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患者决策辅助工具对前交叉韧带损伤后治疗选择的影响。

The impact of a patient decision aid on treatment choices after anterior cruciate ligament injuries.

作者信息

Mainz Hanne, Frandsen Lone, Fauno Peter, Lomborg Kirsten, Lind Martin

机构信息

Clinic of Sports Traumatology, Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark.

Research Centre of Patient Involvement, Aarhus University Hospital, Aarhus, Denmark.

出版信息

J Exp Orthop. 2023 Aug 16;10(1):82. doi: 10.1186/s40634-023-00633-9.

Abstract

PURPOSE

The present study aimed to investigate whether exposure to a patient decision aid (PDA) had an impact on the proportion of patients selecting non-surgical or surgical treatments after anterior cruciate ligament (ACL) injuries and whether exposure to a PDA affected the proportion of patients switching from non-surgical to surgical treatment within the first year.

METHODS

In a consecutive case series, proportions of surgery and non-surgery were compared before and after patients' exposure to a PDA. Data were collected from the health records of patients with ACL injuries who presented to the Clinic of Sports Traumatology. To identify proportional differences between the two groups, t-tests and proportion tests were used.

RESULTS

In total, 1,053 patients with ACL injuries were included: 563 patients with no exposure to the PDA (January 2015 to January 2017) and 490 patients with exposure to the PDA (January 2017 to January 2019). Before implementing the PDA, 27% of the patients selected non-surgical treatment. After implementing the PDA, 30% choose non-surgical treatment (p > 0.05). Before implementing the PDA, 21% of patients who initially chose non-surgical treatment had surgery within the first year. After implementation of the PDA, this number fell to 16%, but the difference was not statistically significant (p > 0,05).

CONCLUSION

Exposure to the PDA did not significantly alter the proportion of ACL injury patients selecting non-surgical or surgical treatments or the proportion of patients switching to surgery within the first year.

摘要

目的

本研究旨在调查接触患者决策辅助工具(PDA)是否会影响前交叉韧带(ACL)损伤患者选择非手术或手术治疗的比例,以及接触PDA是否会影响患者在第一年内从非手术治疗转为手术治疗的比例。

方法

在一个连续病例系列中,比较患者接触PDA前后手术和非手术的比例。数据收集自就诊于运动创伤诊所的ACL损伤患者的健康记录。为了确定两组之间的比例差异,使用了t检验和比例检验。

结果

总共纳入了1053例ACL损伤患者:563例未接触PDA的患者(2015年1月至2017年1月)和490例接触PDA的患者(2017年1月至2019年1月)。在实施PDA之前,27%的患者选择非手术治疗。实施PDA之后,30%的患者选择非手术治疗(p>0.05)。在实施PDA之前,最初选择非手术治疗的患者中有21%在第一年内进行了手术。实施PDA之后,这一数字降至16%,但差异无统计学意义(p>0.05)。

结论

接触PDA并未显著改变ACL损伤患者选择非手术或手术治疗的比例,也未显著改变患者在第一年内转为手术治疗的比例。

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Anterior Cruciate Ligament Tear.前交叉韧带撕裂
N Engl J Med. 2019 Jun 13;380(24):2341-2348. doi: 10.1056/NEJMcp1805931.
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Shared Decision Making and Choice for Elective Surgical Care: A Systematic Review.选择性外科护理的共同决策与选择:一项系统综述
Otolaryngol Head Neck Surg. 2016 Mar;154(3):405-20. doi: 10.1177/0194599815620558. Epub 2015 Dec 8.

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