STUDY DESIGN: Secondary analysis within a large clinical trial. OBJECTIVE: To evaluate the changes in treatment preference before and after watching a video decision aid as part of an informed consent process. SUMMARY OF BACKGROUND DATA: A randomized trial with a similar decision aid in herniated disc patients had shown decreased rate of surgery in the video group, but the effect of the video on expressed preferences is not known. METHODS:Subjects enrolling in the Spine Patient Outcomes Research Trial (SPORT) with intervertebral disc herniation, spinal stenosis, or degenerative spondylolisthesis at 13 multidisciplinary spine centers across the United States were given an evidence-based videotape decision aid viewed prior to enrollment as part of informed consent. RESULTS: Of the 2505 patients, 86% (n = 2151) watched the video and 14% (n = 354) did not. Watchers shifted their preference more often than nonwatchers (37.9% vs. 20.8%, P < 0.0001) and more often demonstrated a strengthened preference (26.2% vs. 11.1%, P < 0.0001). Among the 806 patients whose preference shifted after watching the video, 55% shifted toward surgery (P = 0.003). Among the 617 who started with no preference, after the video 27% preferred nonoperative care, 22% preferred surgery, and 51% remained uncertain. CONCLUSION: After watching the evidence-based patient decision aid (video) used in SPORT, patients with specific lumbar spine disorders formed and/or strengthened their treatment preferences in a balanced way that did not appear biased toward or away from surgery.
RCT Entities:
STUDY DESIGN: Secondary analysis within a large clinical trial. OBJECTIVE: To evaluate the changes in treatment preference before and after watching a video decision aid as part of an informed consent process. SUMMARY OF BACKGROUND DATA: A randomized trial with a similar decision aid in herniated disc patients had shown decreased rate of surgery in the video group, but the effect of the video on expressed preferences is not known. METHODS: Subjects enrolling in the Spine Patient Outcomes Research Trial (SPORT) with intervertebral disc herniation, spinal stenosis, or degenerative spondylolisthesis at 13 multidisciplinary spine centers across the United States were given an evidence-based videotape decision aid viewed prior to enrollment as part of informed consent. RESULTS: Of the 2505 patients, 86% (n = 2151) watched the video and 14% (n = 354) did not. Watchers shifted their preference more often than nonwatchers (37.9% vs. 20.8%, P < 0.0001) and more often demonstrated a strengthened preference (26.2% vs. 11.1%, P < 0.0001). Among the 806 patients whose preference shifted after watching the video, 55% shifted toward surgery (P = 0.003). Among the 617 who started with no preference, after the video 27% preferred nonoperative care, 22% preferred surgery, and 51% remained uncertain. CONCLUSION: After watching the evidence-based patient decision aid (video) used in SPORT, patients with specific lumbar spine disorders formed and/or strengthened their treatment preferences in a balanced way that did not appear biased toward or away from surgery.
Authors: E A Phelan; R A Deyo; D C Cherkin; J N Weinstein; M A Ciol; W Kreuter; J F Howe Journal: Spine (Phila Pa 1976) Date: 2001-01-15 Impact factor: 3.468
Authors: A M O'Connor; D Stacey; V Entwistle; H Llewellyn-Thomas; D Rovner; M Holmes-Rovner; V Tait; J Tetroe; V Fiset; M Barry; J Jones Journal: Cochrane Database Syst Rev Date: 2003
Authors: Maria M Wertli; Franziska Christina Buletti; Ulrike Held; Eva Rasmussen-Barr; Sherri Weiser; Jakob M Burgstaller; Johann Steurer Journal: Eur Spine J Date: 2016-05-13 Impact factor: 3.134
Authors: Emily F Boss; Nishchay Mehta; Neeraja Nagarajan; Anne Links; James R Benke; Zackary Berger; Ali Espinel; Jeremy Meier; Ellen A Lipstein Journal: Otolaryngol Head Neck Surg Date: 2015-12-08 Impact factor: 3.497
Authors: Vanessa B Hurley; Hector P Rodriguez; Stephen Kearing; Yue Wang; Ming D Leung; Stephen M Shortell Journal: Health Aff (Millwood) Date: 2020-01 Impact factor: 6.301
Authors: Vanessa B Hurley; Yue Wang; Hector P Rodriguez; Stephen M Shortell; Stephen Kearing; Lucy A Savitz Journal: Patient Prefer Adherence Date: 2020-01-06 Impact factor: 2.711