Research Award Details

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Shared Decision Making in the Treatment of Scoliosis

Grant Recipient: Juan Brito Campana, MD

Co-Investigators: A. Noelle Larson, MD
Institution:
Mayo Clinic
Presentations & Publications:

Presentations: None

Publications: Manuscript summarizing the Scoliosis Choice development is in preparation

Further Funding:
Additional Information:
The development of Scoliosis Choice took place at the Pediatrics Orthopaedic Clinic within the division of Orthopaedic Surgery at the Mayo Clinic (Rochester, MN). This group includes four pediatric orthopaedic surgeons with expertise in scoliosis management. Eligible patients were identified via the upcoming schedules of said surgeons. Eligible patients included adolescent idiopathic scoliosis (AIS) patients 13 or more years of age with less than 1 year of growth remaining (Risser stage 3 or greater) and scoliosis curves between 40-65 degrees.

The study team reviewed research evidence addressing operative and non-operative management of AIS, including information on the safety, risks, benefits, costs, and quality of life. This information was the primary source of data presented on the Scoliosis Choice. Following the synthesis of this information, 22 standard-of-care videos were collected of patients, families, and surgeons deciding whether to proceed with spinal fusion surgery. One individual (who was neither a patient nor a clinician) analyzed the interactions using validated Mayo Clinic Knowledge Evaluation Research (KER) Unit methodology, looking for patterns of patient-clinician conversations regarding the treatment of scoliosis. Salient themes of patient priorities included benefits; complications; pain; scheduling and recovery; and cost. Previously synthesized evidence was then prioritized and organized according to these priorities. The initial prototype of the Scoliosis Choice was finalized through a series of discussions with members of the study teams and clinicians about the content, format, and ease of use of the prototype; how the prototype affects their knowledge and addresses the salient themes raised; and its focus on patient context, values, and preferences for decision making.