title: Predictors of retention and attrition in a study of an advanced upper limb prosthesis: implications for adoption of the DEKA Arm.
abstract: The purpose was to identify factors associated with completion of the VA home study of the DEKA Arm. Design and methodological procedures used: Differences between groups were examined using chi-square and t-tests. A multivariable logistic regression model predicting completion was generated and odds ratios (OR) for significant variables calculated. Post-hoc analysis was performed to plot the receiver operating characteristics (ROC) curve.
  
  
  
  Participants who completed were more likely to be prosthesis users at study onset (p = .03), and less likely to have a history of musculoskeletal problems (p = .047). There were no statistically significant differences between groups who completed and those who did not in gender, race, veteran status, age, body mass index (BMI), weight, height, musculoskeletal pain at baseline, satisfaction with current prosthesis, type of prosthesis, or months of prosthesis use. Two variables, prosthesis use and history of musculoskeletal problems were significant at p < .10. The area under the curve (AUC) accuracy index was 0.78.
  
  
  
  We considered completion of the home use study a reasonable proxy for participant willingness to adopt the device; and believe that findings can be extrapolated to guide DEKA Arm prescription recommendations. Participants most likely to complete the study were already using a personal prosthesis, and without pre-existing musculoskeletal problems. Implications for rehabilitation Data from the VA Study of the DEKA Arm were analysed to determine which factors were associated with likely successful adoption of the DEKA Arm. Participants most likely to complete the study were those who already using a personal prosthesis, and those without pre-existing chronic or re-occurring musculoskeletal problems. This information may be useful when attempting to identify and target the most appropriate candidates for DEKA Arm prescription.
authors.affiliation: a Providence VA Medical Center , Providence , RI , USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Resnik
authors.affiliation: b Extremity Trauma and Amputation Center of Excellence (EACE) , Military Performance Lab, Center for the Intrepid, Brooke Army Medical Center , Fort Sam Houston , TX , USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Cancio
authors.affiliation: a Providence VA Medical Center , Providence , RI , USA.
authors.forename: Shana
authors.initials: S
authors.lastname: Klinger
authors.affiliation: c Southeast Regional Amputation Center, JAH-VAMC , Tampa , FL , USA.|d Department of Neurology, College of Medicine, Division of PM&R , University of South Florida , Tampa , FL , USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Latlief
authors.affiliation: e New York Harbor Healthcare System , New York University School of Medicine/Rusk Institute , New York , NY , USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Sasson
authors.affiliation: f Department of Advanced Arm Dynamics , Guld Coast Center of Excellence , Houston , TX , USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Smurr-Walters
mesh_terms: D000367:Age Factors; D000671:Amputation, Surgical / Q000534:rehabilitation; D000674:Amputees / Q000523:psychology* / Q000534:rehabilitation*; D001132:Arm; D001186:Artificial Limbs; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010352:Patient Dropouts; D017060:Patient Satisfaction; D011474:Prosthesis Design; D012107:Research Design; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D014493:United States Department of Veterans Affairs
keywords: Amputation; DEKA Arm; attrition; prosthetics; research design; upper limb