Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool.
Repository Usage Stats
BACKGROUND: Although surgical management of a first-time anterior shoulder dislocation (FTASD) can reduce the risk of recurrent dislocation, other treatment characteristics, costs, and outcomes are important to patients considering treatment options. While patient preferences, such as those elicited by conjoint analysis, have been shown to be important in medical decision-making, the magnitudes or effects of patient preferences in treating an FTASD are unknown. PURPOSE: To test a novel shared decision-making tool after sustained FTASD. Specifically measured were the following: (1) importance of aspects of operative versus nonoperative treatment, (2) respondents' agreement with results generated by the tool, (3) willingness to share these results with physicians, and (4) association of results with choice of treatment after FTASD. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A tool was designed and tested using members of Amazon Mechanical Turk, an online panel. The tool included an adaptive conjoint analysis exercise, a method to understand individuals' perceived importance of the following attributes of treatment: (1) chance of recurrent dislocation, (2) cost, (3) short-term limits on shoulder motion, (4) limits on participation in high-risk activities, and (5) duration of physical therapy. Respondents then chose between operative and nonoperative treatment for hypothetical shoulder dislocation. RESULTS: Overall, 374 of 501 (75%) respondents met the inclusion criteria, of which most were young, active males; one-third reported prior dislocation. From the conjoint analysis, the importance of recurrent dislocation and cost of treatment were the most important attributes. A substantial majority agreed with the tool's ability to generate representative preferences and indicated that they would share these preferences with their physician. Importance of recurrence proved significantly predictive of respondents' treatment choices, independent of sex or age; however, activity level was important to previous dislocators. A total of 125 (55%) males and 33 (23%) females chose surgery after FTASD, as did 37% of previous dislocators compared with 45% of nondislocators. CONCLUSION: When given thorough information about the risks and benefits, respondents had strong preferences for operative treatment after an FTASD. Respondents agreed with the survey results and wanted to share the information with providers. Recurrence was the most important attribute and played a role in decisions about treatment.
Published Version (Please cite this version)10.1177/2325967117695788
Publication InfoHuber, Joel C; Mather, Richard Charles III; Orlando, Lori Ann; Reed, Shelby Derene; Streufert, B; & Taylor, Dean Curtis (2017). Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool. Orthop J Sports Med, 5(3). 10.1177/2325967117695788. Retrieved from http://hdl.handle.net/10161/14225.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
More InfoShow full item record
Alan D. Schwartz Professor of Business Administration in the Fuqua School of Business
Joel Huber is the Alan D. Schwartz Professor of Marketing at the Fuqua School of Business. He and John McCann were founding members of the Marketing area when they arrived at Fuqua in 1979. Professor Huber received his undergraduate degree from Princeton and his MBA and Ph.D. from the Wharton School of the University of Pennsylvania. In addition to Fuqua, he has taught at the business schools at Penn, Columbia and Purdue University. He was Associate Dean for the Daytime program at Fuqua from 199
Assistant Professor of Orthopaedic Surgery
Richard C. “Chad” Mather III MD, MBA is an assistant professor and vice chairman of practice innovation in the Department of Orthopaedic Surgery at Duke University School of Medicine. He is also a faculty member at the Duke Clinical Research Institute. Dr. Mather is a health services researcher and decision scientist with a focus on economic analysis, health policy, health preference measurement and personalized decision-making. His current work focuses on buildi
Associate Professor of Medicine
Dr. Lori A. Orlando, MD MHS is an Associate Professor of Medicine and Director of the Precision Medicine Program in the Center for Applied Genomics and Precision Medicine at Duke University. She attended Tulane Medical Center for both medical school (1994-1998) and Internal Medicine residency (1998-2000). There she finished AOA and received a number of awards for teaching and clinical care from the medical school and the residency programs, including the Musser-Burch-Puschett award in 2000 fo
Professor in Population Health Sciences
Shelby D. Reed, PhD, is a professor in medicine at the Duke University School of Medicine. She works primarily at the Duke Clinical Research Institute. Dr. Reed holds a PhD in pharmaceutical health services research from the University of Maryland School of Pharmacy and completed a 2-year postdoctoral fellowship in the Pharmaceutical Outcomes Research and Policy Program and the Center for AIDS Research at the University of Washington. Dr. Reed has nearly 20 years of experience in economic e
Professor of Orthopaedic Surgery
Dr. Dean Taylor is a Sports Medicine Orthopaedic Surgeon whose practice and research interests include shoulder instability, shoulder arthroscopy, knee ligament injuries, meniscus injuries, knee cartilage injuries, and ACL injuries in adults and children. He attended the United States Military Academy at West Point and completed his medical training and residency at Duke University. Dr. Taylor went on to be a part of the John Feagin West Point Sports Medicine Fellowship, retired from the
Alphabetical list of authors with Scholars@Duke profiles.