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Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction

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  • Dun-Hao Chang

    (Division of Plastic and Aesthetic Surgery, Department of Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banciao District, New Taipei City 22060, Taiwan
    Department of Information Management, Yuan Ze University, No. 135 Yuan-Tung Road, Chung-Li, Taoyuan City 32003, Taiwan
    School of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei 11221, Taiwan)

  • Yu-Hsiang Wang

    (Department of Surgery, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung City 40201, Taiwan)

  • Chi-Ying Hsieh

    (Division of Plastic and Aesthetic Surgery, Department of Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banciao District, New Taipei City 22060, Taiwan)

  • Che-Wei Chang

    (Division of Plastic and Aesthetic Surgery, Department of Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banciao District, New Taipei City 22060, Taiwan
    Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei 10617, Taiwan)

  • Ke-Chung Chang

    (Division of Plastic and Aesthetic Surgery, Department of Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banciao District, New Taipei City 22060, Taiwan)

  • Yo-Shen Chen

    (Division of Plastic and Aesthetic Surgery, Department of Surgery, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya S. Road, Banciao District, New Taipei City 22060, Taiwan
    School of Medicine, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei 10617, Taiwan)

Abstract

Background: Few studies have addressed patient preferences in emergent surgical decision making. Aim of the study: Analyzing patient preferences for hand trauma reconstruction to propose a decision-making model. Methods: A conjoint analysis survey was developed with Sawtooth Software. Three common flaps—i.e., a cross-finger flap (CFF), a dorsal metacarpal artery perforator flap (DMAPF), and an arterialized venous flap (AVF)—were listed as treatment alternatives. Five attributes corresponding to these flaps were recovery time, total procedure, postoperative care methods, postoperative scar condition, and complication rate. Utility and importance scores were generated from the software, and preference characteristics were evaluated using cluster analysis. Results: The survey was completed by 197 participants with hand trauma. Complication risk received the highest importance score (42.87%), followed by scar condition (21.55%). Cluster analysis classified the participants as “conservative,” “practical,” and “dual-concern”. The dual-concern and conservative groups had more foreign laborers and highly educated participants, respectively, than the other groups. Most participants in the conservative and practical groups preferred DMAPF, whereas those in the dual-concern group favored CFF. Our proposed model consisted of shared decision-making and treatment recommendation pathways. Conclusion: Incorporating patient preferences into the decision-making model can strengthen patient-centered care. Further research on the applications of the proposed model is warranted.

Suggested Citation

  • Dun-Hao Chang & Yu-Hsiang Wang & Chi-Ying Hsieh & Che-Wei Chang & Ke-Chung Chang & Yo-Shen Chen, 2021. "Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction," IJERPH, MDPI, vol. 18(21), pages 1-13, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:21:p:11081-:d:661732
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    References listed on IDEAS

    as
    1. Thomas Wilke, 2009. "Patient Preferences for an Oral Anticoagulant after Major Orthopedic Surgery," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 2(1), pages 39-49, March.
    2. Stephen G. Pauker, 2010. "Medical Decision Making: How Patients Choose," Medical Decision Making, , vol. 30(5_suppl), pages 8-10, September.
    3. F. Reed Johnson & Kristy E. Mathews, 2001. "Sources and Effects of Utility-Theoretic Inconsistency in Stated-Preference Surveys," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 83(5), pages 1328-1333.
    4. Azza Shaoibi & Brian Neelon & Leslie A. Lenert, 2020. "Shared Decision Making: From Decision Science to Data Science," Medical Decision Making, , vol. 40(3), pages 254-265, April.
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    Cited by:

    1. Chien-Lung Chan & Chi-Chang Chang, 2022. "Big Data, Decision Models, and Public Health," IJERPH, MDPI, vol. 19(14), pages 1-9, July.

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