ArticleBMJ open2017
Barriers and facilitators to orthopaedic surgeons' uptake of decision aids for total knee arthroplasty: a qualitative study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Can we ever have evidence-based decision making in orthopaedics? A qualitative evidence synthesis and conceptual framework.BMC medical informatics and decision making · 2025Pooled it
- Facilitators and barriers to the use of a personalised digital decision aid in total knee replacement consultations: insights from patients and orthopaedic surgeons - an interview study.BMC health services research · 2025Trial
- Implementation and sustainability factors of two early-stage breast cancer conversation aids in diverse practices.Implementation science : IS · 2021Trial
- Trial
- Integrating Gait Analysis and AI Into Knee Osteoarthritis Care: Protocol for a 3-Phase Participatory Qualitative Study.JMIR research protocols · 2026Article
- Shared decision-making and patient decision aids in knee osteoarthritis: a scoping review.Knee surgery & related research · 2026Review
- Surgeon Alignment With Clinical Practice Guidelines: A Qualitative Analysis of Treatment of Distal Radius Fractures.Hand (New York, N.Y.) · 2026Article
- MonitOring the health trajectory of patients with kNee osteoarthritis referred for orthopaedic opinion: Protocol for the MOTION parallel cohort-implementation study.Osteoarthritis and cartilage open · 2025Article
- Patient decision aids for hip and knee arthroplasty decision-making: a scoping review protocol.BMJ open · 2025Article
- Continuous adaptation of conversation aids for uterine fibroids treatment options in a four-year multi-center implementation project.BMC medical informatics and decision making · 2024Article
- Implementation of a Decision Aid for Hip and Knee Osteoarthritis in Orthopedics: A Mixed-Methods Process Evaluation.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- Patients' Views on AI for Risk Prediction in Shared Decision-Making for Knee Replacement Surgery: Qualitative Interview Study.Journal of medical Internet research · 2023Article
- Current use of the National Surgical Quality Improvement Program surgical risk calculator in academic surgery: a mixed-methods study.Surgery in practice and science · 2023Article
- Barriers and Facilitators of Outcome Collection During Hand Surgery Outreach: A Quality Improvement Study.Hand (New York, N.Y.) · 2022Article
- A Nomogram for Predicting Non-Response to Surgery One Year after Elective Total Hip Replacement.Journal of clinical medicine · 2022Article
- Exploring views of orthopaedic surgeons, rheumatologists and general practitioners about osteoarthritis management.Musculoskeletal care · 2021Article
- Program evaluation of GLA:D® Australia: Physiotherapist training outcomes and effectiveness of implementation for people with knee osteoarthritis.Osteoarthritis and cartilage open · 2021Article
- Barriers and facilitators affecting implementation of the Canadian clinical practice guidelines for the diagnosis of acute aortic syndrome.Implementation science communications · 2021Article
- Protocol for systematic review: patient decision aids for total hip and knee arthroplasty decision-making.Systematic reviews · 2021Article
- What Influences Patient Satisfaction after TKA? A Qualitative Investigation.Clinical orthopaedics and related research · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe demand for total knee arthroplasty (TKA) is increasing. Differentiating who will derive a clinically meaningful improvement from TKA from others is a key challenge for orthopaedic surgeons. Decision aids can help surgeons select appropriate candidates for surgery, but their uptake has been low. The aim of this study was to explore the barriers and facilitators to decision aid uptake among orthopaedic surgeons.
designA qualitative study involving face-to-face interviews. Questions were constructed on the Theoretical Domains Framework to systematically explore barriers and facilitators.
settingOne tertiary hospital in Australia.
participantsTwenty orthopaedic surgeons performing TKA. OUTCOME MEASURES: Beliefs underlying similar interview responses were identified and grouped together as themes describing relevant barriers and facilitators to uptake of decision aids.
resultsWhile prioritising their clinical acumen, surgeons believed a decision aid could enhance communication and patient informed consent. Barriers identified included the perception that one's patient outcomes were already optimal; a perceived lack of non-operative alternatives for the management of end-stage osteoarthritis, concerns about mandatory cut-offs for patient-centred care and concerns about the medicolegal implications of using a decision aid.
conclusionsMultifaceted implementation interventions are required to ensure that orthopaedic surgeons are ready, willing and able to use a TKA decision aid. Audit/feedback to address current decision-making biases such as overconfidence may enhance readiness to uptake. Policy changes and/or incentives may enhance willingness to uptake. Finally, the design/implementation of effective non-operative treatments may enhance ability to uptake by ensuring that surgeons have the resources they need to carry out decisions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.