Henderson Alison W, Soltani Maryam, Suckow Bjoern D, Kern Alison R, Matlock Daniel D, Czerniecki Joseph M, Norvell Daniel C
VA Center for Limb Loss and MoBility (CLiMB), 1660 S. Columbian Way, Seattle, WA, 98101, USA.
VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA, 98101, USA.
BMC Med Inform Decis Mak. 2025 Jul 1;25(1):218. doi: 10.1186/s12911-025-03084-7.
This was a feasibility study of the AMPDECIDE amputation level selection patient decision aids (one transmetatarsal vs. transtibial, the other transtibial vs. transfemoral) designed to inform a larger efficacy trial. We intended to gather data about usability of the aids, gather efficacy data about an amputation-level specific knowledge scale, identify any patient-barriers to the use of the decision aids, and evaluate the feasibility of our study methods.
Feasibility study with an uncontrolled before-after design in two medical centers.
A convenience sample of dysvascular patients (both pre- and post-amputation) seen by either the vascular or orthopaedic surgery services at each facility were recruited. Enrolled patients completed baseline measures (including amputation level knowledge items). They then reviewed the decision aid with a research coordinator, followed by additional measures of control preference, numeracy, literacy and open-ended questions.
Eleven patients were enrolled (9-post amputation, 2 pre-amputation). Patients rated the decision aids as easy to navigate. Nearly all patients expressed a desire to see their personalized mobility and reamputation risks should they be made available. Patients demonstrated 17% improved amputation level knowledge after exposure to the decision aids. In addition, 81% of patients indicated wanting to participate in the amputation level decision. The study encountered difficulties identifying and recruiting patients until greater clinician involvement was included.
The AMPDECIDE patient decision aids and the study measures appear well suited for a larger efficacy trial. Patients were able to digest the information supplied in the aids and responded well to them. The initial recruitment strategy was insufficient; greater clinician involvement may help in the future.
Not applicable.
Not applicable.
这是一项关于AMPDECIDE截肢水平选择患者决策辅助工具（一个是经跖骨截肢与经胫骨截肢对比，另一个是经胫骨截肢与经股骨截肢对比）的可行性研究，旨在为一项更大规模的疗效试验提供依据。我们旨在收集有关这些辅助工具可用性的数据，收集关于截肢水平特定知识量表的疗效数据，确定使用决策辅助工具的任何患者障碍，并评估我们研究方法的可行性。
在两个医疗中心采用非对照前后设计的可行性研究。
招募了在每个机构的血管外科或整形外科就诊的血管性疾病患者（截肢前后）的便利样本。入选患者完成基线测量（包括截肢水平知识项目）。然后他们与研究协调员一起查看决策辅助工具，随后进行关于控制偏好、计算能力、读写能力和开放式问题的额外测量。
招募了11名患者（9名截肢后患者，2名截肢前患者）。患者对决策辅助工具的评价是易于操作。几乎所有患者都表示希望看到如果提供个性化的行动能力和再次截肢风险。接触决策辅助工具后，患者的截肢水平知识提高了17%。此外，81%的患者表示希望参与截肢水平决策。在纳入更多临床医生参与之前，该研究在识别和招募患者方面遇到困难。
AMPDECIDE患者决策辅助工具和研究措施似乎非常适合进行更大规模的疗效试验。患者能够理解辅助工具中提供的信息并对其反应良好。最初的招募策略不足；未来更多临床医生的参与可能会有所帮助。
不适用。
不适用。
