Sofia de Achaval|Liana Fraenkel|Robert J. Volk|Veronica Cox|María E. Suarez?Almazor
Impact of educational and patient decision aids on decisional conflict associated with total knee arthroplasty
The University of Texas MD Anderson Cancer Center
abstract objective examine impact videobooklet patient decision aid supplemented interactive values clarification exercise decisional conflict patients knee osteoarthritis oa considering total knee arthroplasty methods total 208 patients participated study mean age 63 years 68 female 66 white participants randomized 1 3 groups 1 educational booklet oa management control 2 patient decision aid videobooklet oa management 3 patient decision aid videobooklet adaptive conjoint analysis aca tool aca tool enables patients consider competing attributes ie specific risksbenefits asking rate series paired comparisons primary outcome decisional conflict scale ranging 0100 differences groups analyzed using analysis variance tukeys honestly significant difference tests results overall decisional conflict decreased significantly groups p lt 005 largest reduction decisional conflict observed participants videobooklet decision aid group 21 points statistically significant differences pre versus postintervention total scores favored videobooklet group compared control group 21 versus 10 videobooklet plus aca group 21 versus 14 p lt 0001 changes decisional conflict score control group compared videobooklet decision aid aca group significantly different conclusion study audiovisual patient decision aid decreased decisional conflict printed material alone addition complex computerbased aca tool requiring intense cognitive involvement explicit value choices