![]() 8 For some conditions, patients were also more likely to choose less invasive treatment options. A Cochrane review of 105 studies (n=31 043) found that people exposed to decision aids made more informed choices about their healthcare and had a more active role in decision making, with no negative effects on outcomes or satisfaction. A decision aid on options for treating subacromial pain syndrome could help patients make informed treatment choices and result in less use of unnecessary surgery. ![]() Patient decision aids present unbiased information on the benefits and harms of different healthcare options. 1 Increases have also been reported in the USA, 4 England 2 7 and Finland. In Australia, the annual number of subacromial decompression surgeries performed increased from 3536 to 7455 between 20, while the number of rotator cuff repair surgeries performed increased from 6212 to 12 436 during this period. Use of subacromial decompression surgery and rotator cuff repair surgery is increasing globally 1–4 despite the above evidence, suggesting people may not be making informed treatment choices. 6 Serious harms (eg, infection) are experienced by 6/1000 people who have arthroscopic shoulder surgery. 5 Rotator cuff repair surgery is not superior to non-surgical options for degenerative rotator cuff tears (low-certainty to moderate-certainty evidence). Subacromial decompression surgery is not superior to placebo (high-certainty evidence) or non-surgical options, such as exercise and glucocorticoid injections (low-certainty to moderate-certainty evidence), for improving pain and function in people with subacromial pain syndrome. Subacromial decompression surgery and rotator cuff repair surgery (with or without decompression) are frequently performed for people with subacromial pain syndrome 1–4-an umbrella diagnosis that accounts for 85% of cases of shoulder pain (including rotator cuff tears)-but evidence suggests these procedures provide limited clinical benefit. Limitations include a small sample size for our quantitative acceptability data, being unable to recruit certain groups of health professionals (eg, rheumatologists, sports doctors) and only interviewing people who speak English. Our decision aid includes several key features recommended to optimise risk communication (eg, presenting numeric estimates, presenting uncertainty, using visuals, tailoring estimates). We developed the patient decision aid with guidance from the International Patient Decision Aids Standards, used a mixed-methods approach to evaluate useability and acceptability, interviewed a broad range of health professionals and patients, and conducted one-on-one interviews which allowed in-depth feedback on the decision aid. This is the first study to rigorously describe the development of a patient decision aid for people with subacromial pain syndrome that presents evidence-based information on the benefits and harms of subacromial decompression surgery and rotator cuff repair surgery, compared with non-surgical options. 8 Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australiaĭr Joshua Zadro.7 Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.6 School of Public Health, University of Sydney, Camperdown, New South Wales, Australia.5 Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.4 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.3 Dept of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.2 Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, New South Wales, Australia.1 Institute for Musculoskeletal Health, Sydney School of Public Health, University of Sydney and Sydney Local Health District, Camperdown, New South Wales, Australia.
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