Evidence map›Paper›PMID 32723572›Full record

Trial reportThe Journal of hand surgery2020

The Influence of Cost Information on Treatment Choice: A Mixed-Methods Study.

Thompson Zhuang, Joost T P Kortlever, Lauren M Shapiro, Laurence Baker, Alex H S Harris, Robin N Kamal

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Journal of hand surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% 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, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

6 authors at 4 institutions in 1 country.

Thompson ZhuangVOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
Joost T P KortleverDepartment of Surgery and Perioperative Care, Dell Medical School-The University of Texas at Austin, Austin, TX.
Lauren M ShapiroVOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.
Laurence BakerDepartment of Health Research and Policy, Stanford University, Redwood City, CA.
Alex H S HarrisCenter for Health Care Evaluation, VA Palo Alto Health Care System, Palo Alto, CA.
Robin N KamalVOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University, Redwood City, CA. Electronic address: rnkamal@stanford.edu.
Stanford Health Care · USStanford University · USThe University of Texas at Austin · USVA Palo Alto Health Care System · US

Funding

Developing and Testing a Tool for Preference Elicitation in Carpal Tunnel SyndromeK23AR073307 · NIAMS · STANFORD UNIVERSITY · PI KAMAL, ROBIN N · 2018 to 2022
$866k
NIAMS NIH HHS K23 AR073307
6 · The paper itself

Abstract

purposeTo test the null hypothesis that exposure to societal cost information does not affect choice of treatment for carpal tunnel syndrome (CTS).

methodsWe enrolled 304 participants using the Amazon Mechanical Turk platform to complete a survey in which participants were given the choice between carpal tunnel release (CTR) or a less-expensive option (orthosis wear) in a hypothetical mild CTS scenario. Patients were randomized to receive information about the societal cost of CTR (cost cohort) or no cost information (control). The primary outcome was the probability of choosing CTR measured on a 6-point ordinal scale. We employed qualitative content analysis to evaluate participants' rationale for their choice. We also explored agreement with various attitudes toward health care costs on an ordinal scale.

resultsParticipants in the cost cohort exhibited a greater probability of choosing surgery than those in the control cohort. The relative risk of choosing surgery after exposure to societal cost information was 1.43 (95% confidence interval, 1.11-1.85). Among participants who had not previously been diagnosed with CTS (n = 232), the relative risk of choosing surgery after exposure to societal cost information was 1.55 (95% confidence interval, 1.17-2.06). Lack of personal monetary responsibility frequently emerged as a theme in those in the cost cohort who chose surgery. The majority (94%) of participants expressed at least some agreement that health care cost is a major problem whereas only 58% indicated that they consider the country's health care costs when making treatment decisions.

conclusionsParticipants who received societal cost information were more likely to choose the more expensive treatment option (CTR) for mild CTS. CLINICAL RELEVANCE: Exposure to societal cost information may influence patient decision making in elective hand surgery. A complete understanding of this influence is required prior to implementing processes toward greater cost transparency for diagnostic/treatment options. Sharing out-of-pocket costs with patients may be a beneficial approach because discussing societal cost information alone will likely not improve value of care.

Indexed as

Carpal Tunnel SyndromeDecision MakingHealth Care CostsHumansPatient SelectionSurveys and QuestionnairesCarpal tunnel releasecarpal tunnel syndromedecision makingsocietal cost

Identifiers

PMID32723572
PMCPMC8139279
OpenAlexW3044717954

What OpenQuestion holds

Textmetadata
LicenceTDM
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.