Trial reportArthritis and rheumatism2013
Willingness and access to joint replacement among African American patients with knee osteoarthritis: a randomized, controlled intervention.
Trial report in Arthritis and rheumatism, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Effects of patient decision aids used pre-consult or in-consult on patient-clinician communication - secondary analysis of a systematic review with meta-analysis.BMC medical informatics and decision making · 2025Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024Pooled it
- Do Decision Aids Benefit Patients with Chronic Musculoskeletal Pain? A Systematic Review.Pain medicine (Malden, Mass.) · 2020Pooled it
- Use of Decision Aids with Minority Patients: a Systematic Review.Journal of general internal medicine · 2016Pooled it
- Effect of a Positive Psychological Intervention on Pain and Functional Difficulty Among Adults With Osteoarthritis: A Randomized Clinical Trial.JAMA network open · 2018Trial
- Effect of a Decision Aid on Access to Total Knee Replacement for Black Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial.JAMA surgery · 2017Trial
- Does a Patient-centered Educational Intervention Affect African-American Access to Knee Replacement? A Randomized Trial.Clinical orthopaedics and related research · 2016Trial
- Race and ethnic disparities arthroplasty trends and hotspots: Bibliometric analysis.Journal of orthopaedics · 2024Article
- Willingness to Have Total Knee Arthroplasty in Rural Areas of Northern China.Orthopaedic surgery · 2022Article
- Racial/Ethnic and Socioeconomic Disparities in Osteoarthritis Management.Rheumatic diseases clinics of North America · 2021Review
- Racial and Gender Shoulder Arthroplasty Utilization Disparities of High- and Low-Volume Centers in New York State.Journal of shoulder and elbow arthroplasty · 2021Article
- Shared decision making in surgery: A scoping review of the literature.Health expectations : an international journal of public participation in health care and health policy · 2020Article
- Disparities in Total Knee Replacement: Population Losses in Quality-Adjusted Life-Years Due to Differential Offer, Acceptance, and Complication Rates for African Americans.Arthritis care & research · 2018Article
- Physician referral patterns and racial disparities in total hip replacement: A network analysis approach.PloS one · 2018Article
- Rationale and design of the Staying Positive with Arthritis (SPA) Study: A randomized controlled trial testing the impact of a positive psychology intervention on racial disparities in pain.Contemporary clinical trials · 2018Article
- Harnessing Implementation Science to Increase the Impact of Health Equity Research.Medical care · 2017Article
- Racial and Ethnic Differences in Total Knee Arthroplasty in the Veterans Affairs Health Care System, 2001-2013.Arthritis care & research · 2017Article
- Article
- Race- and Sex-Specific Incidence Rates and Predictors of Total Knee Arthroplasty: Seven-Year Data From the Osteoarthritis Initiative.Arthritis care & research · 2016Observational
- Determinants of patient preferences for total knee replacement: African-Americans and whites.Arthritis research & therapy · 2015Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveAfrican American patients are significantly less likely to undergo knee replacement for the management of knee osteoarthritis (OA). Racial difference in preference (willingness) has emerged as a key factor. This study was undertaken to examine the efficacy of a patient-centered educational intervention on patient willingness and the likelihood of receiving a referral to an orthopedic clinic.
methodsA total of 639 African American patients with moderate-to-severe knee OA from 3 Veterans Affairs primary care clinics were enrolled in a randomized, controlled trial with a 2 × 2 factorial design. Patients were shown a knee OA decision-aid video with or without brief counseling. The main outcome measures were change in patient willingness and receipt of a referral to an orthopedic clinic. Also assessed were whether patients discussed knee pain with their primary care provider or saw an orthopedic surgeon within 12 months of the intervention.
resultsAt baseline, 67% of the participants were definitely/probably willing to consider knee replacement, with no difference among the groups. The intervention increased patient willingness (75%) in all groups at 1 month. For those who received the decision aid intervention alone, the gains were sustained for up to 3 months. By 12 months postintervention, patients who received any intervention were more likely to report engaging their provider in a discussion about knee pain (92% versus 85%), to receive a referral to an orthopedic surgeon (18% versus 13%), and for those with a referral, to attend an orthopedic consult (61% versus 50%).
conclusionAn educational intervention significantly increased the willingness of African American patients to consider knee replacement. It also improved the likelihood of patient-provider discussion about knee pain and access to surgical evaluation.
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Registered trials
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