Tags

Type your tag names separated by a space and hit enter

Evaluation of a shared decision-making strategy with online decision aids in surgical and orthopaedic practice: study protocol for the E-valuAID, a multicentre study with a stepped-wedge design.
BMC Med Inform Decis Mak. 2021 03 29; 21(1):110.BM

Abstract

BACKGROUND

Inguinal hernia repair, gallbladder removal, and knee- and hip replacements are the most commonly performed surgical procedures, but all are subject to practice variation and variable patient-reported outcomes. Shared decision-making (SDM) has the potential to reduce surgery rates and increase patient satisfaction. This study aims to evaluate the effectiveness of an SDM strategy with online decision aids for surgical and orthopaedic practice in terms of impact on surgery rates, patient-reported outcomes, and cost-effectiveness.

METHODS

The E-valuAID-study is designed as a multicentre, non-randomized stepped-wedge study in patients with an inguinal hernia, gallstones, knee or hip osteoarthritis in six surgical and six orthopaedic departments. The primary outcome is the surgery rate before and after implementation of the SDM strategy. Secondary outcomes are patient-reported outcomes and cost-effectiveness. Patients in the usual care cluster prior to implementation of the SDM strategy will be treated in accordance with the best available clinical evidence, physician's knowledge and preference and the patient's preference. The intervention consists of the implementation of the SDM strategy and provision of disease-specific online decision aids. Decision aids will be provided to the patients before the consultation in which treatment decision is made. During this consultation, treatment preferences are discussed, and the final treatment decision is confirmed. Surgery rates will be extracted from hospital files. Secondary outcomes will be evaluated using questionnaires, at baseline, 3 and 6 months.

DISCUSSION

The E-valuAID-study will examine the cost-effectiveness of an SDM strategy with online decision aids in patients with an inguinal hernia, gallstones, knee or hip osteoarthritis. This study will show whether decision aids reduce operation rates while improving patient-reported outcomes. We hypothesize that the SDM strategy will lead to lower surgery rates, better patient-reported outcomes, and be cost-effective.

TRIAL REGISTRATION

The Netherlands Trial Register, Trial NL8318, registered 22 January 2020. URL: https://www.trialregister.nl/trial/8318 .

Authors+Show Affiliations

Department of Surgery, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.Department of Orthopaedics, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.Department of Surgery, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.Department for Health Evidence, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.Department of Surgery, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands.Department of Orthopaedics, Slingeland Hospital, Doetinchem, The Netherlands. Department of Orthopaedics, Queen Beatrix Hospital, Winterswijk, The Netherlands.Department of Surgery, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands.Department of Orthopaedics, Queen Beatrix Hospital, Winterswijk, The Netherlands.Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.Department of Orthopaedics, VieCuri Hospital, Venray, The Netherlands.Department of Surgery, Van Weel Bethesda Hospital, Dirksland, The Netherlands.Department of Value-Based Health Care, St. Anna Hospital, Geldrop, The Netherlands.Department of Orthopaedics, Rijnstate Hospital, Arnhem, The Netherlands.Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.Department of Surgery, Radboud University Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. philip.dereuver@radboudumc.nl.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33781253

Citation

Thunnissen, Floris M., et al. "Evaluation of a Shared Decision-making Strategy With Online Decision Aids in Surgical and Orthopaedic Practice: Study Protocol for the E-valuAID, a Multicentre Study With a Stepped-wedge Design." BMC Medical Informatics and Decision Making, vol. 21, no. 1, 2021, p. 110.
Thunnissen FM, Schreurs BW, Latenstein CSS, et al. Evaluation of a shared decision-making strategy with online decision aids in surgical and orthopaedic practice: study protocol for the E-valuAID, a multicentre study with a stepped-wedge design. BMC Med Inform Decis Mak. 2021;21(1):110.
Thunnissen, F. M., Schreurs, B. W., Latenstein, C. S. S., Meinders, M. J., Adang, E. M., Elwyn, G., Boersma, D., Bosmans, B., Bosscha, K., Ginsel, B. L., Hazebroek, E. J., Nieuwenhuis, J. J., Staarink, M., Verhallen, D., Wagener, M. L., Atsma, F., & de Reuver, P. R. (2021). Evaluation of a shared decision-making strategy with online decision aids in surgical and orthopaedic practice: study protocol for the E-valuAID, a multicentre study with a stepped-wedge design. BMC Medical Informatics and Decision Making, 21(1), 110. https://doi.org/10.1186/s12911-021-01467-0
Thunnissen FM, et al. Evaluation of a Shared Decision-making Strategy With Online Decision Aids in Surgical and Orthopaedic Practice: Study Protocol for the E-valuAID, a Multicentre Study With a Stepped-wedge Design. BMC Med Inform Decis Mak. 2021 03 29;21(1):110. PubMed PMID: 33781253.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of a shared decision-making strategy with online decision aids in surgical and orthopaedic practice: study protocol for the E-valuAID, a multicentre study with a stepped-wedge design. AU - Thunnissen,Floris M, AU - Schreurs,Bernhard W, AU - Latenstein,Carmen S S, AU - Meinders,Marjan J, AU - Adang,Eddy M, AU - Elwyn,Glyn, AU - Boersma,Doeke, AU - Bosmans,Bas, AU - Bosscha,Koop, AU - Ginsel,Bastiaan L, AU - Hazebroek,Eric J, AU - Nieuwenhuis,Jeroen J, AU - Staarink,Maarten, AU - Verhallen,Dries, AU - Wagener,Marc L, AU - Atsma,Femke, AU - de Reuver,Philip R, Y1 - 2021/03/29/ PY - 2021/01/20/received PY - 2021/03/10/accepted PY - 2021/3/30/entrez PY - 2021/3/31/pubmed PY - 2021/4/24/medline KW - Cholecystolithiasis KW - Decision aids KW - Hip osteoarthritis KW - Inguinal hernia KW - Knee osteoarthritis KW - Shared decision-making SP - 110 EP - 110 JF - BMC medical informatics and decision making JO - BMC Med Inform Decis Mak VL - 21 IS - 1 N2 - BACKGROUND: Inguinal hernia repair, gallbladder removal, and knee- and hip replacements are the most commonly performed surgical procedures, but all are subject to practice variation and variable patient-reported outcomes. Shared decision-making (SDM) has the potential to reduce surgery rates and increase patient satisfaction. This study aims to evaluate the effectiveness of an SDM strategy with online decision aids for surgical and orthopaedic practice in terms of impact on surgery rates, patient-reported outcomes, and cost-effectiveness. METHODS: The E-valuAID-study is designed as a multicentre, non-randomized stepped-wedge study in patients with an inguinal hernia, gallstones, knee or hip osteoarthritis in six surgical and six orthopaedic departments. The primary outcome is the surgery rate before and after implementation of the SDM strategy. Secondary outcomes are patient-reported outcomes and cost-effectiveness. Patients in the usual care cluster prior to implementation of the SDM strategy will be treated in accordance with the best available clinical evidence, physician's knowledge and preference and the patient's preference. The intervention consists of the implementation of the SDM strategy and provision of disease-specific online decision aids. Decision aids will be provided to the patients before the consultation in which treatment decision is made. During this consultation, treatment preferences are discussed, and the final treatment decision is confirmed. Surgery rates will be extracted from hospital files. Secondary outcomes will be evaluated using questionnaires, at baseline, 3 and 6 months. DISCUSSION: The E-valuAID-study will examine the cost-effectiveness of an SDM strategy with online decision aids in patients with an inguinal hernia, gallstones, knee or hip osteoarthritis. This study will show whether decision aids reduce operation rates while improving patient-reported outcomes. We hypothesize that the SDM strategy will lead to lower surgery rates, better patient-reported outcomes, and be cost-effective. TRIAL REGISTRATION: The Netherlands Trial Register, Trial NL8318, registered 22 January 2020. URL: https://www.trialregister.nl/trial/8318 . SN - 1472-6947 UR - https://www.unboundmedicine.com/medline/citation/33781253/Evaluation_of_a_shared_decision_making_strategy_with_online_decision_aids_in_surgical_and_orthopaedic_practice:_study_protocol_for_the_E_valuAID_a_multicentre_study_with_a_stepped_wedge_design_ L2 - https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-021-01467-0 DB - PRIME DP - Unbound Medicine ER -