RT Journal Article
SR Electronic
T1 Development and Αlpha-testing of a Stepped Decision Aid for Patients Considering Nonsurgical Options for Knee and Hip Osteoarthritis Management
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.150736
DO 10.3899/jrheum.150736
A1 Karine  Toupin April
A1 Tamara Rader
A1 Gillian A.  Hawker
A1 Dawn Stacey
A1 Annette M.  O’Connor
A1 Vivian Welch
A1 Anne Lyddiatt
A1 Jessie McGowan
A1 J. Carter  Thorne
A1 Carol Bennett
A1 Jordi  Pardo Pardo
A1 George A.  Wells
A1 Peter Tugwell
YR 2016
UL http://www.jrheum.org/content/early/2016/08/29/jrheum.150736.abstract
AB Objective To develop an innovative stepped patient decision aid (StDA) comparing the benefits and harms of 13 nonsurgical treatment options for managing osteoarthritis (OA) and to evaluate its acceptability and effects on informed decision making. Methods Guided by the Ottawa Decision Support Framework and the International Patient Decision Aid Standards, the process involved (1) developing a decision aid with evidence on 13 nonsurgical treatments from the 2012 American College of Rheumatology OA clinical practice guidelines; and (2) interviewing patients with OA and healthcare providers to test its acceptability and effects on knowledge and decisional conflict. Results The StDA helped make the decision explicit, and presented evidence on 13 OA treatments clustered into 5 steps or levels according to their benefits and harms. Probabilities of benefits and harms were presented using pictograms of 100 faces formatted to allow comparisons across sets of options. It also included a values clarification exercise and knowledge test. Feedback was obtained from 49 patients and 7 healthcare providers. They found that the StDA presented evidence in a clear manner, and helped patients clarify their values and make an informed decision. Some participants found that there was too much information and others said that there was not enough on each treatment option. Conclusion This innovative StDA allows patients to consider both the evidence and their values for multiple options. The findings are being used to revise and plan future evaluation. The StDA is an example of how research evidence in guidelines can be implemented in practice.