The Use of a Patient Decision Aid in the Choice of Surgery for Herniated Disc
|ClinicalTrials.gov Identifier: NCT03884387|
Recruitment Status : Active, not recruiting
First Posted : March 21, 2019
Last Update Posted : April 2, 2019
|Condition or disease||Intervention/treatment||Phase|
|Lumbar Herniated Disk||Other: Patient Decision Aid||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||142 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Single (Outcomes Assessor)|
|Official Title:||The Use of a Decision Aid in the Choice of Surgery for Herniated Disc|
|Actual Study Start Date :||May 22, 2017|
|Actual Primary Completion Date :||April 13, 2018|
|Estimated Study Completion Date :||August 1, 2019|
Experimental: Use of a Patient Decision Aid
A Patient Decision Aid is used in this arm in the clinical encounter. A tool designed to facilitate shared decision making when patients choose between surgical and non-surgical treatment for lumbar disc herniation .
Other: Patient Decision Aid
The Patient Decision aid used in this project is a tool designed to facilitate shared decision making in patients with lumbar herniated disk. It is intended to complement counseling with health professionals and help patients become involved in decision making by making explicit the decision that needs to be made, providing information about the advantages and disadvantages of having or not having surgery, knowledge of treatment outcomes, and by clarifying personal values.
Other Name: Beslutningshjælper©
No Intervention: Usual counceling
Usual counseling in the clinical encounter, when patients choose between surgical and non-surgical treatment for lumbar disc herniation .
- Decision Quality worksheet -for herniated disc (DQW-HD v.2.0) [ Time Frame: Meassured right after the surgeon-patient consultation ]
Decision quality is defined as the extent to which treatments reflect the considered preferences of wellinformed patients and how well it is implemented. Decision quality worksheet - HD include decision-specific items to assess:
- knowledge, or the extent to which patients are informed
- patients' goals, concerns and preferred treatment. These items can then be used to calculate concordance, or the extent to which patients' receive treatments that match their goals.
- the decision making process, or the extent to which providers engage patients in decisions about their care.
The three aspects are reported on separately, as a total knowledge score, a concordance (or in some cases dissonance) score, and a decisions process score.
In this study only the knowledge and the process score is used. A total score is summed for each of the aspects ranging from 0-100 % with higher scores indicating a higher knowledge or a more shared decision- making process respectively.
- Decisional conflict scale [ Time Frame: Meassured right after the surgeon-patient consultation ]
The decisional conflict scale (DCS) measures personal perceptions of:
- uncertainty in choosing options;
- modifiable factors contributing to uncertainty such as feeling uninformed, unclear about personal values and unsupported in decision making; and
- effective decision making such as feeling the choice is informed, values-based, likely to be implemented and expressing satisfaction with the choice.
A total score is presented ranging from 0-100 with 0 indicating no decisional conflict and 100 extremely high decisional conflict.
- Visual Analog Scale (VAS) leg [ Time Frame: One month and one year after decision is made ]The Visual Analogue Scale (VAS) consists of a straight line (10 cm of length) with the endpoints defining the limits 'no pain at all' to the left and 'pain as bad as it could be' to the right. The patient is asked to mark his pain level on the line between the two endpoints. The distance between 'no pain at all' and the mark then defines the patient's pain. A score is given ranging from 0-100 mm. A higher score indicates greater pain intensity.
- Decisional Regret Scale [ Time Frame: One month and one year after decision is made ]The Decision Regret Scale (a 5-item scale) measures "distress or remorse after a [health care] decision. A total score is presented ranging from 0-100 with 0 indicating no regret and 100 means high regret.
- Oswestry Disability Index [ Time Frame: One year after the decision is made ]This questionnaire has been designed to give information as to how patients back or leg pain is affecting their ability to manage in everyday life. The test is considered the 'gold standard' of low back functional outcome tools. A total score is presented ranging from 0-100 with 0 indicating no regret and 100 means high regret.
- European Quality of life - 5 Dimensions (EQ-5D) [ Time Frame: One year after decision is made ]EQ-5D is a standardized/generic measure of health status. It consists of 5 dimensions. Each of the dimensions are divided into 5 levels of perceived problems. A health state is defined by combining 1 level from each of the 5 dimensions. Each state is referred to in terms of a 5 digit code. In this study an idex value is found using the UK EQ-5D-5L index, which can define 3125 (=55) different health states. The value lies between -0.624 - 1.0, with higher index indicating better health state/quality of life and vice versa. (0.0 indicates death and -0,293 is beeing unconscious).
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03884387
|Middelfart spine surgery research department|
|Middelfart, Denmark, 5500|
|Principal Investigator:||Stina B Andersen, MHS||Sygehus Lillebaelt|