Decision aids for patients considering total joint replacement: a cost-effectiveness analysis alongside a randomised controlled trial

摘要: Summary Background Shared decision-making (SDM) is a key priority to improve patient-centred care, and can play an important role in helping patients decide whether undergo total joint arthroplasty (TJA). Patient decision aids support SDM; however, they may incur upfront cost. We aimed estimate the health economic effects of patient for TJA. Methods A cost-effectiveness analysis randomised controlled trial (RCT) with 2-year follow-up. 343 were recruited from two orthopedic screening clinics Ottawa, Canada. Patients randomized either aid plus surgeon preference report (decision aid) or usual care. Primary outcomes costs (in 2014 CAD$), quality-adjusted life-years (QALYs), incremental ratio (ICER). Costs calculated by multiplying self-reported resource use unit costs. QALYs mapping Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) EuroQol 5-Dimension (EQ-5D) utilities. discounted at 5%. Multiple imputation was used handle missing data, bootstrapping uncertainty. Results The sample comprised 167 intervention control group patients. arm had fewer surgeries over period thereby incurring negative cost of −$560 (95% CI: −$1358 $426) per while providing 0.05 CI: −0.04 0.13) additional patient. Consequently, dominant. Conclusion associated care costs, producing similar outcomes. Clinical registration number CT00911638 (clinicaltrials.gov).