Decision Aid Implementation and Patients’ Preferences for Hip and Knee Osteoarthritis Treatment: Insights from the High Value Healthcare Collaborative

Figures & data

Table 1 Descriptive Statistics for DA Exposed Knee and Hip Patients Across All HVHC Systems

	Knee (N = 1343)		Hip (N = 495)
	N	% of Column Total	N	% of Column Total
Age (Mean, SD)	59.3 (9.6)		58.5 (10.1)
Gender
Female	869	64.7	278	56.1
Male	474	35.3	217	43.8
Race (vs White)
Non-White/Other	358	26.7	85	17.1
White	985	73.3	410	82.8
Marital Status
Unmarried	591	44	200	40.4
Married	752	56	295	59.6
Pre-DA Uncertain	384	28.6	117	23.6
Switched Preference Post-DA (from pre-DA choice)
Uncertain to Surgical	55	4.1	22	4.4
Uncertain to Non-Surgical	71	5.3	11	2.2
Other	82	6.1	24	4.8
Stable Preferences	1135	84.5	438	88.5
Decision Making Stage Post-DA
Increase	262	19.5	63	12.7
Stable	971	72.3	396	80
Decrease	85	6.3	29	5.9
Charlson Comorbidity Index (Mean, SD)	1.38 (2.00)		1.40 (2.79)
Pain Score (HOOS or KOOS)	52.7 (18.5)		54.8 (19.8)
Education Level
Less than/Graduated High School/GED	389	29	110	22.2
Some College/Graduated from College	699	52	277	56
Postgraduate Education	255	19	108	21.8

Notes: Other includes patients switching from a surgical or non-surgical preference to uncertain, patients switching from a surgical preference to non-surgical preference post-DA exposure, and patients switching from a non-surgical preference to surgical preference post-DA exposure. Includes patients who were continuously uncertain (pre- and post-DA).

Table 2 Association Between Patient Characteristics and Post-DA Surgical Choice, All HVHC Systems

	Patients Choosing Surgery Post-DA
	Knee (n = 648)		Hip (n = 311)
	Adjusted Model	CI	Adjusted Model	CI
Age	Age (Reference: 51–64)		Age (Reference: 64 and under)
Under 50	0.89	0.60–1.32	N/A	N/A
65+	0.79	0.58–1.07	1.03	0.61–1.73
Gender
Female	0.57**	0.43–0.75	1.12	0.70–1.80
Male	Ref	Ref	Ref	Ref
Race (vs White)
Hispanic	1.27	0.77–2.08	0.87	0.20–3.71
Non-White/Other	1.15	0.81–1.63	0.79	0.43–1.48
White	Ref	Ref	Ref	Ref
Marital Status
Unmarried	1.00	0.76–1.31	0.52**	0.32–0.85
Married	Ref	Ref	Ref	Ref
Pre-DA Uncertainty	0.09**	0.06–1.14	0.06**	0.03–0.11
Switched Preference Post-DA (from pre-DA choice)	0.91	0.82–1.36	0.80	0.39–1.67
Decision Making Stage Post-DA
Stable	3.72**	2.06–6.69	1.07	0.29–2.69
Increase	0.89	0.28–4.57	0.89	0.41–2.80
Decrease	Ref	Ref	Ref	Ref
Charlson Comorbidity Index	0.93**	0.88–0.99	1.01	0.92–1.12
Pain Score (HOOS or KOOS)	1.04**	1.03–1.05	1.05**	1.03–1.06
Education Level
Some College/Graduated from College	1.15	0.76–1.73	1.33	0.74–2.39
Postgraduate Education	1.10	0.79–1.52
Less than/Graduated High School/GED	Ref	Ref	Ref	Ref

Note: **p<0.01.

Table 3 Association Between Patient Characteristics and Post-DA Surgical Choice, Upstream Implementing HVHC Systems Only

	Adjusted Model	Confidence Interval (CI)	Adjusted Model	CI
	Knee Patients (n = 246)		Hip Patients (n = 75)
Age	Age (Reference: 51–64)		Age (Reference: 64 and Under)
Under 50	0.77	0.27–2.19	N/A	N/A
65+	0.58	0.30–1.12	0.98	0.19–5.05
Gender
Female	0.66	0.32–1.37	0.86	0.11–6.70
Male	Ref		Ref
Race
Hispanic	0.93	0.15–5.63		N/A
Other/Non-white	0.94	0.23–3.84	1.85	0.15–23.45
White	Ref		Ref
Marital Status
Not Married	1.37	0.69–2.71	1.81	0.22–15.12
Married	Ref		Ref
Pre-DA Uncertainty	0.17**	0.07–0.43	<0.001*	<0.001–0.05
Switched Preference Post-DA (from pre-DA choice)	1.32	0.45–3.83	1.91	0.06–65.58
Decision Making Stage
Stable	2.82	0.58–13.66	3.57	0.14–92.45
Increase	1.93	0.38–9.87	3.44	0.07–166.20
Decrease	Ref		Ref
Charlson Comorbidity Index	1.04	0.91–1.20	1.23	0.74–2.03
Pain Score	1.04**	1.02–1.06	1.19**	1.07–1.31
Education
Some College/College Graduate	1.47	0.71–3.04	6.34	0.89–45.20
Postgraduate Education	1.36	0.52–3.57	N/A	N/A
Graduated High School	Ref		Ref

Notes: *p<0.05, **p<0.01.