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Willingness to participate in placebo-controlled surgical trials of the knee A DISCRETE CHOICE EXPERIMENT OF PATIENTS AND SURGEONS

Wall, L. ; Bunzli, S. ; Nelson, E. LU ; Hawke, L. J. ; Genie, M. ; Hinwood, M. ; Lang, D. ; Dowsey, M. M. ; Clarke, P. LU and Choong, P. F. , et al. (2024) In Bone and Joint Journal 106B(12). p.1408-1415
Abstract

Aims Surgeon and patient reluctance to participate are potential significant barriers to conducting placebo-controlled trials of orthopaedic surgery. Understanding the preferences of orthopaedic surgeons and patients regarding the design of randomized placebo-controlled trials (RCT-Ps) of knee procedures can help to identify what RCT-P features will lead to the greatest participation. This information could inform future trial designs and feasibility assessments. Methods This study used two discrete choice experiments (DCEs) to determine which features of RCT-Ps of knee procedures influence surgeon and patient participation. A mixed-methods approach informed the DCE development. The DCEs were analyzed with a baseline category... (More)

Aims Surgeon and patient reluctance to participate are potential significant barriers to conducting placebo-controlled trials of orthopaedic surgery. Understanding the preferences of orthopaedic surgeons and patients regarding the design of randomized placebo-controlled trials (RCT-Ps) of knee procedures can help to identify what RCT-P features will lead to the greatest participation. This information could inform future trial designs and feasibility assessments. Methods This study used two discrete choice experiments (DCEs) to determine which features of RCT-Ps of knee procedures influence surgeon and patient participation. A mixed-methods approach informed the DCE development. The DCEs were analyzed with a baseline category multinomial logit model. Results The proportion of respondents (surgeons n : 103; patients n : 140) who would not participate in any of the DCE choice sets (surgeons : 31%; patients : 40%), and the proportion who would participate in all (surgeons : 18%; patients : 30%), indicated strong views regarding the conduct of RCT-Ps. There were three main findings: for both surgeons and patients, studies which involved an arthroscopic procedure were more likely to result in participation than those with a total knee arthroplasty; as the age (for patients) and years of experience (for surgeons) increased, the overall likelihood of participation decreased; and, for surgeons, offering authorship and input into the RCT-P design was preferred for less experienced surgeons, while only completing the procedure was preferred by more experienced surgeons. Conclusion Patients and surgeons have strong views regarding participation in RCT-Ps. However, understanding their preferences can inform future trial designs and feasibility assessments with regard to recruitment rates.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Bone and Joint Journal
volume
106B
issue
12
pages
1408 - 1415
publisher
British Editorial Society of Bone & Joint Surgery
external identifiers
  • pmid:39615522
  • scopus:85211414189
ISSN
2049-4394
DOI
10.1302/0301-620X.106B12.BJJ-2023-1266.R2
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 Wall et al.
id
b0021d97-d0e3-4f16-bcd3-030a62ae6082
date added to LUP
2026-07-23 16:27:41
date last changed
2026-10-02 10:58:48
@article{b0021d97-d0e3-4f16-bcd3-030a62ae6082,
  abstract     = {{<p>Aims Surgeon and patient reluctance to participate are potential significant barriers to conducting placebo-controlled trials of orthopaedic surgery. Understanding the preferences of orthopaedic surgeons and patients regarding the design of randomized placebo-controlled trials (RCT-Ps) of knee procedures can help to identify what RCT-P features will lead to the greatest participation. This information could inform future trial designs and feasibility assessments. Methods This study used two discrete choice experiments (DCEs) to determine which features of RCT-Ps of knee procedures influence surgeon and patient participation. A mixed-methods approach informed the DCE development. The DCEs were analyzed with a baseline category multinomial logit model. Results The proportion of respondents (surgeons n : 103; patients n : 140) who would not participate in any of the DCE choice sets (surgeons : 31%; patients : 40%), and the proportion who would participate in all (surgeons : 18%; patients : 30%), indicated strong views regarding the conduct of RCT-Ps. There were three main findings: for both surgeons and patients, studies which involved an arthroscopic procedure were more likely to result in participation than those with a total knee arthroplasty; as the age (for patients) and years of experience (for surgeons) increased, the overall likelihood of participation decreased; and, for surgeons, offering authorship and input into the RCT-P design was preferred for less experienced surgeons, while only completing the procedure was preferred by more experienced surgeons. Conclusion Patients and surgeons have strong views regarding participation in RCT-Ps. However, understanding their preferences can inform future trial designs and feasibility assessments with regard to recruitment rates.</p>}},
  author       = {{Wall, L. and Bunzli, S. and Nelson, E. and Hawke, L. J. and Genie, M. and Hinwood, M. and Lang, D. and Dowsey, M. M. and Clarke, P. and Choong, P. F. and Balogh, Z. J. and Lohmander, L. S. and Paolucci, F.}},
  issn         = {{2049-4394}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{1408--1415}},
  publisher    = {{British Editorial Society of Bone & Joint Surgery}},
  series       = {{Bone and Joint Journal}},
  title        = {{Willingness to participate in placebo-controlled surgical trials of the knee A DISCRETE CHOICE EXPERIMENT OF PATIENTS AND SURGEONS}},
  url          = {{http://dx.doi.org/10.1302/0301-620X.106B12.BJJ-2023-1266.R2}},
  doi          = {{10.1302/0301-620X.106B12.BJJ-2023-1266.R2}},
  volume       = {{106B}},
  year         = {{2024}},
}