title: An interactive videodisc program for low back pain patients.
abstract: Decisions about back pain treatment are often made in the presence of both physician and patient uncertainty. Therefore, we developed a computerized, interactive video program to help patients make informed decisions about undergoing low back surgery. Program development was guided by the shared decision-making model, a comprehensive literature synthesis, information from administrative databases, and focus groups of patients and physicians. Core segments are tailored to each patient's age and diagnosis; and include a narrative, excerpts from patient interviews, animated graphics illustrating spinal anatomy, and tabular summaries of the benefits and risks of both surgical and non-surgical treatment. As part of a multifocal information dissemination effort, interactive videodiscs were placed in five medical facilities in two Washington State counties. Patients (N = 239) who viewed the video program completed short evaluation forms. The majority rated the video's understandability (84%) and interest (64%) as very good or excellent. Most patients felt the amount of information provided was appropriate (75%) and over half (56%) believed the discussion of surgical versus non-surgical treatment was completely balanced. Fewer patients (17%) remained undecided about therapy after watching the program than before (29%). We conclude that interactive videodisc technology offers substantial promise as a means of involving patients in their own medical decision making.
authors.affiliation: Department of Health Services, University of Washington, Seattle 98105, USA.
authors.forename: B S
authors.initials: BS
authors.lastname: Spunt
authors.forename: R A
authors.initials: RA
authors.lastname: Deyo
authors.forename: V M
authors.initials: VM
authors.lastname: Taylor
authors.forename: K M
authors.initials: KM
authors.lastname: Leek
authors.forename: H I
authors.initials: HI
authors.lastname: Goldberg
authors.forename: A G
authors.initials: AG
authors.lastname: Mulley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D015397:Program Evaluation; D012307:Risk Factors; D014742:Videodisc Recording