Patients’ Preferences for Bone-Anchored Prostheses After Lower-Extremity Amputation ; A 2-Center Discrete Choice Experiment in The Netherlands (PREFER-BAP-1)

Background: The rising popularity and use of a bone-anchored prosthesis (BAP) involving an osseointegrated implant for patients with lower-limb amputations experiencing socket-related issues have led to increased interest in the measurement of clinical and functional outcomes. However, the value of BAP treatment characteristics from the patient perspective has not yet been investigated. This study aimed to determine the relative importance of specific BAP characteristics, and the effect of complications in quality-of-life (QoL) points and monetary utility decrement (loss [€]), using a 2-center... Mehr ...

Verfasser: Saleib, Gabriel-Kyrillos M.
Jonker, Marcel F.
Van Vledder, Mark G.
Verhofstad, Michael H.J.
Paping, Maria A.
Leijendekkers, Ruud A.
Van Waes, Oscar J.F.
Dokumenttyp: Artikel
Erscheinungsdatum: 2024
Reihe/Periodikum: Journal of Bone and Joint Surgery ; ISSN 0021-9355 1535-1386
Verlag/Hrsg.: Ovid Technologies (Wolters Kluwer Health)
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29616255
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.2106/jbjs.24.00204

Background: The rising popularity and use of a bone-anchored prosthesis (BAP) involving an osseointegrated implant for patients with lower-limb amputations experiencing socket-related issues have led to increased interest in the measurement of clinical and functional outcomes. However, the value of BAP treatment characteristics from the patient perspective has not yet been investigated. This study aimed to determine the relative importance of specific BAP characteristics, and the effect of complications in quality-of-life (QoL) points and monetary utility decrement (loss [€]), using a 2-center discrete choice experiment (DCE) conducted in The Netherlands. Methods: A DCE was developed that included the most salient characteristics of BAP treatment based on a review of the literature and qualitative and quantitative methods. The following characteristics were selected: QoL change, short- and long-term complications, osseointegrated implant survival, and out-of-pocket contributions (costs). Patients aged 18 to 99 years who were eligible for, or had already received, an osseointegrated implant were invited to participate, after informed consent, to elicit BAP treatment preferences. A Bayesian mixed logit model was used. Results: Two hundred and forty-seven completed surveys were collected; 64% of the patients were male, 73% had undergone a transfemoral amputation, and 33% had >36 months of experience with a BAP. Patients considered long-term complications and QoL the most important characteristics. Long-term complications were 3.4 times more important than short-term complications. Opting out was undesirable, and patients valued better and beneficial levels (associated with better outcomes) of BAP characteristics positively. Implant removal was the level with the greatest loss among all complications, at 1.15 (95% credible interval [CI], 0.96 to 1.38) QoL points and €16,940 (95% CI, €14,780 to €19,040) loss. Conclusions: To our knowledge, this is the first study to use a DCE to elicit patients’ preferences ...