Evidence map›Paper›PMID 33055120›Full record

ArticleBMJ open2020

Patients' preferences for occupational therapy after upper extremity fractures: a discrete choice experiment.

Joshua Kyle Napora, Haley Demyanovich, Alexandra Mulliken, Kimberly Oslin, Raymond Pensy, Gerard Slobogean, Robert V O'Toole, Nathan O'Hara

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 15% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. 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

8 authors at 2 institutions in 1 country.

Joshua Kyle NaporaDepartment of Orthopaedics, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA jknapora@gmail.com.ORCID 0000-0001-6516-0273
Haley DemyanovichOrthopedics, University of Maryland, Baltimore, Maryland, USA.
Alexandra MullikenOrthopedics, University of Maryland, Baltimore, Maryland, USA.
Kimberly OslinOrthopedics, University of Maryland, Baltimore, Maryland, USA.
Raymond PensyOrthopedics, University of Maryland, Baltimore, Maryland, USA.
Gerard SlobogeanOrthopedics, University of Maryland, Baltimore, Maryland, USA.
Robert V O'TooleOrthopedics, University of Maryland, Baltimore, Maryland, USA.ORCID 0000-0003-0537-3474
Nathan O'HaraOrthopedics, University of Maryland, Baltimore, Maryland, USA.ORCID 0000-0003-0537-3474
University of Maryland, Baltimore · USUniversity Hospitals of Cleveland · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveOccupational therapy is often prescribed after the acute treatment of upper extremity fractures. However, high out-of-pocket expenses and logistical constraints can reduce access to formal therapy services. We aimed to quantify preferences of patients with upper extremity fracture for attending occupational therapy, when considering possible differences in clinical outcomes.

designDiscrete choice experiment.

settingLevel 1 trauma centre in Baltimore, Maryland, USA.

participants134 adult patients with upper extremity fractures. PRIMARY OUTCOME MEASURES: The scenarios were described with five attributes: cost, duration of therapy session, location of therapy, final range of motion and pain. We report the relative importance of each attribute as a proportion of total importance, and the willingness to pay for benefits of the therapy services.

resultsOf the 134 study participants, the mean age was 47 years and 53% were men. Cost (32%) and range of motion (29%) were the attributes of greatest relative importance. Pain (17%), duration of therapy (13%) and location of therapy (8%) were of lesser importance. Patients were willing to pay $85 more per therapy session for a 40% improvement in their range of motion. Patients were willing to pay $43 more per therapy session to improve from severe pain to mild pain. Patients were indifferent to whether the therapy treatment was home-based or in a clinical environment.

conclusionsWhen deciding on an upper extremity fracture therapy programme, out-of-pocket costs are a paramount consideration of patients. Improvements in range of motion are of greater importance than residual pain, the duration of therapy sessions and the location of service provision. Patients with upper extremity fracture should be prescribed occupational therapy services that align with these patients' preferences.

Indexed as

Fractures, BoneOccupational TherapyAdultFemaleHealth ExpendituresHumansMaleMiddle AgedPatient PreferenceUpper Extremityelbow & shoulderhand & wristtrauma management

Identifiers

PMID33055120
PMCPMC7559050
OpenAlexW3092682458

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.