Demographic reality dictates that orthopaedic surgeons will be under ever-increasing pressure to serve aging patients. This explosion in the need for diagnostic and treatment services calls for engaged and informed patients to work with physicians in a shared decision-making process.
In the August 2, 2017 issue of The Journal, Sepucha et al. document the positive impact that patient decision aids—succinct presentations of treatment options and their attendant risks and benefits—have in shared decision making for hip, knee, and spinal complaints. In this prospective cohort study focused on routine orthopaedic care, the authors show that decision aids lead to higher knowledge scores among patients, greater patient involvement in shared decision making, lower surgical rates, and better patient-experience ratings.
The quality of available decision aids is generally excellent, and they are typically more evidence-based than information patients can locate on the Internet. In this time when orthopaedic surgeons are evaluating higher volumes of patients, these tools can inform patients before or after they interact with their orthopaedist. In addition to providing everyday-language explanations of clinical benefits and risks, these aids help individual patients align their health-care decisions with their personal values, needs, and lifestyles. I hope that these tools will find increasing use over the next 5 to 10 years in the orthopaedic practice environment.
Marc Swiontkowski, MD