Devlin Vincent J, Gonzalez Sepulveda Juan Marcos, Gebben David, Larson A Noelle, Marks Michelle Claire, Newton Peter, Peat Raquel, Tarver Michelle, Babalola Olufemi, Cahill Patrick, Shah Suken, Samdani Amer, Bachmann Keith, Lonner Baron
US Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, MD, USA.
Duke Clinical Research Institute, Durham, NC, USA.
Global Spine J. 2025 Apr 1:21925682251330217. doi: 10.1177/21925682251330217.
Study DesignOriginal research, cross-sectional study.ObjectivesEvaluate preferences of patients, caregivers, and patient-caregiver dyads for non-fusion vs fusion surgery.MethodsA survey-based discrete choice experiment included patients 12-15 years of age with idiopathic scoliosis and their caregivers. Preference weights were estimated for 2 types of attributes that differed between fusion and non-fusion surgery: treatment outcomes (ie, appearance, confidence in planned correction, spinal motion, device failure, reoperation, and recovery period) and procedure-type requirements associated with each surgery type. Correlations between preference weights for patients, caregivers, and dyads were calculated to assess preference concordance between cohorts.ResultsA total of 344 respondents (124 patients, 92 caregivers, and 128 patient/caregiver dyads) completed the survey. Appearance was the most important treatment outcome for the average respondent in all cohorts. For patients, the least important treatment outcome was recovery time, whereas reoperation rate was the least important treatment outcome for caregivers and dyads. After controlling for treatment outcomes, patients and patient-caregiver dyads preferred the procedure-type requirements associated with fusion surgery, while caregivers preferred the procedure-type requirements associated with non-fusion surgery. Preferences of respondents who completed the survey prior to surgery were similar to those who completed the survey after surgery. Patient and caregiver preferences were more similar to the preferences of dyads than to each other.ConclusionsPatients and patient-caregiver dyads preferred the procedure-type requirements associated with fusion surgery, while caregivers preferred the procedure-type requirements associated with non-fusion surgery. Appearance was the most important treatment outcome for patients, caregivers, and patient-caregiver dyads.
研究设计
原创性研究，横断面研究。
目的
评估患者、照料者以及患者 - 照料者二元组对非融合手术与融合手术的偏好。
方法
一项基于调查的离散选择实验纳入了12至15岁的特发性脊柱侧弯患者及其照料者。针对融合手术和非融合手术之间不同的两类属性估计偏好权重：治疗结果（即外观、对计划矫正的信心、脊柱活动度、器械故障、再次手术以及恢复期）以及与每种手术类型相关的手术类型要求。计算患者、照料者和二元组的偏好权重之间的相关性，以评估不同队列之间的偏好一致性。
结果
共有344名受访者（124名患者、92名照料者以及128个患者/照料者二元组）完成了调查。外观是所有队列中平均受访者最重要的治疗结果。对于患者而言，最不重要的治疗结果是恢复时间，而对于照料者和二元组来说，再次手术率是最不重要的治疗结果。在控制治疗结果后，患者和患者 - 照料者二元组更倾向于与融合手术相关的手术类型要求，而照料者更倾向于与非融合手术相关的手术类型要求。术前完成调查的受访者的偏好与术后完成调查的受访者相似。患者和照料者的偏好与二元组的偏好相比，彼此之间更为相似。
结论
患者和患者 - 照料者二元组更倾向于与融合手术相关的手术类型要求，而照料者更倾向于与非融合手术相关的手术类型要求。外观是患者、照料者以及患者 - 照料者二元组最重要的治疗结果。
