Conjoint Analysis of Treatment Preferences for Nondisplaced Scaphoid Fractures

Shammas, Ronnie L.; Mela, Nathan; Wallace, Scott; Tong, Betty C.; Huber, Joel; Mithani, Suhail K.

doi:10.1016/j.jhsa.2017.12.021

Cited by 23 publications

(17 citation statements)

References 45 publications

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“…The cost of treatment and use of anesthesia were the 2 least influential factors. Shammas et al 28 identified cost as the most important attribute in the relative importance of treatment attributes through the use of a conjoint analysis tool in individuals asked about a hypothetical nondisplaced scaphoid waist fracture. The importance of cost in that study may be secondary to using people without the condition (not patients) who are not dealing with their own insurance plans and deductibles or due to the difference in hand conditions studied.…”

Section: Discussionmentioning

confidence: 99%

“…20 Preference elicitation using conjoint analysis has been studied in hand surgery in hospital selection for carpal tunnel release 27 and in the importance of treatment attributes in patients with a theoretical nondisplaced scaphoid waist fracture. 28 The aim of this study was to evaluate the feasibility and usability of a ranking preference elicitation tool used at point of care (in real time) for the treatment of trigger finger.…”

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confidence: 99%

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The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger

Shapiro

Eppler

Kamal

2019

The Journal of Hand Surgery

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Purpose-Shared decision making is an approach where physicians and patients collaborate to make decisions based on patient values. This requires eliciting patients' preferences for each treatment attribute before making decisions; a structured process for preference elicitation does not exist in hand surgery. We tested the feasibility and usability of a ranking tool to elicit patient preferences for the treatment of trigger finger. We hypothesized that the tool would be usable and feasible at the point of care. Methods-Thirty patients with a trigger finger without prior treatment were recruited from a hand surgery clinic. A preference elicitation tool was created that presented 3 treatment options (surgical release, injection, and therapy and orthosis) and described attributes of each treatment extracted from literature review (eg, success rate, complications). We presented these attributes to patients using the tool and patients ranked the relative importance (preference) of these attributes to aid in their decision making. The System Usability Scale and tool completion time were used to evaluate usability and feasibility, respectively. Results-The tool demonstrated excellent usability (System Usability Scale: 88.7). The mean completion time was 3.05 minutes. Five (16.7%) patients chose surgery, 20 (66.7%) chose an injection, and 5 (16.7%) chose therapy and orthosis. Patients ranked treatment success and cost as the most and least important attributes, respectively. Twenty-nine (96.7%) patients were very to extremely satisfied with the tool. Conclusions-A preference elicitation tool for patients to rank treatment attributes by relative importance is feasible and usable at the point of care. A structured process for preference elicitation ensures that patients understand the trade-offs between choices and can assist physicians in aligning treatment decisions with patient preferences. Clinical relevance-A ranking tool is a simple, structured process physicians can use to elicit preferences during shared decision making and highlight trade-offs between treatment options to inform treatment, choices.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger

Shapiro

Eppler

Kamal

2019

The Journal of Hand Surgery

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“…A panel of orthopaedic surgeons, health economists, and health services researchers contributed to refine the initial list. The survey was then tested using Amazon’s Mechanical Turk, a web-based participant pool well studied and used in social sciences and recently utilized in orthopaedics 36-40 . Preference results and qualitative comments were used to further refine the attribute list.…”

Section: Methodsmentioning

confidence: 99%

Characterizing Patient Preferences Surrounding Total Knee Arthroplasty

Reuter

Hutyra

Politzer

et al. 2018

JBJS OA

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Background: Episode-based bundled payments for total knee arthroplasty emphasize cost-effective patient-centered care. Understanding patients’ perceptions of components of the total knee arthroplasty care episode is critical to achieving this care. This study investigated patient preferences for components of the total knee arthroplasty care episode. Methods: Best-worst scaling was used to analyze patient preferences for components of the total knee arthroplasty care episode. Participants were selected from patients presenting to 2 orthopaedic clinics with chronic knee pain. They were presented with descriptions of 17 attributes before completing a best-worst scaling exercise. Attribute importance was determined using hierarchical Bayesian estimation. Latent class analysis was used to evaluate varying preference profiles. Results: One hundred and seventy-four patients completed the survey, and 117 patients (67%) were female. The mean age was 62.71 years. Participants placed the highest value on surgeon factors, including level of experience, satisfaction rating, and complication rates. Latent class analysis provided a 4-segment model of the population. Conclusions: This study demonstrated differences in patient preferences for the components of a total knee arthroplasty care episode and characterized distinct preference profiles among patient subsets. Stakeholders can use this information to focus efforts and policy on high-value components and to potentially create customized bundles guided by preference profiles. Clinical Relevance: This study is clinically relevant because the patient preferences identified here may help providers to design customized bundles for total knee arthroplasty care.

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“…A growing body of evidence has demonstrated the validity of MTurk as a participant recruitment tool for behavioral research, including prior work in hand surgery. [24][25][26][27][28]…”

Section: Designmentioning

confidence: 99%

The Influence of Cost Information on Treatment Choice: A Mixed-Methods Study

Zhuang

Kortlever

Shapiro

et al. 2020

The Journal of Hand Surgery

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Purpose: To test the null hypothesis that exposure to societal cost information does not affect choice of treatment for carpal tunnel syndrome (CTS). Methods:We enrolled 304 participants using the Amazon Mechanical Turk (MTurk) platform to complete a survey where participants were given the choice between carpal tunnel release (CTR) or a less expensive option (splinting) in a hypothetical mild CTS scenario. Patients were randomized to receive information about the societal cost of CTR (cost cohort) or no cost information (control). The primary outcome was the probability of choosing CTR measured on a 6-point ordinal scale. We employed qualitative content analysis to evaluate participants' rationale for their choice. We also explored agreement with various attitudes towards healthcare costs on an ordinal scale.

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Conjoint Analysis of Treatment Preferences for Nondisplaced Scaphoid Fractures

Cited by 23 publications

References 45 publications

The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger

The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger

Characterizing Patient Preferences Surrounding Total Knee Arthroplasty

The Influence of Cost Information on Treatment Choice: A Mixed-Methods Study

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