Dawn Stacey|Monica Taljaard|Geoffrey F. Dervin|Peter Tugwell|Annette M. O’Connor|Marie?Pascale Pomey|Laura Boland|Sarah Beach|David Meltzer|Gillian Hawker
Impact of patient decision aids on appropriate and timely access to hip or knee arthroplasty for osteoarthritis: a randomized controlled trial
University of Ottawa|Ottawa Hospital|University of Ottawa|Ottawa Hospital|Ottawa Hospital|University of Ottawa|Ottawa Hospital|University of Ottawa|Université de Montréal|University of Ottawa|Ottawa Hospital|University of Chicago|Women's College Hospital|University of Toronto
evaluate effectiveness patient decision aids ptda compared usual education appropriate timely access total joint arthroplasty patients osteoarthritisa randomized controlled trial rct patients undergoing orthopedic screening control intervention arms received usual education intervention arm also received ptda surgeon preference report wait times primary outcome described using stratified kaplanmeier survival curves patients censored time death loss followup multivariable cox proportional hazards regression secondary outcomes compared using stratified cochranmantelhaenszel chisquared tests343 patients randomized intervention n 174 control n 169 typical patient 66 years old retired living someone 51 high school education less intervention associated trend towards reduction wait time hazard ratio hr 125 95 confidence interval ci 099160 p 00653 median wait times 3 weeks shorter intervention control community site difference academic site good decision quality reached 561 intervention 445 control relative risk rr 125 95 ci 100156 p 0050 surgery rates 732 intervention 805 controls rr 091 95 ci 081103 12 intervention 73 eight control participants 49 returning surgery within 2 years p 0791compared controls decision aid recipients shorter wait times one site fewer surgeries likely reach good decision quality overall effect statistically significantthe full trial protocol available clinicaltrialsgov nct00911638