Do we really allow patient decision-making in rotator cuff surgery? A prospective randomized study.
Outcomes
Patient participation
Rotator cuff
Rotator cuff-repair
Shared decision-making
Journal
Journal of orthopaedic surgery and research
ISSN: 1749-799X
Titre abrégé: J Orthop Surg Res
Pays: England
ID NLM: 101265112
Informations de publication
Date de publication:
29 Apr 2019
29 Apr 2019
Historique:
received:
21
08
2018
accepted:
16
04
2019
entrez:
1
5
2019
pubmed:
1
5
2019
medline:
18
12
2019
Statut:
epublish
Résumé
There is a growing patient interest in being involved in the decision-making process. However, little information is provided on how this information should be structured. Does it make a difference, in patient treatment decision-making, whether information is given based on the benefits or on the side effects in rotator cuff disorders? It is a prospective randomized study that includes patients diagnosed with rotator cuff tears. Patients were randomly allocated to either group A (benefit-inform) or group B (side effect-inform) and were asked to answer the following questions based on their assigned group: Group A: Your doctor informs you that you have a rotator cuff tear and states that if he/she surgically repairs your cuff tear you will improve and that the cuff remains healed at the 2-year follow-up in 71% of the cases where surgery is done. Would you choose surgery? Yes or No Group B: Your doctor informs you that you have a rotator cuff tear and that if he/she surgically repairs your cuff tear you will improve and that the cuff is torn again at 2-year follow-up in 29% of the cases where surgery is done. Would you choose surgery? Yes or No Age, gender, the shoulder affected and the functional status assessed through the Constant score were also recorded. 80 patients were randomized (43 to group A and 37 to group B). The patients assigned to group A (benefit) accepted surgery significantly more frequently than those assigned to group B (complication) (P = 0.000). In group A, 36 of 43 (84%) accepted surgery, compared to 17 of 37 (46%) in group B. The way that information on rotator cuff disorders is provided strongly influences patients' treatment decisions. ClinicalTrials.gov, NCT03205852 . Registered 29 June 2017. Retrospectively registered.
Sections du résumé
BACKGROUND
BACKGROUND
There is a growing patient interest in being involved in the decision-making process. However, little information is provided on how this information should be structured. Does it make a difference, in patient treatment decision-making, whether information is given based on the benefits or on the side effects in rotator cuff disorders?
METHODS
METHODS
It is a prospective randomized study that includes patients diagnosed with rotator cuff tears. Patients were randomly allocated to either group A (benefit-inform) or group B (side effect-inform) and were asked to answer the following questions based on their assigned group: Group A: Your doctor informs you that you have a rotator cuff tear and states that if he/she surgically repairs your cuff tear you will improve and that the cuff remains healed at the 2-year follow-up in 71% of the cases where surgery is done. Would you choose surgery? Yes or No Group B: Your doctor informs you that you have a rotator cuff tear and that if he/she surgically repairs your cuff tear you will improve and that the cuff is torn again at 2-year follow-up in 29% of the cases where surgery is done. Would you choose surgery? Yes or No Age, gender, the shoulder affected and the functional status assessed through the Constant score were also recorded.
RESULTS
RESULTS
80 patients were randomized (43 to group A and 37 to group B). The patients assigned to group A (benefit) accepted surgery significantly more frequently than those assigned to group B (complication) (P = 0.000). In group A, 36 of 43 (84%) accepted surgery, compared to 17 of 37 (46%) in group B.
CONCLUSIONS
CONCLUSIONS
The way that information on rotator cuff disorders is provided strongly influences patients' treatment decisions.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov, NCT03205852 . Registered 29 June 2017. Retrospectively registered.
Identifiants
pubmed: 31036041
doi: 10.1186/s13018-019-1157-2
pii: 10.1186/s13018-019-1157-2
pmc: PMC6489206
doi:
Banques de données
ClinicalTrials.gov
['NCT03205852']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
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