Evidence map›Paper›PMID 31555844›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020

Preferences and beliefs of Dutch orthopaedic surgeons and patients reduce the implementation of "Choosing Wisely" recommendations in degenerative knee disease.

T Rietbergen, R L Diercks, I Anker-van der Wel, M E van den Akker-van Marle, N Lopuhaä, R P A Janssen, H M J van der Linden-van der Zwaag, R G H H Nelissen, P J Marang-van de Mheen, L van Bodegom-Vos

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In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

T RietbergenDepartment of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Postzone J10-s, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
R L DiercksDepartment of Orthopaedics, University Medical Center Groningen, Groningen, The Netherlands.
I Anker-van der WelDepartment of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Postzone J10-s, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
M E van den Akker-van MarleDepartment of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Postzone J10-s, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
N LopuhaäReumaNederland, Amsterdam, The Netherlands.
R P A JanssenDepartment of Orthopaedics, Máxima Medical Center, Eindhoven, The Netherlands.
H M J van der Linden-van der ZwaagDepartment of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
R G H H NelissenDepartment of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands.
P J Marang-van de MheenDepartment of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Postzone J10-s, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
L van Bodegom-VosDepartment of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Postzone J10-s, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. l.vanbodegom-vos@lumc.nl.ORCID http://orcid.org/0000-0002-8486-6404
Leiden University Medical Center · NLRadboud University Nijmegen · NLUniversity Medical Center Groningen · NL

Funding

ZonMw 8392010022
6 · The paper itself

Abstract

purposeThe purpose of this study was to assess which factors were associated with the implementation of "Choosing Wisely" recommendations to refrain from routine MRI and arthroscopy use in degenerative knee disease.

methodsCross-sectional surveys were sent to 123 patients (response rate 95%) and 413 orthopaedic surgeons (response rate 62%) fulfilling the inclusion criteria. Univariate and multivariate logistic regression analyses were used to identify factors associated with implementation of "Choosing Wisely" recommendations.

resultsFactors reducing implementation of the MRI recommendation among patients included explanation of added value by an orthopaedic surgeon [OR 0.18 (95% CI 0.07-0.47)] and patient preference for MRI [OR 0.27 (95% CI 0.08-0.92)]. Factors reducing implementation among orthopaedic surgeons were higher valuation of own MRI experience than existing evidence [OR 0.41 (95% CI 0.19-0.88)] and higher estimated patients' knowledge to participate in shared decision-making [OR 0.38 (95% CI 0.17-0.88)]. Factors reducing implementation of the arthroscopy recommendation among patients were orthopaedic surgeons' preferences for an arthroscopy [OR 0.03 (95% CI 0.00-0.22)] and positive experiences with arthroscopy of friends/family [OR 0.03 (95% CI 0.00-0.39)]. Factors reducing implementation among orthopaedic surgeons were higher valuation of own arthroscopy experience than existing evidence [OR 0.17 (95% CI 0.07-0.46)] and belief in the added value [OR 0.28 (95% CI 0.10-0.81)].

conclusionsImplementation of "Choosing Wisely" recommendations in degenerative knee disease can be improved by strategies to change clinician beliefs about the added value of MRIs and arthroscopies, and by patient-directed strategies addressing patient preferences and underlying beliefs for added value of MRI and arthroscopies resulting from experiences of people in their environment. LEVEL OF EVIDENCE: IV.

Indexed as

AgedArthroscopyCross-Sectional StudiesFemaleGuideline AdherenceHumansKnee JointMagnetic Resonance ImagingMaleMiddle AgedOrthopedic SurgeonsPatient PreferenceUnnecessary ProceduresBarriers and facilitatorsChoosing WiselyDegenerative knee diseaseDe-implementationKnee arthroscopyMagnetic resonance imaging

Identifiers

PMID31555844
PMCPMC7511282
OpenAlexW2977206535

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.