title: Patients' values and preferences of the expected efficacy of hip arthroscopy for osteoarthritis: a protocol for a multinational structured interview-based study combined with a randomised survey on the optimal amount of information to elicit preferences.
abstract: BACKGROUND
  Symptomatic hip osteoarthritis (OA) is a disabling condition with up to a 25% cumulative lifetime risk. Total hip arthroplasty (THA) is effective in relieving patients' symptoms and improving function. It is, however, associated with substantial risk of complications, pain and major functional limitation before patients can return to full function. In contrast, hip arthroscopy (HA) is less invasive and can postpone THA. However, there is no evidence regarding the delay in the need for THA that patients would find acceptable to undergoing HA. Knowing patients' values and preferences (VP) on this expected delay is critical when making recommendations regarding the advisability of HA. Furthermore, little is known on the optimal amount of information regarding interventions and outcomes needed to present in order to optimally elicit patients' VP.
  
  
  METHODS
  We will perform a multinational, structured interview-based survey of preference in delay time for THA among patients with non-advanced OA who failed to respond to conservative therapy. We will combine these interviews with a randomised trial addressing the optimal amount of information regarding the interventions and outcomes required to elicit preferences. Eligible patients will be randomly assigned (1 : 1) to either a short or a long format of health scenarios of THA and HA. We will determine each patient's VP using a trade-off and anticipated regret exercises. Our primary outcomes for the combined surveys will be: (1) the minimal delay time in the need for THA surgery that patients would find acceptable to undertaking HA, (2) patients' satisfaction with the amount of information provided in the health scenarios used to elicit their VPs.
  
  
  BACKGROUND
  The protocol has been approved by the Hamilton Integrated Research Ethics Board (HIREB13-506). We will disseminate our study findings through peer-reviewed publications and conference presentations, and make them available to guideline makers issuing recommendations addressing HA and THA.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Yuqing
authors.identifier: http://orcid.org/0000-0002-6318-3575
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.|Departments of Urology and Public Health, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Kari A O
authors.initials: KAO
authors.lastname: Tikkinen
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Agoritsas
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Olufemi R
authors.initials: OR
authors.lastname: Ayeni
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Alexander
authors.affiliation: Faculty of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada.
authors.forename: Maha
authors.initials: M
authors.lastname: Imam
authors.affiliation: Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Yoo
authors.affiliation: Division of Evidence-based Medicine, University of South Florida, Tampa, Florida, USA.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Tsalatsanis
authors.affiliation: Department of Internal Medicine, University of South Florida, Tampa, Florida, USA.|H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Djulbegovic
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, and Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Holger
authors.initials: H
authors.lastname: Schünemann
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, and Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Guyatt
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Decision Making; Hip Arthroscopy; Patient Written Information; Patients' values and preference; Total Hip Arthroplasty