ArticleBMC musculoskeletal disorders2022
Evaluating willingness for surgery using the SMART Choice (Knee) patient prognostic tool for total knee arthroplasty: study protocol for a pragmatic randomised controlled trial.
Article in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Effect of financial health risk protection education on health insurance knowledge and enrollment willingness among rural households in Tanzania: a cluster randomized controlled trial.BMC public health · 2025Trial
- Predictive Tool Use and Willingness for Surgery in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Evaluating a web-based personalized decision report for total knee or hip replacement: Lessons learned from patients.Journal of evaluation in clinical practice · 2023Trial
- A narrative review of the use of PROMs and machine learning to impact value-based clinical decision-making.BMC medical informatics and decision making · 2025Review
- Application of Artificial Intelligence and its Subsets in Various Stages of Knee Arthroplasty from Pre-op to Post-op: An Overview.Journal of orthopaedics and sports medicine · 2025Article
- The ability of artificial intelligence tools to formulate orthopaedic clinical decisions in comparison to human clinicians: An analysis of ChatGPT 3.5, ChatGPT 4, and Bard.Journal of orthopaedics · 2024Article
- Global mapping of institutional and hospital-based (Level II-IV) arthroplasty registries: a scoping review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Patients' perspectives on the benefits of feedback on patient-reported outcome measures in a web-based personalized decision report for hip and knee osteoarthritis.BMC musculoskeletal disorders · 2022Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundApproximately 1 in 5 patients feel unsatisfied after total knee arthroplasty (TKA). Prognostic tools may aid in the patient selection process and reduce the proportion of patients who experience unsatisfactory surgery. This study uses the prognostic tool SMART Choice (Patient Prognostic Tool for Total Knee Arthroplasty) to predict patient improvement after TKA. The tool aims to be used by the patient without clinician input and does not require clinical data such as X-ray findings or blood results. The objective of this study is to evaluate the SMART Choice tool on patient decision making, particularly willingness for surgery. We hypothesise that the use of the SMART Choice tool will influence willingness to undergo surgery, especially when used earlier in the patient TKA journey.
methodsThis is a multicentred, pragmatic, randomised controlled trial conducted in Melbourne, Australia. Participants will be recruited from the St. Vincent's Hospital, Melbourne (SVHM) Orthopaedic Clinic, and the client base of HCF, Australia (private health insurance company). Patients over 45 years of age who have been diagnosed with knee osteoarthritis and considering TKA are eligible for participation. Participants will be randomised to either use the SMART Choice tool or treatment as usual. The SMART Choice tool provides users with a prediction for improvement or deterioration / no change after surgery based on utility score change calculated from the Veterans-RAND 12 (VR-12) survey. The primary outcome of the study is patient willingness for TKA surgery. The secondary outcomes include evaluating the optimal timing for tool use and using decision quality questionnaires to understand the patient experience when using the tool. Participants will be followed up for 6 months from the time of recruitment. DISCUSSION: The SMART Choice tool has the potential to improve patient decision making for TKA. Although many prognostic tools have been developed for other areas of surgery, most are confined within academic bodies of work. This study will be one of the first to evaluate the impact of a prognostic tool on patient decision making using a prospective clinical trial, an important step in transitioning the tool for use in clinical practice.
trial registrationAustralia and New Zealand Clinical Trials Registry (ANZCTR) - ACTRN12622000072718 . Prospectively registered - 21 January 2022.
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