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Using discrete choice experiments as a decision aid in total knee arthroplasty: study protocol for a randomised
Michelle M Dowsey1,2, Anthony Scott3, Elizabeth A Nelson4
1Department of Surgery, The University of Melbourne, St. Vincent's Hospital, Level 2 Clinical Sciences Building, 29 Regent Street, Fitzroy, Melbourne, 3065, VIC, Australia. mmdowsey@unimelb.edu.au.
Trials
|August 21, 2016
Summary
This study uses a discrete choice experiment (DCE) to manage patient expectations before total knee arthroplasty (TKA). Optimizing expectations can improve patient satisfaction and health outcomes after TKA surgery.
Area of Science:
- Orthopedics
- Health Services Research
- Medical Decision Making
Background:
- Osteoarthritis (OA) is a major cause of disability, with total knee arthroplasty (TKA) being a common treatment.
- A significant proportion of patients (up to 33%) report dissatisfaction after TKA, often linked to unmet expectations.
- Optimizing patient expectations is crucial for improving satisfaction and outcomes following TKA.
Purpose of the Study:
- To investigate the impact of a discrete choice experiment (DCE) on patient expectations before TKA.
- To determine if providing information on actual TKA outcomes can enhance patient satisfaction and self-reported health.
- To reduce patient dissatisfaction and the associated burden on the healthcare system.
Main Methods:
- A randomized controlled trial (RCT) involving 132 patients awaiting TKA.
- The intervention group received a DCE survey detailing TKA risks and outcomes; the control group received a modified survey.
- Primary outcomes (pain, function, satisfaction) were assessed at 12 months post-surgery by a blinded examiner.
Main Results:
- The study aims to evaluate the effect of the DCE on patient-reported outcomes.
- It will compare patient and surgeon expectations to identify discrepancies.
- Analyses will be conducted on an intention-to-treat basis using linear regression.
Conclusions:
- This research pioneers the use of DCEs to align patient expectations with TKA realities.
- By managing expectations, the study seeks to decrease post-TKA dissatisfaction.
- Reducing dissatisfaction can alleviate the healthcare system's burden from suboptimal surgical outcomes.