Development and validation of a patient's decision aid for the treatment of ankle arthritis. My name is Olushaya Raymond, and I worked on this project with Dr. Casey-Joe Humberd. Do you not have any disclosures? For background, after the development of ankle osteoarthritis, it can be challenging for patients to decide between treatment options. This is because they must first decide whether they want to pursue surgical or non-surgical management, and must then choose a treatment option under either of those categories. Previous studies have found that decision aids improve patient knowledge about treatment options as well as their satisfaction with whatever choice they make. So the objectives of our study were twofold, one, to create our ankle arthritis patient decision aid based on available research, and two, to validate our tool in a representative patient population. We recruited 80 patients from two U.S. academic foot and ankle practices between October of 2020 and June of 2021. We first sent them a survey that began with a knowledge pretest, which assessed their understanding of ankle arthritis as well as the treatment options available for it. We then allowed them to review our decision aid, and after that, gave them another knowledge test that once again assessed their understanding of the treatment options available. We then had some additional questions that assessed what treatment they would choose if they were to develop ankle arthritis, and what level of decisional conflict they had with that choice. We also asked questions for participants to evaluate the overall quality of our decision aid. So the outcomes that we measured were knowledge scores, we compared our pre- and post-test scores using students' paired t-tests, we also evaluated the decisional conflict score for the respondents, as well as their ratings of how helpful our decision aid was, or how helpful they found our decision aid to be. So here's our ankle arthritis patient decision aid. It's a five-page tool that was created based on Dell Medical School decision aid guidelines, which state that an effective decision aid includes a description of the diagnosis or the treatment options, and possible complications, advantages, and disadvantages of each treatment option, as well as common considerations the patients in these situations had. So for our results, we invited 1,234 patients to join our project, 100 began our survey, and 80 completed the survey. If you look at the table on the right-hand side here, we see that one asked what treatment option they would choose if they were to develop ankle arthritis. A majority of respondents would choose non-surgical intervention. One asked about the level of decisional conflict that they had relating to that choice. Here, a maximum score of 40 was possible. Zero would mean that they did not have any difficulty making the choice. Forty would mean that they found the choice to be rather challenging. Here we have a mean score of 4.1, suggesting that our respondents did not find the choice to be very challenging. Here we have our knowledge scores, with a maximum score of 8 possible. And we see a statistically significant increase in knowledge scores when comparing the pre- to post-test scores. And here we can also take a look at how helpful our respondents found our decision aid to be, which they presented using a helpfulness score. A maximum score of 7 was possible here, and this mean score of 5.9 suggests that respondents found our tool to be rather helpful. For our conclusions, after viewing the tool, respondents had an increase in knowledge scores as well as low decisional conflict scores. They also found our tool to be rather helpful to obtain quality information. So this increase in knowledge scores as well as the policy of evaluations of our decision aid support tool's validity. But our study is not without its limitations. A majority of our participants were white, female, and over the age of 55, so this may limit the generalizability of our results. And non-response bias is always important to consider in a survey study. For future directions, we'd like to create an interactive digital format of our ANCOR authorized decision aid that would allow patients to answer questions and choose scenarios that are better tailored to their clinical situation. Thank you for your time.

patient's decision aid

ankle arthritis

development

validation

treatment options