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Using MaxDiff Analysis to Elicit Patients' Treatment Preferences for Distal Radius Fractures in Patients Aged 60 Years and Older.

Publication ,  Journal Article
Phan, A; Schloemann, D; Calderon, T; Hammert, WC
Published in: J Hand Surg Am
June 2023

PURPOSE: The objective of our study was to determine how the attributes of surgical and nonsurgical distal radius fracture (DRF) treatments affect patient treatment preferences. METHODS: Two hundred fifty patients aged 60 years and older were contacted from a single-hand surgeon's practice, and 172 chose to participate. We built a series of best-worst scaling experiments for the MaxDiff analysis to determine the relative importance of treatment attributes. Hierarchical Bayes analysis was used to generate individual-level item scores (ISs) for each attribute that together have a total sum of 100. RESULTS: One hundred general hand clinic patients without a history of a DRF and 43 patients with a history of a DRF completed the survey. For the general hand clinic patients, the most important attributes to avoid when choosing a DRF treatment (in descending order) were the longer time to full recovery (IS, 24.9; 95% confidence interval [CI]: 23.4-26.3), longer time spent in a cast (IS, 22.8; 95% CI, 21.5-24.2), and higher complication rates (IS, 18.4; 95% CI, 16.9-19.8). Meanwhile, for patients with a history of a DRF, the most important attributes to avoid (in descending order) were a longer time to full recovery (IS, 25.6; 95% CI, 23.3-27.9), longer time spent in a cast (IS, 22.8; 95% CI, 19.9-25.7), and abnormal alignment of the radius on x-ray (IS, 18.3; 95% CI, 15.4-21.3). For both the groups, the least concerning attributes based on the IS were appearance-scar, appearance-bump, and the need for anesthesia. CONCLUSIONS: Eliciting patient preferences is a vital component of shared decision-making and advancing patient-centered care. As conceptualized in this MaxDiff analysis, when choosing a DRF treatment, patients mostly want to avoid a longer time to full recovery and a longer time in a cast, whereas patients have the least concern about appearance and need for anesthesia. CLINICAL RELEVANCE: Eliciting patient preferences is a vital component of shared decision-making. Our results may provide guidance to surgeons in discussions on the relative benefits of surgical and nonsurgical DRF treatments, by quantifying the most and least important factors to patients.

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Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

June 2023

Volume

48

Issue

6

Start / End Page

575 / 584

Location

United States

Related Subject Headings

  • Wrist Fractures
  • Radius Fractures
  • Patient Preference
  • Orthopedics
  • Middle Aged
  • Humans
  • Decision Making, Shared
  • Bayes Theorem
  • Aged
  • 4201 Allied health and rehabilitation science
 

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Phan, A., Schloemann, D., Calderon, T., & Hammert, W. C. (2023). Using MaxDiff Analysis to Elicit Patients' Treatment Preferences for Distal Radius Fractures in Patients Aged 60 Years and Older. J Hand Surg Am, 48(6), 575–584. https://doi.org/10.1016/j.jhsa.2023.03.004
Phan, Amy, Derek Schloemann, Thais Calderon, and Warren C. Hammert. “Using MaxDiff Analysis to Elicit Patients' Treatment Preferences for Distal Radius Fractures in Patients Aged 60 Years and Older.J Hand Surg Am 48, no. 6 (June 2023): 575–84. https://doi.org/10.1016/j.jhsa.2023.03.004.
Phan A, Schloemann D, Calderon T, Hammert WC. Using MaxDiff Analysis to Elicit Patients' Treatment Preferences for Distal Radius Fractures in Patients Aged 60 Years and Older. J Hand Surg Am. 2023 Jun;48(6):575–84.
Phan, Amy, et al. “Using MaxDiff Analysis to Elicit Patients' Treatment Preferences for Distal Radius Fractures in Patients Aged 60 Years and Older.J Hand Surg Am, vol. 48, no. 6, June 2023, pp. 575–84. Pubmed, doi:10.1016/j.jhsa.2023.03.004.
Phan A, Schloemann D, Calderon T, Hammert WC. Using MaxDiff Analysis to Elicit Patients' Treatment Preferences for Distal Radius Fractures in Patients Aged 60 Years and Older. J Hand Surg Am. 2023 Jun;48(6):575–584.
Journal cover image

Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

June 2023

Volume

48

Issue

6

Start / End Page

575 / 584

Location

United States

Related Subject Headings

  • Wrist Fractures
  • Radius Fractures
  • Patient Preference
  • Orthopedics
  • Middle Aged
  • Humans
  • Decision Making, Shared
  • Bayes Theorem
  • Aged
  • 4201 Allied health and rehabilitation science