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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article, presented data from a randomized controlled trial, demonstrating that more patients made informed treatment decisions during their first appointment with an orthopedic surgeon if shared decision-making (interventions were used [Bozic KJ et al. \u003Cem\u003EJ Bone Joint Surg Am\u003C\/em\u003E 2013].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EKevin J Bozic, MD, MBA, University of California, San Francisco, San Francisco, California, USA, presented data from a randomized controlled trial (RCT), demonstrating that more patients made informed treatment decisions during their first appointment with an orthopedic surgeon if shared decision-making (SDM) interventions were used [Bozic KJ et al. \u003Cem\u003EJ Bone Joint Surg Am\u003C\/em\u003E 2013].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EAlthough the concept of SDM is an important philosophy that has been shown to be effective in clinical practice, the use of tools for treatment decisions to enhance decision quality and patient engagement has not yet been widely adopted in orthopedic practice.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EConsequently, Dr. Bozic and colleagues designed a RCT in patients with osteoarthritis (OA) of the hip or knee to assess the impact of decision and communication aids on patient knowledge, decision-making efficiency, treatment choice, and patient and surgeon experience.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EPatients who were appropriate candidates for hip or knee replacement (n=123) were included in the study and randomized to a SDM intervention group (IG; n=61), or usual care (UC; n=62). Those in the IG received a combination of aids to enhance patient knowledge, question asking and information recall. Their decision aid was a DVD and booklet detailing the natural history and treatment alternatives for OA of the hip and knee, and comparing the risks and benefits of surgical and nonsurgical options. They also received a telephone consultation with a trained health coach to help them formulate a list of questions for their surgeon into an organized one-page document. Patients in the control group received information in the mail about the surgeon\u0027s practice.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EInclusion criteria included a primary diagnosis of OA of the hip or knee, first visit with an orthopedic surgeon for this problem, and no history of a lower-extremity joint arthroplasty. Patients were excluded if they could not read or speak English, or had previously visited another orthopedic surgeon for evaluation of the problem.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe primary outcome was whether patients reached an informed decision during their first appointment. Secondary outcomes included treatment choice, patient and provider satisfaction, and length of appointment time. Ultimately, 61 individuals in the IG, and 62 individuals in the UC group were included in the data analysis.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThe results demonstrated that significantly more patients in the IG reached an informed decision during their first orthopedic appointment compared with those in the UC group (58.3% vs 33.3%; p=0.01; \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). Additionally, patients in the IG were more confident that they knew what questions to ask their surgeon during the visit (p=0.0034). Following the appointment, there was no significant difference between groups in their treatment choice (eg, surgical or nonsurgical; p=0.48).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15654\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15654\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15654\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EInformed Decision-Making During First Appointment\u003Csup\u003E*\u003C\/sup\u003E\n            \u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-13\u0022\u003ESurgeons also experienced benefits associated with SDM. With respect to the IG, they reported being asked more appropriate questions by patients (p\u0026lt;0.0001), increased satisfaction with the efficiency of the visits (p\u0026lt;0.0001), and increased overall satisfaction with the patient encounter (p\u0026lt;0.0001).\u003C\/p\u003E\u003Cp id=\u0022p-14\u0022\u003EDr. Bozic and colleagues concluded that the results of their study demonstrate that SDM interventions in orthopedic practice benefit both the patient and surgeon, and he emphasized the value of introducing decision and communication aids into routine orthopedic practice.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/2\/18.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzpcvq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzpcvq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}