | no | no | yes | yes | yes |
Suarez, 2010 [43] | yes | yes | yes | yes | yes | no | no | no | yes | no |
Yeh, 2016 [35] | yes | yes | yes | yes | yes | yes | yes | yes | yes | yes |
Barlow, 2018 [36] | yes | yes | yes | yes | yes | yes | yes | yes | yes | yes |
Ho, 2015 [44] | no | no | no | no | no | no | no | no | no | no |
O’Brien, 2019 [37] | yes | yes | yes | yes | yes | yes | yes | yes | yes | yes |
Hsu, 2018 [38] | yes | yes | yes | yes | yes | yes | yes | yes | no | no |
Methodological Assessment of the Quantitative Studies Using Hoy’s Risk of Bias Tool [26]. | ||||||||||
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1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | Total Points | |
Arterburn, 2012 [29] | no | no | no | no | yes | yes | yes | yes | yes | 4 |
De Achaval, 2013 [33] | no | yes | yes | no | yes | yes | yes | yes | yes | 2 |
Filardo, 2017 [45] | no | no | no | no | no | yes | yes | no | yes | 6 |
Ibrahim, 2016 [32] | no | yes | yes | no | yes | yes | yes | yes | yes | 2 |
Stacey, 2014 [31] | no | no | yes | yes | yes | yes | yes | yes | yes | 2 |
Volkmann, 2015 [34] | no | no | no | no | yes | yes | yes | yes | yes | 4 |
Boland, 2018 [35] | no | no | yes | yes | yes | yes | yes | yes | no | 3 |
Theme/ Categories | Result |
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Personal factors with the potential to impact decisions regarding TKR care | |
Factors related to fear and concerns regarding the surgical treatment | |
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Factors related to concerns and preferences of candidacy or to postpone/refuse surgery | |
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Ethnical variability | |
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External factors with the potential to impact decision regarding TKR care | |
Factors regarding interaction between patient and orthopedic surgeon | |
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Issues that could enhance, delay or hinder decision making | |
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Patient reliance on a variety of information sources for TKR decisions | |
Personal experiences and opinions | |
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Experiences and opinions of relevant others | |
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Decision tools | |
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Prediction tools and presentation of relevant information to enhance care decision | |
Instruments or interventions to obtain relevant information | |
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Presentation of relevant information | |
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Arterburn, 2012 [29]. | De Achaval, 2012 [33]. | Filardo, 2017 [45]. | Ibrahim, 2016 [32]. | Stacey, 2014 [31]. | Volkmann, 2015 [34]. | Boland, 2018 [30]. | |
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Decisional need & preference | |||||||
Personal factors related to SDM | no | no | partly | no | no | no | no |
External factors related to SDM | no | no | no | no | no | no | partly |
Sources of information to enhance SDM | partly | partly | no | partly | partly | partly | partly |
Prediction tools and presentation of relevant information | no | partly | no | no | no | partly | no |
Authors, Year of Publication | Population, Inclusion Criteria Participants; Age (SD, Range); Gender (%); Ethnicity. | Aim of Study | Study Design | Authors Conclusions |
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Buhagiar, 2017 | Phase 1: Consecutive eligible private patients (mean age 66) about to undergo arthroplasty surgery and their caregivers (mean age 63) were invited to participate while attending a preoperative admission clinic at one of two private arthroplasty hospital Providers. Patient eligibility included having a principal diagnosis of osteoarthritis and was about to undergo either a unilateral or bilateral TKR or THR. Caregiver eligibility included being identified as the primary caregiver for one of these individuals. Phase 2 involved key clinicians (Orthopedic surgeon, physiotherapist and rehab specialist) involved in the care of knee or hip arthroplasty recipients. | To understand private consumer and clinician preferences towards different rehabilitation modes following knee or hip arthroplasty and identify factors which influence the chosen rehabilitation pathway. | Qualitative study | No one rehabilitation mode provided following arthroplasty is singularly preferred by stakeholders. Factors other than the belief that a particular mode was more effective than another appear to dominate the pathway followed by private arthroplasty consumers, indicating evidence-based policies around rehabilitation provision may have limited appeal in the private sector. |
Ballantyne, 2007 | Patients unwilling to undergo TJR, n = 29; Mean age 69 (n/a, n/a); Female 69%; n/a. | To further an understanding of the treatment decisions surrounding TJR. | Qualitative study | Participants frequently rejected the medicalization of arthritis, normalizing the experience of functional decline and defining it as age normative. Participants drew on a broad set of previous experiences with informal and formal care to make decisions about how to manage their condition. Previous negative encounters in medical and surgical care, including those from a distant past or those experienced vicariously, combined with the perception (reinforced by physicians and others) that doing nothing was a viable option deterred arthritis-related help seeking in the health care system. |
Clarck, 2004 | Eligible but unwilling patients, to undergo TJR, n = 17; n/a (n/a, n/a); n/a; n/a. | To understand these patients’ unwillingness by exploring the nature of their decision-making processes. | Qualitative study | The complexity of decision-making, in particular the concept of a moving target, challenges our attempts to model and help patients make decisions about arthritis treatment such as total joint replacement. This insight into the decision-making process enhances our understanding of patients’ unwillingness to consider surgery and highlights ways to improve arthritis care and treatment. |
Conner-Spady, 2014 | n = 65, 65 (10, n/a); female 66%; n/a. | While some studies have identified patient readiness as a key component in their decision whether to have total joint replacement surgery (TJR) none have examined how patients determine their readiness for surgery. | Qualitative study | The patient’s feeling that they were both mentally and physically ready for surgery. Mental readiness was described as an internal state or feeling of being ready or prepared while physical readiness was described as being physically fit and in good shape for surgery. Factors associated with readiness included: 1) pain: its severity, the ability to cope with it and how it affected their quality of life; 2) mental preparation; 3) physical preparation; 4) the optimal timing of surgery, including age, anticipated rate of deterioration, prosthesis lifespan and the length of the waiting list. |
Riffin, 2015 | Inclusion: potential candidates for TJR, collected from the EpicCare health records at two outpatient practices in New York City. Exclusion: age < 40y, not fluent in English, had previously undergone joint replacement or exhibited cognitive impairment, defined by a score of less than 3 on a six-item screener (Callahan, Unverzagt, Hui, Perkins, & Hendrie, 2002), n = 99; 66,6 (10,6, n/a): female (83,7%); % white 72,4%. | To investigate age differences in the types of decision support that total joint replacement (TJR) candidates desire and receive when making the decision to pursue surgery. We consider the social structural (relationship to the patient) and experiential factors (network members’ experience with TJR) that influence individuals’ support preferences and the interactions of these factors with age. We also examine whether a lack of support is linked with increased decisional conflict and reduced willingness to undergo surgery. | Telephone survey | TJR candidates desired and received decision support from health care providers, family members and individuals who had previously undergone TJR. They reported higher deficits in informational and emotional support than in instrumental support. Overall, a lack of instrumental support was associated with greater decisional conflict; a lack of instrumental support and a lack of informational support were associated with reduced willingness to undergo TJR. |
Authors, Year of Publication | Population, Inclusion Criteria Participants; Age (SD, Range); Gender (%); Ethnicity. | Aim of Study | Study Design | Authors Conclusions |
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Sepucha, 2013 [19] | Adults 40 years of age and older, with hip or knee osteoarthritis, who made a decision about total hip or knee replacement with their physician in the previous 2 years. Exclusion criteria included having a previous joint replacement more than 2 years before, rheumatoid arthritis, psoriatic arthritis, osteonecrosis, partial knee replacement, revision surgery or simultaneous bilateral TJR, n = 382; 62,7 (9,6, n/a); Female (55,8%); n/a. | The aim of this study was to examine decision quality for patients with hip and knee osteoarthritis who recently made the decision about whether or not to have TJR. | Cross-sectional mail survey of osteoarthritis patients. | A third of patients who recently made a decision about osteoarthritis treatment met both criteria for a high quality decision. Controlling for treatment, patients reporting more involvement in the decision making process, higher quality of life and being seen at a site that uses decision aids were associated with higher decision quality. |
Trenaman, 2018 [19] | Inclusion: aged ≥ 18, moderate or severe hip or knee radiographic osteoarthritis and were determined at the orthopedic screening clinic to be appropriate for surgical consultation about joint arthroplasty. Exclusion: inflammatory arthritis, previous joint arthroplasty surgical consultation or osteotomy, non-corrected hearing or visual impairment, unable to read or understand English, no access to television with a VCR or DVD player; Decision aid arm 66,1 (9,8, n/a) usual care arm 66,9 (9,1, n/a); female (56%), n/a. | To estimate the health and economic effects of PDA’s for TJR. | A cost-effectiveness analysis of a RCT with 2-year follow-up. | Suggestion is that the implementation of a clinical care pathway for individuals with moderate to severe osteoarthritis could encourage greater patient-centered care at a reduced cost to the health care system, while producing similar health outcomes for patients. The 2-year time horizon for the analysis raises questions about whether these results are maintained over the long-term. |
de Jesus, 2017 [22] | Persons recruited at a Joint Assessment Triage Clinic at an academic tertiary care hospital (Canada). Eligible patients: patients who exhausted conservative treatment, were ready to pursue surgical treatment and had severe medial compartment OA as defined by bone-on-bone disease in a standing anteroposterior weight-bearing radiograph. Exclusion: UKR contractures greater than 10, any bone-on-bone patella femoral disease on skyline radiograph, BMI >40 and no correctable varus or anterior cruciate ligament deficiency by positive Lachmann, n=383; 64,6 (n/a, 50,0-90,0), female (42,22%); n/a. | objective was to evaluate the acceptability and usefulness of a PDA for informing and helping patients reach a surgical preference without increasing decisional conflict. Quantitative analysis of acceptability, decisional conflict, knowledge and preferred surgical option was then performed. | Quantitative analysis of acceptability, decisional conflict, knowledge and preferred surgical option was then performed. | Patients understood the majority of the benefits and risks for each surgical option without increasing decisional conflict. The decision aid for advanced medial compartment osteoarthritis is shown to be acceptable and useful for choosing between UKR and TKR. |
Stacey, 2015 [23] | Patients were recruited from two orthopedic screening clinics in Eastern Ontario, Canada. Inclusion: aged ≥ 18, moderate or severe hip or knee radiographic osteoarthritis and were determined at the orthopedic screening clinic to be appropriate for surgical consultation about joint arthroplasty. Exclusion: inflammatory arthritis, previous joint arthroplasty surgical consultation or osteotomy, non-corrected hearing or visual impairment, unable to read or understand English, no access to television with a VCR or DVD player. Intervention group: age 66,1 (9.8, n/a); n=167, female (53,3%); n/a. | To evaluate the effectiveness of patient decision aids (PtDA) compared to usual education on appropriate and timely access to total joint arthroplasty in patients with osteoarthritis. | Subgroup analysis of a RCT. | Using PDAs for patients with osteoarthritis considering hip or knee arthroplasty appears to have optimized the surgical referral by enhancing patients’ knowledge, ensuring realistic expectations of outcomes of options and helping patients be clear about what matters most. However, despite having a trend towards shorter wait time in the PDA group, this was observed at only one site and the overall effect was not statistically significant. |
Shue, 2016 [24] | Inclusion: (1) had a diagnosis of advanced OA of the hip or knee by clinical designation (at least limited range of motion in more than one direction or the presence of pain or both); (2) had a radiographic designation of advanced OA (joint space narrowing 40.5 mm, osteophyte formation or grade III or IV on the Kellgren-Lawrence or Li scale); (3) were candidates for total hip or knee replacement; (4) were at least 21 years old; and (5) were psychosocially, mentally and physically able to fully complete questionnaires. Exclusion: previously undergone THR or TKR. Other exclusion criteria included primary diagnosis of a disease other than OA, inability to speak or read English, cognitive impairment and patient refusal to complete study questionnaires; age: 61 (11, n/a); Female (53%); Asian (4%), African American (33%), White (50%), Hispanic (12%), others (1%). | To evaluate the use of decision aids for hip and knee OA regarding the potential risks and benefits of different treatment options. | RCT | The decision aids were accepted for most patients and effective in improving patient knowledge and willingness to participate in the decision process. Nevertheless, the addition of a more expensive DVD to the booklet program did not improve patient acceptance or knowledge. |
Sepucha, 2019 [28] | Participants were recruited from an academic medical center, community hospital and orthopedic specialty hospital from April 2016 through December 2017. ≥ 21 years, able to read and speak English or Spanish, diagnosis of hip or knee OA and attend the visit with the surgeon. Exclusion: PDA in the prior 12 months, a joint replacement within the prior 5 years, a hip fracture or aseptic necrosis in the prior 12 months, a diagnosis of rheumatoid or psoriatic arthritis, cognitive impairment such that the patient was unable to consent to participate or a no osteoarthritis-related reason for the visit; n = 1124; age 65 (10, n/a); female (57%); 89% white non-Hispanic. | To compare 2 PDA’s with regard to their ability to help patients become informed and receive their preferred treatment (that is, make an informed patient-centered decision), SDM, surgical rates and surgeon satisfaction. | 2 * 2 factorial randomized trial | The short PDA outperformed the long PDA with regard to knowledge scores and was comparable with respect to other outcomes. The surgeons reported high satisfaction and normal visit duration with both PDA’s. |
References
- Barry, M.J.; Edgman-Levitan, S. Shared Decision Making—The Pinnacle of Patient-Centered Care. New Engl. J. Med. 2012, 366, 780–781. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Elwyn, G.; Durand, M.A.; Song, J.; Aarts, J.; Barr, P.J.; Berger, Z.; Cochran, N.; Frosch, D.; Galasiński, D.; Gulbrandsen, P.; et al. A three-talk model for shared decision making: Multistage consultation process. BMJ 2017, 1–7. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dawes, M.; Summerskill, W.S.M.; Glasziou, P.; Cartabellotta, A.; Martin, J.; Hopayian, K.; Porzsolt, F.; Burls, A.; Osborne, J. Sicily statement on evidence-based practice. BMC Med Educ. 2005, 5, 1. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hawker, G.A.; Badley, E.M.; Borkhoff, C.M.; Croxford, R.; Davis, A.M.; Dunn, S.; Gignac, M.A.; Jaglal, S.B.; Kreder, H.J.; Sale, J.E.M. Which Patients Are Most Likely to Benefit From Total Joint Arthroplasty? Arthritis Rheum. 2013, 65, 1243–1252. [Google Scholar] [CrossRef]
- Beswick, A.D.; Wylde, V.; Gooberman-Hill, R.; Blom, A.; Dieppe, P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open 2012, 2, e000435. [Google Scholar] [CrossRef]
- Skou, S.T. Good Life with osteoArthritis in Denmark ( GLA: D TM ): Evidence-based education and supervised neuromuscular exercise delivered by certified physiotherapists nationwide. BMC Musculoskelet. Disord. 2017, 1–13. [Google Scholar] [CrossRef] [Green Version]
- Skou, S.T.; Roos, E.M.; Laursen, M.B.; Rathleff, M.S.; Arendt-Nielsen, L.; Simonsen, O. A Randomized, Controlled Trial of Total Knee Replacement. N. Engl. J. Med. 2015, 373, 1597–1606. [Google Scholar] [CrossRef]
- Van Der Woude, J.T.A.; Wiegant, K.; Van Roermund, P.M.; Intema, F.; Custers, R.J.; Eckstein, F.; Van Laar, J.M.; Mastbergen, S.C.; Lafeber, F. Five-Year Follow-up of Knee Joint Distraction: Clinical Benefit and Cartilaginous Tissue Repair in an Open Uncontrolled Prospective Study. Cartilage 2017. [Google Scholar] [CrossRef]
- Arksey, H.; Malley, L.O. Scoping Studies: Towards a Methodological Framework. Int. J. Soc. Res. Methodol. 2005, 8, 19–32. [Google Scholar] [CrossRef] [Green Version]
- Légaré, F.; Stacey, D.; Turcotte, S.; Cossi, M.-J.; Kryworuchko, J.; Graham, I.D.; Lyddiatt, A.; Politi, M.C.; Thomson, R.; Elwyn, G. Interventions for improving the adoption of shared decision making by healthcare professionals (Review). Cochrane Database Syst. Rev. 2014. [Google Scholar] [CrossRef] [Green Version]
- Bourne, R.B.; Chesworth, B.; Davis, A.; Mahomed, N. Comparing Patient Outcomes After THA and TKA Is There a Difference? Clin. Orthop. Relat. Res. 2010, 542–546. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Glass, N.A.; Segal, N.A.; Callaghan, J.J.; Clark, C.R.; Noiseux, N.; Gao, Y.; Johnston, R. Comparison of the extent to which total hip and total knee arthroplasty restore patient-reported physical function. Osteoarthr. Cartil. 2016, 24, 1875–1882. [Google Scholar] [CrossRef] [Green Version]
- Wright, J.G.; Hawker, G.A.; Hudak, P.L.; Toronto Arthroplasty Research Group Writing Committee. Variability in physician opinions about the indications for knee arthroplasty. J. Arthroplast. 2011, 26, 569–575. [Google Scholar] [CrossRef]
- Hawker, G.A. Who, when, and why total joint replacement surgery? The patient’s perspective. Curr Opin Rheumatol. 2006, 5, 526–530. [Google Scholar] [CrossRef]
- Buhagiar, M.A.; Naylor, J.M.; Simpson, G.; Harris, I.A.; Kohler, F. Understanding consumer and clinician preferences and decision making for rehabilitation following arthroplasty in the private sector. BMC Health Serv. Res. 2017, 1–10. [Google Scholar] [CrossRef] [Green Version]
- Ballantyne, P.; Gignac, M.A.M.; Hawker, G.A. A patient-centered perspective on surgery avoidance for hip or knee arthritis: Lessons for the future. Arthritis Rheum. 2007, 57, 27–34. [Google Scholar] [CrossRef]
- Clark, J.P.; Hudak, P.L.; Hawker, G.A.; Coyte, P.C.; Mahomed, N.N.; Kreder, H.J.; Wright, J.G. The moving target: A qualitative study of elderly patients’ decision-making regarding total joint replacement surgery. J. Bone Joint Surg. Am. 2004, 86, 1366–1374. [Google Scholar] [CrossRef]
- Conner-Spady, B.L.; Marshall, D.A.; Hawker, G.; Bohm, E.; Dunbar, M.; Frank, C.B.; Noseworthy, T. You’ll know when you’re ready: A qualitative study exploring how patients decide when the time is right for joint replacement surgery. BMC Health Serv. Res. 2014, 14, 454. [Google Scholar] [CrossRef] [Green Version]
- Sepucha, K.R.; Feibelmann, S.; Chang, Y.; Clay, C.F.; Kearing, S.A.; Tomek, I.; Yang, T.; Katz, J.N. Factors Associated with the Quality of Patients’ Surgical Decisions for Treatment of Hip and Knee Osteoarthritis. J. Am. Coll. Surg. 2013, 217, 694–701. [Google Scholar] [CrossRef]
- Riffin, C.; Pillemer, K.; Reid, M.C.; Tung, J.; Lckenhoff, C.E. Decision Support for Joint Replacement: Implications for Decisional Conflict and Willingness to Undergo Surgery. J. Gerontol. B Psychol. Sci. Soc. Sci. 2016. [Google Scholar] [CrossRef] [Green Version]
- Trenaman, L.; Stacey, D.; Bryan, S.; Taljaard, M.; Hawker, G.; Dervin, G.F.; Tugwell, P.; Bansback, N. Decision aids for patients considering total joint replacement: A cost-effectiveness analysis alongside a randomised controlled trial. Osteoarthr. Cartil. 2018, 25, 1615–1622. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- De Jesus, C.; Stacey, D.; Dervin, G.F. Evaluation of a Patient Decision Aid for Unicompartmental or Total Knee Arthroplasty for Medial Knee Osteoarthritis. J. Arthroplast. 2018, 32, 3340–3344. [Google Scholar] [CrossRef] [PubMed]
- Stacey, D.; Taljaard, M.; Dervin, G.; Tugwell, P.; O’Connor, A.; Pomey, M.-P.; Boland, L.; Beach, S.; Meltzer, D.O.; Hawker, G.A. Impact of patient decision aids on appropriate and timely access to hip or knee arthroplasty for osteoarthritis: A randomized controlled trial. Osteoarthr. Cartil. 2016, 24, 99–107. [Google Scholar] [CrossRef] [Green Version]
- Shue, J.; Karia, R.; Cardone, D.; Samuels, J.; Shah, M.; Slover, J.D. A Randomized Controlled Trial of Two Distinct Shared Decision-Making Aids for Hip and Knee Osteoarthritis in an Ethnically Diverse Patient Population. Value Health J. Int. Soc. Pharm. Outcomes Res. 2016, 19, 487–493. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cypress, B.S. Rigor or Reliability and Validity in Qualitative Research: Perspectives, Strategies, Reconceptualization, and Recommendations. Dimens. Crit. Care Nurs. 2017, 36, 253–263. [Google Scholar] [CrossRef]
- Hoy, D.; Brooks, P.; Woolf, A.; Blyth, F.; March, L.; Bain, C.; Baker, P.; Smith, E.; Buchbinder, R. Assessing risk of bias in prevalence studies: Modification of an existing tool and evidence of interrater agreement. J. Clin. Epidemiol. 2012, 65, 934–939. [Google Scholar] [CrossRef] [PubMed]
- Walsh, D.; Downe, S. Meta-synthesis method for qualitative research: A literature review. J. Adv. Nurs. 2005, 50. [Google Scholar] [CrossRef]
- Sepucha, K.; Bedair, H.; Yu, L.; Dorrwachter, J.M.; Dwyer, M.; Talmo, C.T.; Vo, H.; Freiberg, A.A. Decision support strategies for hip and knee Osteoarthritis: Less Is More. J. Bone Jt. Surg. Am. 2019, 101, 1645–1653. [Google Scholar] [CrossRef]
- Arterburn, D.; Wellman, R.; Westbrook, E.; Rutter, C.; Ross, T.; McCulloch, D.; Handley, M.; Jung, C. Introducing decision aids at group health was linked to sharply lower hip and knee surgery rates and costs. Health Aff. 2012, 31, 2094–2104. [Google Scholar] [CrossRef] [Green Version]
- Boland, L.; Stacey, D. Effect of patient decision aid was influenced by presurgical evaluation among patients with osteoarthritis of the knee. Can. J. Surg. 2018, 61, 28–33. [Google Scholar] [CrossRef] [Green Version]
- Stacey, D.; Hawker, G.; Dervin, G.F.; Tugwell, P.; Boland, L.; Pomey, M.-P.; O’Connor, A.; Taljaard, M. Decision aid for patients considering total knee arthroplasty with preference report for surgeons: A pilot randomized controlled trial. BMC Musculoskelet. Disord. 2014, 15, 54. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ibrahim, S.A.; Blum, M.; Lee, G.-C.; Mooar, P.; Medvedeva, E.; Collier, A.; Richardson, D. Effect of a Decision Aid on Access to Total Knee Replacement for Black Patients With Osteoarthritis of the Knee. JAMA Surg. 2017, 152, e164225. [Google Scholar] [CrossRef] [PubMed]
- De Achaval, S.; Fraenkel, L.; Volk, L.J.; Cox, V. MES-A. Impact of educational and patient decision aids on decisional conflict associated with total knee arthroplasty. Arthiritis Care Res. 2013, 64, 229–237. [Google Scholar] [CrossRef] [PubMed]
- Volkmann, E.R.; FitzGerald, J.D. Reducing gender disparities in post-total knee arthroplasty expectations through a decision aid. BMC Musculoskelet. Disord. 2015, 16, 16. [Google Scholar] [CrossRef] [Green Version]
- Al-Taiar, A.; Al-Sabah, R.; Elsalawy, E.; Shehab, D.; Al-Mahmoud, S. Attitudes to knee osteoarthritis and total knee replacement in Arab women: A qualitative study. BMC Res. Notes 2013, 6, 406. [Google Scholar] [CrossRef] [Green Version]
- Barlow, T.; Scott, P.; Griffin, D.R.; Realpe, A. How outcome prediction could affect patient decision making in knee replacements: A qualitative study. BMC Musculoskelet. Disord. 2016, 17, 304. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ho, A.; Pinney, S.J.; Bozic, K. Ethical concerns in caring for elderly patients with cognitive limitations: A capacity-adjusted shared decision-making approach. J. Bone Jt. Surg. Am. Vol. 2015, 97, e16. [Google Scholar] [CrossRef] [PubMed]
- Kesternich, I.; Caro, F.G.; Gottlieb, A.S.; Hoffmann, S.; Winter, J.K. The Role of Outcome Forecasts in Patients’ Treatment Decisions-Evidence from a Survey Experiment on Knee Replacement Surgery. Health Serv. Res. 2015, 51, 302–313. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Yeh, W.-L.; Tsai, Y.-F.; Hsu, K.-Y.; Chen, D.W.; Chen, C.-Y. Factors related to the indecision of older adults with knee osteoarthritis about receiving physician-recommended total knee arthroplasty. Disabil. Rehabil. 2016, 1–6. [Google Scholar] [CrossRef] [PubMed]
- Suarez-Almazor, M.E.; Richardson, M.; Kroll, T.L.; Sharf, B.F. A Qualitative Analysis of Decision-Making for Total Knee Replacement in Patients With Osteoarthritis. J. Clin. Rheumatol. 2010, 16, 158–163. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kroll, T.L.; Richardson, M.; Sharf, B.F.; Suarez-Almazor, M.E. “Keep on truckin”’ or “It’s got you in this little vacuum”: Race-based perceptions in decision-making for total knee arthroplasty. J. Rheumatol. 2007, 34, 1069–1075. [Google Scholar] [PubMed]
- Barlow, T.; Scott, P.; Thomson, L.; Griffin, D. The decision—making threshold and the factors that affect it: A qualitative study of patients ’ decision—making in knee replacement surgery. Musculoskelet. Care 2018, 16, 3–12. [Google Scholar] [CrossRef] [PubMed]
- O’Brien, P.; Bunzli, S.; Ayton, D.; Dowsey, M.M.; Gunn, J.; Manski-Nankervis, J. What are the patient factors that impact on decisions to progress to total knee replacement? A qualitative study involving patients with knee osteoarthritis. BMJ Open 2019. [Google Scholar] [CrossRef] [PubMed]
- Hsu, K.Y.; Tsai, Y.F.; Yeh, W.L.; Chen, D.W.; Chen, C.Y.; Wang, Y.W. Triggers and decision-making patterns for receiving total knee arthroplasty among older adults with knee osteoarthritis: A qualitative descriptive study. J. Clin. Nurs. 2018, 27, 4373–4380. [Google Scholar] [CrossRef] [PubMed]
- Filardo, G.; Roffi, A.; Merli, G.; Marcacci, T.; Ceroni, F.B.; Raboni, D.; Kon, E. Patients control preferences and results in knee arthroplasty. Knee Surg. Sport Traumatol. Arthrosc. 2017. [Google Scholar] [CrossRef] [PubMed]
- Barlow, T.; Griffin, D.R.; Barlow, D.; Realpe, A. Patients’ decision making in total knee arthroplasty: A systematic review of qualitative research. Bone Jt. Res. 2015, 4, 163–169. [Google Scholar] [CrossRef] [PubMed]
- O’Neill, T.; Jinks, C.; Ong, B.N. Decision-making regarding total knee replacement surgery: A qualitative meta-synthesis. BMC Health Serv. Res. 2007, 7, 52. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hoffmann, T.; Légaré, F.; Simmons, M.B.; McNamara, K.; McCaffery, K.; Trevena, L.J.; Hudson, B.; Glasziou, P.P.; Del Mar, C.B. Shared decision making: What do clinicians need to know and why should they bother? Med. J. Aust. 2014, 201, 35–39. [Google Scholar] [CrossRef] [PubMed]
- Elwyn, G.; Frosch, D.L.; Kobrin, S. Implementing shared decision-making: Consider all the consequences. Implement. Sci. 2015, 11, 114. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sepucha, K.R.; Borkhoff, C.M.; Lally, J.; Levin, C.A.; Matlock, D.D.; Ng, C.J.; Ropka, M.E.; Stacey, D.; Joseph-Williams, N.; Wills, C.E.; et al. Establishing the effectiveness of patient decision aids: Key constructs and measurement instruments. BMC Med Inform. Decis. Mak. 2013, 13 (Suppl. 2), S12. [Google Scholar] [CrossRef] [Green Version]
- Hargraves, I.; Montori, V.M. Decision aids, empowerment, and shared decision making. BMJ 2014, 349, g5811. [Google Scholar] [CrossRef]
- Bansback, N.; Trenaman, L.; Macdonald, K.V.; Hawker, G.A.; Johnson, J.A.; Stacey, D.; Marshall, D.A. An individualized patient-reported outcome measure (PROM) based patient decision aid and surgeon report for patients considering total knee arthroplasty: Protocol for a pragmatic randomized controlled trial. BMC Musculoskelet. Disord. 2019, 2, 1–10. [Google Scholar]
- Bozic, K.J. Advanced decision—Making using patient—Reported outcome measures in total joint replacement. J. Ortop. Res. 2020, 1–9. [Google Scholar] [CrossRef]
- Mccormack, J.; Elwyn, G. Shared decision is the only outcome that matters when it comes to evaluating evidence-based practice. BMJ Evid. Based Med. 2018, 23, 137–139. [Google Scholar] [CrossRef] [PubMed]
- Mangla, M.; Bedair, H.; Chang, Y.; Daggett, S.; Dwyer, M.K.; Freiberg, A.A.; Mwangi, S.; Talmo, C.; Vo, H.; Sepucha, K. Protocol for a randomised trial evaluating the comparative effectiveness of strategies to promote shared decision making for hip and knee osteoarthritis ( DECIDE-OA study ). BMJ Open 2019, 1–12. [Google Scholar] [CrossRef]
- Spatz, E.S.; Krumholz, H.M.; Moulton, B.W. Prime Time for Shared Decision Making. JAMA 2017, 317, 1309–1310. [Google Scholar] [CrossRef] [PubMed]
- Klifto, K.; Klifto, C.; Slover, J. Current concepts of shared decision making in orthopedic surgery. Curr. Rev. Musculoskelet. Med. 2017, 253–257. [Google Scholar] [CrossRef] [Green Version]
Author, Year of Publication | Population, Inclusion Criteria Participants; Age (SD, Range); Gender (%); Ethnicity | Aim of Study | Study Design | Authors Conclusions |
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Al Taiar, 2013 [35] | Female patients on the waiting list for TKR in Kuwait; n = 39; 62 (7.9); female (100%); Arabic | Study of pain experience and mobility limitations as well as the patient decision among woman on the waiting list for TKR surgery. | Qualitative study In depth interviews | Both verbal and written information about TKR should be provided as part of preoperative rehabilitation. This is critical to improve doctor-patient interactions and facilitate informed decision about the procedure and thus achieve patient-centered healthcare. |
Barlow, 2016 [36] | Focus groups with patients after TKR and in depth interviews with patients considering TKR; n = 12 in focus group and n = 10 in in-depth interviews; 65,5; female (45%); British, Asian | Examination how individual predictions of outcome could affect patients decision making by providing fictions predictions to patients at different stages of treatment. | Qualitative study In depth interviews | An outcome prediction tool has the most effect targeted towards people at the start of their treatment pathway, with a “bottom line” prediction of outcome. |
Ho, 2015 [37] | An elderly patient with cognitive limitations with a symptomatic right knee; n = 1; 77; one female; American. | Establishing the decisional capacity of elderly patients and providing a capacity adjusted approach to SDM. | Case report | With respect for autonomy demands support for patient participation and decision making in their own care, many elderly patients demonstrate questionable understanding and/or desire in making healthcare decisions. |
Kesternich, 2016 [38] | Hypothetical patients diagnosed with knee OA; n/a; n/a; n/a. | To analyze the effect of personalized outcome probabilities on treatment decisions. | Qualitative study Internet survey | Patient specific outcome forecasts significantly influenced decisions with effect sizes comparable to those of physicians opinion and patient testimonials. |
Yeh, 2016 [39] | Older adults (1) diagnosed with knee OA and recommended by their physicians to undergo TKR, (2) in decision about the surgery, (3) 60 years old and (4) able to communicate; n = 26; 73.6 years old (SD 1⁄4 6.9, range 1⁄4 61–86); female (76.9%); Taiwanese. | To explore factors related to the indecision of older adults with knee osteoarthritis (OA) about receiving physician-recommended total knee arthroplasty (TKR) and their needs during the decision-making process. | Qualitative study In depth interviews | Subjects were undecided about whether to undergo physician-recommended TKR due to treatment-related, physical condition-related, surgery-related and postsurgical care concerns. When a TKR is recommended, physicians must also educate patients about preparations for surgery, postsurgical care, rehabilitation and medicines while they are deciding whether to undergo knee-replacement surgery. |
Suarez-Almazor, 2010 [40] | Physician diagnosis of knee osteoarthritis; no previous knee replacement; race (African-American and non-Hispanic, Hispanic or white and non-Hispanic); age (55 to 80 years); n = 37; n/a; female (62.1%); 13 White, 15 African-American, 9 Hispanic. | To conduct a qualitative analysis of decision-making factors influencing preferences for TKR in patients with knee osteoarthritis. | Qualitative study In depth interviews | Patient experiences, fears and expectations and physician trust are prominent factors influencing decision making. An open doctor-patient is important to achieve satisfactory shared decision-making for TKR. Doctor-patient interactions and subsequent patient decision-making could be improved by developing and using decision aids for patients and educating physicians about patient concerns and expectations. |
Kroll, 2007 [41] | Inclusion: physician diagnosis of knee OA, no previous knee replacement, self-reported ethnic background African American non-Hispanic, white non-Hispanic, age 55–80, English language proficiency; n = 37; 64 (no SD); female (62.1%); African American non-Hispanic, Hispanic, white non-Hispanic. | To identify decision making factors influencing ethnic preferences for TKR in patients with knee OA. | Qualitative study | Patient attitudes and beliefs vary among ethnic groups. There is a need for open patient-doctor communication around individual experiences and beliefs in an effort to enhance decision making for TKR. |
Barlow, 2018 [42] | Focus group: n = 12 Interviews: n = 10. Inclusion: n/a, exclusion n/a. Focus group: 71,75 (n/a, n/a), female (58.33%), white n = 11, Indian n = 1. Interview group: 64 (n/a, n/a), female (30%), white (n = 9), Asian n = 1. | To explore the factors that affect decision making in TKR surgery, to help understand patients’ decision-making, which is critical in informing patient-centered care. These can be used to enhance decision-making and dialogue between clinicians and patients, allowing a more informed choice. | Qualitative study In depth interviews | An awareness of the deliberation phase, the factors that influence it, the stress associated with it, preferred models of care and the influence of the decision-making threshold will aid useful communication between doctors and patients. |
O’Brien 2019 [43] | Patients on a waiting list to undergo TKA (n = 27) Female 48.1%, age over 70: 44.4% BMI > 30 kg/m2: 59.3% TKR contralateral: 48.1% | To explore patient factors that impact to the decision to progress to TKR, including experiences in general practice, perceptions of their condition and the access to community based allied health services | Qualitative investigation using semi structured interviews | Analyzing patients’ experiences highlighted missed opportunities in general practice to orient patients to try first non-surgical interventions. Patients require improved support to navigate allied health services |
Hsu 2018 [44] | Older adult patients (n = 79) scheduled for TKR within 1 month Female 74.7% Mean age 71.6 years (6.8) Previous TKR: 24.1% | To explore triggers of and decision making patterns for older adults with knee OA to receive TKR | Qualitative study Data were collected in individual interviews using a semi structured guide | Main triggers to receive TKR in older adults were severe pain and inability to walk. Four decision making patterns were identified: surgery as last choice, previously receives TKR, perceived one as young and wanted to enjoy life and adjusted work characteristics but in vain. |
Authors, Year of Publication | Population, Inclusion Criteria; Number of Participants; Age (SD, Range); Gender (%); Gender; Ethnicity. | Aim of Study | Study Design | Main Findings |
---|---|---|---|---|
Arterburn, 2012 [29] | Patients with knee or hip osteoarthritis (ICD-9), over 45 years of age; n = 3510; 65.0 (11.1); female (62%); n/a. | To examine the associations between introducing decision aids for elective hip and knee replacement and changes in rates of surgery and costs of care. | Observational study | The introduction of decision aids was associated with 38% fewer knee replacements and 12-21 % lower costs over 6 months. Decision aids:
|
Filardo, 2017 [45] | Patients who underwent TKR between 2011 and 2015 in one hospital in Italy; n = 176; 66 (9); female (68.2%); n/a | To evaluate if a more active role in the patient decision making preference may be correlated with a more successful outcome in patients undergoing TKR. | Observational study. | The control preference of patients undergoing TKR is correlated with the final outcome. Decision aids: non described. |
de Achaval, 2012 [33] | Patients medically appropriate for a TKR; n = 208; 62.8 (9.0); female (68%); 66% white, 24% black, 7% Hispanic and 3% other. | To evaluate the impact of different decision aids, on patients’ decisional conflict associated with TKR surgery. | Randomized controlled trial. | Audio-visual patient decision aid decreased decisional conflict more than printed material alone or than the addition of a more complex ACA tool. Decision aids:
|
Ibrahim, 2016 [32] | People, self-identified as black person with frequent knee pain and over 50 years of age; n = 304; 59.1 (7,2); female (51%); Black. | To assess whether a decision aid improves access to total knee replacement surgery for black patients with OA of the knee. | Randomized controlled trial. | The use of a knee decision aid increased the receipt of TKR within 12 months by 85%, compared to the control group. Decision aid: video that provides information about different treatment options (risk, benefits, known efficiency), as well as information about surgery (indications, duration of surgery and hospital admission, need for rehabilitation and physical therapy, recovery time and effort, cost, risk of surgery). Goal of decision aid: to increase relevant knowledge. |
Volkmann, 2015 [34] | Eligible participants were between 55–85 years of age, able to speak and read English and had moderate to severe knee OA, (score of >39 on the WOMAC). Exclusion criteria: included: ≥3 Charlson comorbidity index or a single specific comorbidity (dementia, stroke with residual plegia or paresis, cancer (other than skin) and/or end-stage liver disease. Patients reporting a history of inflammatory arthritis, recent significant knee trauma, residence in a nursing home or prior hip or knee replacement surgery were also excluded; n = 111; female 72 (8.2), male 70 (9.6); female (63.1%); n/a. | To examine the impact of exposure to a decision aid on changes in expectations of health outcomes following TKR and to evaluate decision-making parameters of the decision aid among men and women with knee OA. | Observational study. | A decision aid has the potential to improve post-TKR expectations. It may be beneficial reducing gender disparities in TKR patients. Decision aid:
|
Stacey, 2014 [31] | Eligible knee OA patients were those with access to a television with a VCR or DVD player. Exclusion: inflammatory arthritis, previous TJR, uncorrected hearing or visual impairment or unable to read or understand English; n = 142; Intervention 76.1 (10.85) control 67.3 (12.16); female (67.7%); n/a. | To evaluate feasibility and to provide preliminary data on the effectiveness of a decision aid with a preference report for surgeons on wait times and decision quality in patients with OA considering TKR. | Pilot randomized controlled trial. | It was feasible to recruit patients with knee osteoarthritis, administer the decision support interventions and collect outcome measures. Preliminary effectiveness outcomes demonstrated that the used decisional aid was associated with less waiting time, lower surgery rates and improved decision quality and knowledge. Decision aid:
|
Boland, 2018 [30] | Inclusion: moderate to severe knee OA. Exclusion: inflammatory arthritis, previous total joint arthroplasty surgical consultation, unable to read or understand English or no access to a television with a VCR/DVD player to view decision aid. n = 242; 65 ( 10.3, n/a), 67 ( 9.2, n/a) 69 ( 8.2, n/a), 67 (7.8, n/a); female (59.99%); n/a. | To gather more knowledge, in order to better understand the circumstances that optimize the use of decision aids. | A subgroup analysis of a larger prospective 2-site randomized controlled trial. | The decision aid had a greater effect at the academic site than at the community site, which provided longer consultations with more verbal education. Hence, decision aids might be of greater value when more extensive total knee arthroplasty pre-surgical assessment and counselling are either impractical or unavailable. Decision aids:
|
Al Taiar 2013 | Barlow 2016 | Ho 2015 | Kesternich 2016 | Yeh 2016 | Suarez 2010 | Kroll 2007 | Barlow 2018 | O’Brien 2019 | Hsu 2018 | |
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Themes/categories | ||||||||||
Theme 1: Personal factors with the potential to impact decisions regarding TKR care | ||||||||||
Fears and concerns regarding the surgery | ||||||||||
Concerns and preferences of candidacy or refuse surgery | ||||||||||
Ethnic variability | ||||||||||
Theme 2: External factors with the potential to impact decision regarding TKR care | ||||||||||
Interaction between patient and orthopedic surgeon | ||||||||||
Issues that could enhance, delay or hinder decision making | ||||||||||
Theme 3: Patient reliance on a variety of information sources for TKR decisions | ||||||||||
Personal experiences | ||||||||||
Experiences of relevant others | ||||||||||
Theme 4: Prediction tools and presentation of relevant information to enhance care decision | ||||||||||
Value of prediction outcome tool | ||||||||||
Methods to obtain relevant information | ||||||||||
Presentation of relevant information |
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van der Sluis, G.; Jager, J.; Punt, I.; Goldbohm, A.; Meinders, M.J.; Bimmel, R.; van Meeteren, N.L.U.; Nijhuis-van Der Sanden, M.W.G.; Hoogeboom, T.J. Current Status and Future Prospects for Shared Decision Making before and after Total Knee Replacement Surgery—A Scoping Review. Int. J. Environ. Res. Public Health 2021, 18, 668. https://doi.org/10.3390/ijerph18020668
van der Sluis G, Jager J, Punt I, Goldbohm A, Meinders MJ, Bimmel R, van Meeteren NLU, Nijhuis-van Der Sanden MWG, Hoogeboom TJ. Current Status and Future Prospects for Shared Decision Making before and after Total Knee Replacement Surgery—A Scoping Review. International Journal of Environmental Research and Public Health. 2021; 18(2):668. https://doi.org/10.3390/ijerph18020668
Chicago/Turabian Stylevan der Sluis, Geert, Jelmer Jager, Ilona Punt, Alexandra Goldbohm, Marjan J. Meinders, Richard Bimmel, Nico L.U. van Meeteren, Maria W. G. Nijhuis-van Der Sanden, and Thomas J. Hoogeboom. 2021. "Current Status and Future Prospects for Shared Decision Making before and after Total Knee Replacement Surgery—A Scoping Review" International Journal of Environmental Research and Public Health 18, no. 2: 668. https://doi.org/10.3390/ijerph18020668