Characterizing Patient Preferences Surrounding Total Knee Arthroplasty

Reuter, John M.; Hutyra, Carolyn A.; Politzer, Cary S.; Calixte, Christopher C.; Scott, Daniel M.; Attarian, David E.; Mather, Richard C.

doi:10.2106/jbjs.oa.18.00017

Cited by 2 publications

(3 citation statements)

References 50 publications

(54 reference statements)

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“…Furthermore, it is not practical to list every attribute that might influence a patient's decision to pursue TJA. Through a comprehensive review, we were forced to omit several factors that have been shown to influence patient preferences, including surgeon experience and out-of-pocket cost [16,30]. Considering this, we believe our selected variables represent the most commonly discussed topics during patient discussions with orthopaedic surgeons.…”

Section: Limitationsmentioning

confidence: 99%

Which Factors Are Considered by Patients When Considering Total Joint Arthroplasty? A Discrete-choice Experiment

Salimy

Humphrey

Katakam

et al. 2022

Clin Orthop Relat Res

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Background TKA and THA are major surgical procedures, and they are associated with the potential for serious, even life-threatening complications. Patients must weigh the risks of these complications against the benefits of surgery. However, little is known about the relative importance patients place on the potential complications of surgery compared with any potential benefit the procedures may achieve. Furthermore, patient preferences may often be discordant with surgeon preferences regarding the treatment decision-making process. A discrete-choice experiment (DCE) is a quantitative survey technique designed to elicit patient preferences by presenting patients with two or more hypothetical scenarios. Each scenario is composed of several attributes or factors, and the relative extent to which respondents prioritize these attributes can be quantified to assess preferences when making a decision, such as whether to pursue lower extremity arthroplasty. Questions/purposes In this DCE, we asked: (1) Which patient-related factors (such as pain and functional level) and surgery-related factors (such as the risk of infection, revision, or death) are influential in patients' decisions about whether to undergo lower extremity arthroplasty? (2) Which of these factors do patients emphasize the most when making this decision? Methods A DCE was designed with the following attributes: pain; physical function; return to work; and infection risks, reoperation, implant failure leading to premature revision, deep vein thrombosis, and mortality. From October 2021 to March 2022, we recruited all new patients to two arthroplasty surgeons' clinics who were older than 18 years and scheduled for a consultation for knee-or hiprelated complaints who had no previous history of a primary TKA or THA. A total of 56% (292 of 517) of new patients met the inclusion criteria and were approached with the opportunity to complete the DCE. Among the cohort, 51% (150 of 292) of patients completed the DCE. Patients were administered the DCE, which consisted of 10 hypothetical scenarios that had the patient decide between a surgical and nonsurgical outcome, each consisting of varying levels of eight attributes (such as infection, reoperation, and ability to return to work). A subsequent demographic questionnaire followed this assessment. To answer our first research question about the patient-related and surgery-related factors that most Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Ethical approval for this study was obtained from Mass General Brigham, protocol number 2021P002129.

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Section: Limitationsmentioning

confidence: 99%

Which Factors Are Considered by Patients When Considering Total Joint Arthroplasty? A Discrete-choice Experiment

Salimy

Humphrey

Katakam

et al. 2022

Clin Orthop Relat Res

View full text Add to dashboard Cite

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“…Three questions documented patient demographics: patient age, education level, and frequency of internet use. One question prompted patients to rate specific orthopedic surgeon selection criteria [6][7][8]36] on a 4-point Likert scale ranging from 1 defined as "not important" to 4 defined as "very important." Two questions polled patient opinion regarding internet patient reviews and if patient satisfaction equates to a successful treatment outcome.…”

Section: Methodsmentioning

confidence: 99%

“…Health organizations have underscored the importance of health literacy as an essential component of patient-centered care [3,4]. Consequently, a rich body of literature established factors that influence health care choices [4][5][6][7][8] and investigated trends in health care consumerism [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Patient Utilization of Online Information and its Influence on Orthopedic Surgeon Selection: Cross-sectional Survey of Patient Beliefs and Behaviors

Hoang¹,

Parekh²,

Sagers³

et al. 2022

JMIR Form Res

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Background Patient attitudes and behavior are critical to understand owing to the increasing role of patient choice. There is a paucity of investigation into the perceived credibility of online information and whether such information impacts how patients choose their surgeons. Objective The purpose of this study was to explore the attitudes and behavior of patients regarding online information and orthopedic surgeon selection. Secondary purposes included gaining insight into the relative importance of provider selection factors, and their association with patient age and education level. Methods This was a cross-sectional study involving five multispecialty orthopedic surgery groups. A total of 329 patients who sought treatment by six different orthopedic surgeons were asked to anonymously answer a questionnaire consisting of 25 questions. Four questions regarded demographic information, 10 questions asked patients to rate the importance of specific criteria regarding the selection of their orthopedic surgeon (on a 4-point Likert scale), and 6 questions were designed to determine patient attitude and behaviors related to online information. Results Patient-reported referral sources included the emergency room (29/329, 8.8%), friend (42/329, 12.8%), insurance company (47/329, 14.3%), internet search/website (28/329, 8.5%), primary care physician (148/329, 45.0%), and other (34/329, 10.3%). Among the 329 patients, 130 (39.5%) reported that they searched the internet for information before their first visit. There was a trend of increased belief in online information to be accurate and complete in younger age groups (P=.02). There was an increased relative frequency in younger groups to perceive physician rating websites to be unbiased (P=.003), provide sufficient patient satisfaction information (P=.01), and information about physician education and training (P=.03). There was a significant trend for patients that found a surgeon’s website to be useful (P<.001), with the relative frequency increased in younger age groups. Conclusions This study shows that insurance network, physician referrals, appointment availability, and office location are important to patients, whereas advertising and internet reviews by other patients were considered to be not as helpful in choosing an orthopedic surgeon. Future studies may seek to identify obstacles to patients in integrating online resources for decision-making and strategies to improve health-seeking behaviors.

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Characterizing Patient Preferences Surrounding Total Knee Arthroplasty

Cited by 2 publications

References 50 publications

Which Factors Are Considered by Patients When Considering Total Joint Arthroplasty? A Discrete-choice Experiment

Which Factors Are Considered by Patients When Considering Total Joint Arthroplasty? A Discrete-choice Experiment

Patient Utilization of Online Information and its Influence on Orthopedic Surgeon Selection: Cross-sectional Survey of Patient Beliefs and Behaviors

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