Document Detail

Patients' preferences for scoliosis brace treatment: a discrete choice experiment.
MedLine Citation:
PMID:  20023605     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Discrete choice experiment. OBJECTIVE: To investigate the reduction in the risk of surgery that scoliosis patients would require in order to consider brace treatment as acceptable, and to elicit the trade-offs individuals make between characteristics of brace treatment. SUMMARY OF BACKGROUND DATA: The effectiveness of brace treatment in idiopathic scoliosis patients has not been established in randomized controlled trials (RCTs). Treatment with a brace can be quite bothersome. Patients' preferences for brace treatment are unknown. Insight into patients' preferences for (characteristics of) brace treatment will be useful for future trials and for the development of braces that may optimize compliance with brace treatment. METHODS: A total of 197 patients who had completed treatment (brace and/or surgery) for scoliosis were approached for the study, of which 135 gave informed consent. A discrete choice experiment was designed in which patients had to choose between hypothetical brace treatment profiles that differed in following 4 treatment attributes: effectiveness, visibility, discomfort, and treatment duration. A multinomial logit model was used to analyze the relative importance of these attributes. Subgroup analyses were conducted for brace-only, brace-surgery, and surgery-only patients. RESULTS: The response rate was 86% (116/135). All treatment attributes proved to be important for patients' choices. All subgroups were prepared to initiate treatment with a Boston brace if the brace would reduce the need for surgery by 53%. Risk reductions in a range of 32% to 74% were required for acceptance of a treatment duration of 3 years. CONCLUSION: Scoliosis patients stated to be prepared to undergo brace treatment only if it provides sizeable reduction of the risk of surgery. Effectiveness and discomfort in wearing a brace were the most important determinants of the choices. These results are important if RCTs would conclusively establish that bracing is effective, and show directions for the further technical development of braces to increase the compliance with brace treatment.
Eveline M Bunge; Esther W de Bekker-Grob; Frans C van Biezen; Marie-Louise Essink-Bot; Harry J de Koning
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  35     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-31     Completed Date:  2010-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  57-63     Citation Subset:  IM    
Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Choice Behavior*
Patient Compliance
Patient Preference / psychology*
Patient Satisfaction
Regression Analysis
Scoliosis / psychology,  therapy*
Statistics, Nonparametric
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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