Evidence map›Paper›PMID 39267183›Full record

ArticleImplementation science communications2024

Refining, implementing, and evaluating an anesthesia choice conversation aid for older adults with hip fracture: protocol for a stepped wedge cluster randomized trial.

Eliana C Goldstein, Mary C Politi, James H Baraldi, Glyn Elwyn, Hugo Campos, Rui Feng, Samir Mehta, Karah Whatley, Viktoria Schmitz, Mark D Neuman

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Implementation science communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06438640 (Implementation and Evaluation of a Strategy to Improve Pre-Anesthesia Care Discussions), which is not on this 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
–field-weighted citation impact
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.

NCT06438640 narecruitingnot on this map

Implementation and Evaluation of a Strategy to Improve Pre-Anesthesia Care Discussions (My Anesthesia Choice-Hip Fracture)

TypeinterventionalSponsorUniversity of PennsylvaniaRan2024 to 2028Enrolled1,881ConditionsHip Fractures, Femoral Neck Fractures, Intertrochanteric Fractures, Subtrochanteric FracturesArmsMy Anesthesia Choice-HF Model
3 · Its place in the literature

Who cites it

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

  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

10 authors.

Eliana C GoldsteinDivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, 660 S Euclid Ave, Campus MSC 8100-94-02, St. Louis, MO, 63110, USA.
Mary C PolitiDivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, 660 S Euclid Ave, Campus MSC 8100-94-02, St. Louis, MO, 63110, USA.ORCID http://orcid.org/0000-0001-9103-6495
James H BaraldiDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, 308 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA.ORCID http://orcid.org/0000-0002-6312-3812
Glyn ElwynDartmouth College, 74 College Street, Hanover, NH, 03755, USA.
Hugo CamposPatient partner, Oakland, CA, USA.
Rui FengDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Samir MehtaOrthopaedic Trauma & Fracture Service, Department of Orthopaedic Surgery, Penn Medicine, 3737 Market Street, Philadelphia, PA, 19104, USA.
Karah WhatleyDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, 308 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
Viktoria SchmitzDivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, 660 S Euclid Ave, Campus MSC 8100-94-02, St. Louis, MO, 63110, USA.
Mark D NeumanDepartment of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, 308 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA. mark.neuman@uphs.upenn.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHip fracture surgery under general or spinal anesthesia is a common procedure for older adults in the United States (US). Although spinal or general anesthesia can be appropriate for many patients, and the choice between anesthesia types is preference-sensitive, shared decision-making is not consistently used by anesthesiologists counseling patients on anesthesia for this procedure. We designed an Option Grid™-style conversation aid, My Anesthesia Choice─Hip Fracture, to promote shared decision making in this interaction. This study will refine the aid and evaluate its implementation and effectiveness in clinical practice.

methodsThe study will be conducted over 2 phases: qualitative interviews with relevant clinicians and patients to refine the aid, followed by a stepped wedge cluster randomized trial of the intervention at 6 settings in the US. Primary outcomes will include the percentage of eligible patients who receive the intervention (intervention reach) and the change in quality of patient/clinician communication (intervention effectiveness). Secondary outcomes addressing other RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) domains will also be collected. Outcomes will be compared between baseline data and an active implementation period and then compared between the active implementation period and a sustainment period. Implementation strategies are guided by three constructs from the Practical, Robust Implementation and Sustainability Model (PRISM): intervention, recipients, and implementation and sustainability infrastructure. DISCUSSION: This is a novel, large-scale trial evaluating and implementing a shared decision-making conversation aid for anesthesia choices. Strong buy-in from site leads and expert advisors will support both the success of implementation and the future dissemination of results and the intervention. Results from this study will inform the broader implementation of this aid for patients with hip fractures and can lead to the development and implementation of similar conversation aids for other anesthesia choices.

trial registrationClinicalTrials.gov, NCT06438640.

Indexed as

AnesthesiaHip fractureImplementation sciencePatient-centered outcomesPerioperative careShared decision making

Identifiers

PMID39267183
PMCPMC11396076

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.