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How outcome prediction could affect patient decision making in knee replacements: a qualitative study
Timothy Barlow1, Patricia Scott1, Damian Griffin2
1CSB, University of Warwick, UHCW, Clifford Bridge Road, Coventry, CV2 2DX, UK.
BMC Musculoskeletal Disorders
|July 23, 2016
Summary
Patient decision-making for knee replacement surgery can be influenced by outcome predictions. Early-stage patients benefit most from simple, "bottom line" outcome information, though optimism bias may blunt negative predictions.
Area of Science:
- Orthopedic Surgery
- Patient Decision Making
- Health Psychology
Background:
- Approximately 17% of knee replacement patients report dissatisfaction.
- There is a need for tools to pre-operatively identify patients at risk of dissatisfaction.
- Optimal methods for presenting outcome information and its impact on patient decisions remain unclear.
Purpose of the Study:
- To examine how individual outcome predictions affect patient decision-making.
- To explore the optimal timing and presentation of outcome prediction tools for knee replacement patients.
Main Methods:
- Conducted focus groups (12 participants) and in-depth interviews (10 participants).
- Provided fictitious outcome predictions to patients at various treatment stages.
- Utilized thematic analysis to interpret qualitative data.
Main Results:
- Patients tend to adjust expectations upward (optimism bias), blunting the effect of negative predictions.
- Patients prefer a simple "bottom line" outcome summary over detailed information.
- Information was more impactful for patients earlier in their osteoarthritis treatment pathway.
Conclusions:
- Outcome prediction tools are most effective early in the treatment pathway with "bottom line" predictions.
- Optimism bias may reduce the impact of poor outcome predictions.
- Further research with larger sample sizes is recommended to validate findings.
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