Show simple item record

Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool.

dc.contributor.author Streufert, Ben
dc.contributor.author Reed, Shelby D
dc.contributor.author Orlando, Lori A
dc.contributor.author Taylor, Dean C
dc.contributor.author Huber, Joel C
dc.contributor.author Mather, Richard C
dc.coverage.spatial United States
dc.date.accessioned 2017-05-01T13:43:48Z
dc.date.available 2017-05-01T13:43:48Z
dc.date.issued 2017-03
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/28377932
dc.identifier 10.1177_2325967117695788
dc.identifier.uri https://hdl.handle.net/10161/14225
dc.description.abstract 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.
dc.language eng
dc.publisher SAGE Publications
dc.relation.ispartof Orthop J Sports Med
dc.relation.isversionof 10.1177/2325967117695788
dc.subject economic and decision analysis
dc.subject instability
dc.subject shoulder
dc.title Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool.
dc.type Journal article
duke.contributor.id Reed, Shelby D|0272070
duke.contributor.id Orlando, Lori A|0294963
duke.contributor.id Taylor, Dean C|0081152
duke.contributor.id Huber, Joel C|0099700
duke.contributor.id Mather, Richard C|0280209
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/28377932
pubs.issue 3
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, General Internal Medicine
pubs.organisational-group Orthopaedics
pubs.organisational-group School of Medicine
pubs.publication-status Published online
pubs.volume 5
duke.contributor.orcid Reed, Shelby D|0000-0002-7654-4464
duke.contributor.orcid Orlando, Lori A|0000-0003-2534-7855
duke.contributor.orcid Taylor, Dean C|0000-0001-7748-0469


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record