A Decision Aid for Patients Considering Surgery for Sciatica: Codesign and User-Testing With Patients and Clinicians

Area of Science:

• Health Informatics
• Patient Decision Making
• Surgical Outcomes Research

Background:

• Sciatica surgery offers faster initial recovery, but 12-month outcomes mirror non-surgical approaches.
• The decision for sciatica surgery requires careful consideration, highlighting the need for patient decision aids.
• Patient decision aids are evidence-based tools designed to support patients in complex medical choices.

Purpose of the Study:

• To develop and refine a patient decision aid for individuals with sciatica.
• To assist patients in choosing between surgical intervention and non-surgical management ('wait and see').

Main Methods:

• Semistructured interviews and think-aloud user-testing protocols were employed.
• The study involved 20 clinicians and 20 patients with sciatica or low back pain experience.
• Iterative refinement occurred over seven rounds of user-testing, incorporating feedback from clinicians and patients.

Main Results:

• The decision aid was rated highly by clinicians for usefulness (5.9/7) and ease of use (6.0/7).
• Patients demonstrated good understanding, answering 3.4/5 knowledge questions correctly, with a reading grade level of 9.0.
• Patients reported high preparation for decision-making (4.4/5), indicating empowerment and readiness for informed choices.

Conclusions:

• The developed decision aid is acceptable to clinicians and easy to understand for patients.
• Both patient and clinician feedback indicated the aid empowers patients to engage actively in their care.
• Collaborative development and user-testing were essential for creating a decision aid that meets user needs and promotes value-aligned decisions.