The Effect of Review of a Decision Aid Prior to the Appointment on Decisional Conflict Compared to Usual Care in the Treatment of Trapeziometacarpal (TMC) Arthritis
A Randomized Trial Measuring the Effect of Review of a Decision Aid Prior to the Appointment on Decisional Conflict Compared to Usual Care in the Treatment of Trapeziometacarpal (TMC) Arthritis
調査の概要
詳細な説明
Decision aids (shared decision making tools-websites, videos, or pamphlets) are interventions to prepare patients to make more informed decisions and satisfying decisions that match their preferences and values. With greater understanding of the risks and benefits of the treatment options patients may make a more informed choice.
Decision aids - delivered online, on paper, or on video - increase patient participation in the decision-making process,1 and can result in a decrease in discretionary surgery for knee osteoarthritis, herniated disk, and benign prostatic hypertrophy.2-4 They also reduce decisional conflict. Relatively few studies have investigated the influence of decision aids in orthopedic or hand surgery. Decision aids might affect decisional conflict, satisfaction, and outcomes in hand surgery where many treatments are discretionary and address quality of life.
Utilizing the Ottawa Decision Support Framework- an evidence-based, practical theory used to guide the development of decision aids - and the International Patient Decision Aid Standards criteria the investigators developed a decision aid for trapeziometacarpal arthritis.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Massachusetts
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Boston、Massachusetts、アメリカ、02114
- Massachusetts General Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- at least 18 years of age
- English-speaking
- Diagnosis of trapeziometacarpal (TMC) arthritis
Exclusion Criteria:
- Prior surgical intervention for trapeziometacarpal (TMC) arthritis
- Previously accessed or used the online TMC arthritis Decision Aid (DA)
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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アクティブコンパレータ:Decision Aid
Cohort that will receive a decision aid.
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コホート I は意思決定支援装置 (以下「DA」) を使用して管理され、コホート II は意思決定支援装置なしで管理されます。
コホート I の患者は DA を受け取り、別室で記入して持ち帰ることができます。
意思決定支援には、疾患/状態、治療の選択肢、利点、リスク、科学的不確実性、患者の健康リスク要因に合わせた潜在的な結果の確率に関する情報が含まれます。
さらに、結果を機能的な観点から説明すること、患者にとってどの利点とリスクが最も重要であるかを考慮するよう求めること、意思決定のステップにおけるガイダンスや家族/友人との決定の話し合いなどの価値観の明確化も含まれます。
これはインタラクティブかつダイナミックであり、患者が自分の好みを明確にし、自分にとって最善と感じる決定に至るのに役立ちます。
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介入なし:No Decision Aid (control)
One cohort will not receive the decision aid, and instead will receive only a brochure as standard treatment.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Decision Conflict Scale (DCS)
時間枠:Day 1
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This scale measures patients' perception of uncertainty in making health-related decisions and consists of 3 subscales: (1) uncertainty choosing between different options, (2) modifiable factors contributing to this uncertainty-feeling uninformed, unclear about personal values, and feeling unsupported, and (3) perceived effectiveness of the decision-making an informed and values-based choice and expressing satisfaction with the decision.
We used the validated statement format Decisional Conflict Scale, consisting of 16 items with 5 response options.
Total scores range from 0 (no decisional conflict) to 100 (extremely high decisional conflict).
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Day 1
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
QuickDASH (Disabilities of the Arm, Shoulder and Hand) Questionnaire
時間枠:Day 1
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The short form of the Disabilities of Arm Shoulder and Hand to assess upper extremity disability.
The scale range is from 0-100, where 0 is no difficulty performing tasks and 100 is the most difficulty or unable to complete any tasks.
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Day 1
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Patient Health Questionnaire-2 (PHQ-2)
時間枠:Day 1
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The PHQ-2 screens for depressive mood over the past 2 weeks.
The score ranges from 0-6, where 0 is not at all depressed and 6 is major depression.
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Day 1
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Consultation and Relational Empathy (CARE) Measure
時間枠:Day 1
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The CARE measure is a 10-item questionnaire capturing patient perception of the physician's empathetic understanding under the office visit.
Each item is rated on a 5-point Likert scale, yielding a total score from 0-50.
A higher score indicates greater empathy.
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Day 1
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11-point Ordinal Satisfaction Scale
時間枠:Day 1
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The patient satisfaction scale measures how satisfied a patient is with their treatment for their thumb arthritis.
Patients score satisfaction on a scale of 0 to 10, where 0 is not satisfied and 10 is extremely satisfied.
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Day 1
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Change in Decision Regret Scale After 6 Weeks and 6 Months
時間枠:6 week and 6 month follow up
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Change in the Decision Regret Scale, which measures distress or remorse after a health care decision.
The scale consists of 5 questions, which range from strongly agree to strongly disagree, scoring 0-100 with higher scores indicating more regret.
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6 week and 6 month follow up
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Stacey D, Legare F, Col NF, Bennett CL, Barry MJ, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L, Wu JH. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014 Jan 28;(1):CD001431. doi: 10.1002/14651858.CD001431.pub4.
- Deyo RA, Cherkin DC, Weinstein J, Howe J, Ciol M, Mulley AG Jr. Involving patients in clinical decisions: impact of an interactive video program on use of back surgery. Med Care. 2000 Sep;38(9):959-69. doi: 10.1097/00005650-200009000-00009.
- Jayadev C, Khan T, Coulter A, Beard DJ, Price AJ. Patient decision aids in knee replacement surgery. Knee. 2012 Dec;19(6):746-50. doi: 10.1016/j.knee.2012.02.001. Epub 2012 Mar 2.
- Murray E, Davis H, Tai SS, Coulter A, Gray A, Haines A. Randomised controlled trial of an interactive multimedia decision aid on benign prostatic hypertrophy in primary care. BMJ. 2001 Sep 1;323(7311):493-6. doi: 10.1136/bmj.323.7311.493.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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意思決定支援の臨床試験
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University of Wisconsin, MadisonAgency for Healthcare Research and Quality (AHRQ)募集
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Fondazione Poliambulanza Istituto Ospedaliero完了
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Chania General Hospital "St. George"University of Thessalyまだ募集していませんうつ | 不安 | 認知機能1、社会 | 満足度、消費者 | 増幅 | 補聴器 | 聞く努力
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University of Alabama at BirminghamNational Cancer Institute (NCI)募集
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Assistance Publique - Hôpitaux de ParisNational Research Agency, France完了関節リウマチ | ブドウ膜炎 | 血管炎 | 1型糖尿病 | クローン病 | 筋炎 | 健康ボランティア | 強直性脊椎炎 | FMF | 全身性エリテマトーデス/抗リン脂質症候群 | クリオピリン関連周期性症候群/TNF受容体関連周期性症候群 | 潰瘍性直腸炎 | 未分類 IAD 膝および/または股関節炎、筋ジストロフィーフランス