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Evaluation of a Digital Decision Aid for Knee Replacement Surgery
Jörg Lützner1, Stefanie Deckert, Franziska Beyer
1University Center of Orthopedic, Trauma and Plastic Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany; Center for Evidence-Based Healthcare, University Hospital and Faculty of Medicine Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany; Institute for Medical Informatics and Biometry, University Hospital and Faculty of Medicine Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany; AOK Federal Association.
An individualized digital decision aid significantly improved knee replacement surgery decision quality. This tool enhances patient understanding of treatment options, leading to better-informed choices about knee arthroplasty.
Area of Science:
- Orthopedics
- Medical Informatics
- Patient Decision Making
Background:
- Knee arthroplasty is a common procedure for knee osteoarthritis.
- High-quality decision-making is crucial for patient satisfaction and outcomes.
- Digital tools offer potential to improve patient engagement in healthcare decisions.
Purpose of the Study:
- To evaluate the effectiveness of an individualized digital decision aid in improving decision-making quality for knee arthroplasty.
- To assess the impact of the EKIT tool on patient understanding and preferences.
Main Methods:
- A stepped-wedge, cluster-randomized trial involving 10 centers in Germany.
- Development of an app-based decision aid (EKIT tool) for patients with knee osteoarthritis.
- Comparison of decision quality (measured by HK-DQI) between an intervention group using the EKIT tool and a control group.
Main Results:
- 1055 patients' data were analyzed (616 intervention, 439 control).
- 86.0% of patients in the intervention group achieved good decision quality versus 67.4% in the control group.
- The EKIT tool showed a relative risk of 1.24 (95% CI [1.15; 1.33]) for good decision quality.
Conclusions:
- An individualized digital decision aid significantly enhances decision quality for or against knee replacement.
- The EKIT tool shows promise for widespread adoption to improve patient decision-making.
- Potential for greater impact with broader implementation, especially in high-volume centers.
