Purpose
Shared decision making is an approach where physicians and patients collaborate to
make decisions based on patient values. This requires eliciting patients’ preferences
for each treatment attribute before making decisions; a structured process for preference
elicitation does not exist in hand surgery. We tested the feasibility and usability
of a ranking tool to elicit patient preferences for the treatment of trigger finger.
We hypothesized that the tool would be usable and feasible at the point of care.
Methods
Thirty patients with a trigger finger without prior treatment were recruited from
a hand surgery clinic. A preference elicitation tool was created that presented 3
treatment options (surgical release, injection, and therapy and orthosis) and described
attributes of each treatment extracted from literature review (eg, success rate, complications).
We presented these attributes to patients using the tool and patients ranked the relative
importance (preference) of these attributes to aid in their decision making. The System
Usability Scale and tool completion time were used to evaluate usability and feasibility,
respectively.
Results
The tool demonstrated excellent usability (System Usability Scale: 88.7). The mean
completion time was 3.05 minutes. Five (16.7%) patients chose surgery, 20 (66.7%)
chose an injection, and 5 (16.7%) chose therapy and orthosis. Patients ranked treatment
success and cost as the most and least important attributes, respectively. Twenty-nine
(96.7%) patients were very to extremely satisfied with the tool.
Conclusions
A preference elicitation tool for patients to rank treatment attributes by relative
importance is feasible and usable at the point of care. A structured process for preference
elicitation ensures that patients understand the trade-offs between choices and can
assist physicians in aligning treatment decisions with patient preferences.
Clinical relevance
A ranking tool is a simple, structured process physicians can use to elicit preferences
during shared decision making and highlight trade-offs between treatment options to
inform treatment choices.
Key words
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Article Info
Publication History
Published online: February 20, 2019
Accepted:
January 2,
2019
Received:
April 19,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
