The development of a decision aid to elicit treatment preferences for displaced femoral neck fractures
Tóm tắt
Background: Decision aids help physicians convey information to patients and enable patients to be involved in the decision-making process. There is a lack of use of decision aids in the orthopedic literature. The purpose of this study was to develop a decision board to elicit preferences for treatment of displaced femoral neck fractures in patients over 60 years old. Materials and Methods: We developed a decision board presenting descriptions and potential outcomes and complications of two treatment options, hemiarthroplasty (HA) and internal fixation (IF), for displaced femoral neck fractures. Five orthopedic surgeons evaluated the face and content validity of the decision board and 10 volunteers completed “scope tests” to determine the comprehensibility. We then presented the decision board to 108 study participants faced with the scenario of sustaining a displaced femoral neck fracture. Participants stated their preference for operative procedure and described the reasons for their choices. Results: The decision board achieved good face and content validity. All participants in the scope tests appropriately switched their preference to the other modality when probabilities were altered. Most participants found the decision board easy to understand and helpful in making an informed decision. Also, most participants were satisfied with the amount of information presented and with the use of the decision board as a decision making tool. Sixty-one participants (56%) chose IF as their operative procedure of choice quoting less blood loss, shorter operative time, and less invasiveness as the top factors that contributed to this choice. Participants who preferred HA (44%) did so primarily due to the lower re-operation rate. Conclusions: The decision board is a useful and reliable tool to inform patients about the treatment options for displaced femoral neck fractures. They should be utilized by surgeons to incorporate patients’ preferences into the decision-making process.
Tài liệu tham khảo
Haynes RB, Devereaux PJ, Guyatt GH. Physicians’ and patients’ choices in evidence based practice. BMJ 2002;324:1350.
Levine MN, Gafni A, Markham B, MacFarlane D. A bedside decision instrument to elicit a patient’s preference concerning adjuvant chemotherapy for breast cancer. Ann Intern Med 1992;1171:53–8.
Adam JA, Khaw FM, Thomson RG, Gregg PJ, Llewellyn-Thomas HA. Patient decision aids in joint replacement surgery: A literature review and an opinion survey of consultant orthopaedic surgeons. Ann R Coll Surg Engl 2008;90:198–207.
Stacey D, Hawker G, Dervin G, Tomek I, Chochran N, Tugwell P, et al. Management of Chronic Pain: Improving shared decision making in osteoarthritis. BMJ 2008;336:954–5.
Melton LJ 3rd. Hip fractures: A worldwide problem today and tomorrow. Bone 1993;14:S1–8.
Papadimitropoulos EA, Coyte PC, Josse RG, Greenwood CE. Current and projected rates of hip fracture in Canada. CMAJ 1997;157:1357–63.
Ray NF, Chan JK, Thamer M, Melton LJ 3rd. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: Report from the National Osteoporosis Foundation. J Bone Miner Res 1997;12:24–35.
Lu-Yao GL, Keller RB, Littenberg B, Wennberg JE. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am 1994;761:15–25.
Bhandari M, Devereaux PJ, Swiontkowski MF, Tornetta P 3rd, Obremskey W, Koval KJ, et al. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A meta-analysis. J Bone Joint Surg Am 2003;85-A:1673–81.
Masson M, Parker MJ, Fleischer S. Internal fixation versus arthroplasty for intracapsular proximal femoral fractures in adults. Cochrane Database Syst Rev 2003;2:CD001708.
Bhandari M, Devereaux PJ, Tornetta P 3rd, Swiontkowski MF, Berry DJ, Haidukewych G, et al. Operative management of displaced femoral neck fractures in elderly patients. An international survey. J Bone Joint Surg Am 2005;87:2122–30.
Guyatt GH, Haynes RB, Jaeschke R, Cook D, Green L, Nayler D, et al. Introduction: The philosophy of evidence-based medicine. In: Guyatt GH and Rennie D (editor). Users’ Guides to the Medical Literature: A Manual of Evidence-Based Clinical Practice. Chicago: American Medical Association; 2002. p. 3–12.
Whelan T, Levine M, Gafni A, Sanders K, Willan A, Mirsky D, et al. Mastectomy or lumpectomy? Helping women make informed choices. J Clin Oncol 1999;17:1727–35.
Whelan T, Gafni A, Charles C, Levine M. Lessons learned from the Decision Board: A unique and evolving decision aid. Health Expect 2000;3:69–76.
Whelan T, Sawka C, Levine M, Gafni A, Reyno L, Willan A, et al. Helping patients make informed choices: A randomized trial of a decision aid for adjuvant chemotherapy in lymph node-negative breast cancer. J Natl Cancer Inst 2003;95:581–7.
Whelan T, Levine M, Willan A, Gafni A, Sanders K, Mirsky D, et al. Effect of a decision aid on knowledge and treatment decision making for breast cancer surgery: A randomized trial. JAMA 2004;292:435–41.
Matthews DC, Birch S, Gafni A, DiCenso A. Willingness to pay for periodontal therapy: Development and testing of an instrument. J Public Health Dent 1999;59:44–51.
Matthews D, Rocchi A, Wang EC, Gafni A. Use of an interactive tool to assess patients’ willingness-to-pay. J Biomed Inform 2001;34:311–20.
Matthews D, Rocchi A, Gafni A. Putting your money where your mouth is: Willingness to pay for dental gel. Pharmacoeconomics 2002;20:245–55.
O’connor AM, Stacey D, Entwistle V, Llewellyn-Thomas H, Rovner D, Holmes-Rovner M, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2003;2:CD001431.
Parker MJ, Khan RJ, Crawford J, Pryor GA. Hemiarthroplasty versus internal fixation for displaced intracapsular hip fractures in the elderly. A randomised trial of 455 patients. J Bone Joint Surg Br 2002;84:1150–5.
Roden M, Schon M, Fredin H. Treatment of displaced femoral neck fractures: A randomized minimum 5-year follow-up study of screws and bipolar hemiprostheses in 100 patients. Acta Orthop Scand 2003;74:42–4.
Tidermark J, Ponzer S, Svensson O, Soderqvist A, Tornkvist H. Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly. A randomised, controlled trial. J Bone Joint Surg Br 2003;85:380–8.
Whelan TJ, Levine MN, Gafni A, Lukka H, Mohide EA, Patel M, et al. Breast irradiation postlumpectomy: Development and evaluation of a decision instrument. J Clin Oncol 1995;13:847–53.
Bryant D, Bednarski E, Gafni A. Incorporating patient preferences into orthopaedic practice: Should the orthopaedic encounter change? Injury 2006;37:328–34.
Greenfield S, Kaplan SH, Ware JE Jr, Yano EM, Frank HJ. Patients’ participation in medical care: Effects on blood sugar control and quality of life in diabetes. J Gen Intern Med 1988;3:448–57.
Greenfield S, Kaplan S, Ware JE Jr. Expanding patient involvement in care: Effects on patient outcomes. Ann Intern Med 1985;102:520–8.
O’Connor AM, Bennett CL, Stacey D, Barry M, Col NF, Eden KB, et al. Decision aids for people facing health treatment or screening decisions. Chochrane Database Syst Rev 2009;8:CD001431.
Parker MJ, Gurusamy K. Internal fixation versus arthroplasty for intracapsular proximal femoral fractures in adults. Cochrane Database Syst Rev 2006;4:CD001708.
Frihagen F, Nordsletten L, Madsen JE. Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: Randomised controlled trial. BMJ 2007;335:1251–4.
Keating JF, Grant A, Masson M, Scott NW, Forbes JF. Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty. Treatment of displaced intracapsular hip fractures in healthy older patients. J Bone Joint Surg Am 2006;88:249–60.
Devereaux PJ, Anderson DR, Gardner MJ, Putnam W, Flowerdew GJ, Brownell BF, et al. Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study. BMJ 2001;323:1218–22.
Slevin ML, Stubbs L, Plant HJ, Wilson P, Gregory WM, Armes PJ, et al. Attitudes to chemotherapy: Comparing views of patients with cancer with those of doctirs, nurses and general public. BMJ 1990;300:1458–60.