{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T02:18:31Z","timestamp":1768875511820,"version":"3.49.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Despite the increasing number of tools available to predict the outcomes of total knee arthroplasty (TKA), the effect of these predictive tools on patient decision-making remains uncertain.<\/jats:p><\/jats:sec>Objective<\/jats:title>To assess the effect of an online predictive tool on patient-reported willingness to undergo TKA.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This parallel, double-masked, 2-arm randomized clinical trial compared predictive tool use with treatment as usual (TAU). The study was conducted between June 30, 2022, and July 31, 2023. Participants were followed up for 6 months after enrollment. Participants were recruited from a major Australian private health insurance company and from the surgical waiting list for publicly funded TKA at a tertiary hospital. Eligible participants had unilateral knee osteoarthritis, were contemplating TKA, and had previously tried nonsurgical interventions, such as lifestyle modifications, physiotherapy, and pain medications.<\/jats:p><\/jats:sec>Intervention<\/jats:title>The intervention group was provided access to an online predictive tool at the beginning of the study. This tool offered information regarding the likelihood of improvement in quality of life if patients chose to undergo TKA. The predictions were based on the patient\u2019s age, sex, and baseline symptoms. Conversely, the control group received TAU without access to the predictive tool.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome measure was the reduction in participants\u2019 willingness to undergo surgery at 6 months after tool use as measured by binomial logistic regression. Secondary outcome measures included participant treatment preference and the quality of their decision-making process as measured by the Knee Decision Quality Instrument.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 211 randomized participants (mean [SD] age, 65.8 [8.3] years; 118 female [55.9%]), 105 were allocated to the predictive tool group and 106 to the TAU group. After adjusting for baseline differences in willingness for surgery, the predictive tool did not significantly reduce the primary outcome of willingness for surgery at 6 months (adjusted odds ratio, 0.85; 95% CI, 0.42-1.71; P<\/jats:italic>\u2009=\u2009.64).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Despite the absence of treatment effect on willingness for TKA, predictive tools might still enhance health outcomes of patients with knee osteoarthritis. Additional research is needed to optimize the design and implementation of predictive tools, address limitations, and fully understand their effect on the decision-making process in TKA.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ANZCTR.org.au Identifier: ACTRN12622000072718<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.0890","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T16:31:15Z","timestamp":1709915475000},"page":"e240890","source":"Crossref","is-referenced-by-count":3,"title":["Predictive Tool Use and Willingness for Surgery in Patients With Knee Osteoarthritis"],"prefix":"10.1001","volume":"7","author":[{"given":"Yushy","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Department of Orthopaedic Surgery, St Vincent\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Patten","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Department of Orthopaedic Surgery, St Vincent\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Spelman","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Bunzli","sequence":"additional","affiliation":[{"name":"School of Health Sciences and Social Work, Griffith University, Nathan Campus, Brisbane, Queensland, Australia"},{"name":"Physiotherapy Department, Royal Brisbane and Women\u2019s Hospital, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter F. M.","family":"Choong","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle M.","family":"Dowsey","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Department of Orthopaedic Surgery, St Vincent\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Schilling","sequence":"additional","affiliation":[{"name":"Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2024,3,8]]},"reference":[{"issue":"12","key":"zoi240062r1","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.1302\/0301-620X.104B12.BJJ-2022-0922.R1","article-title":"Concerns surrounding application of artificial intelligence in hip and knee arthroplasty: a review of literature and recommendations for meaningful adoption.","volume":"104-B","author":"Polisetty","year":"2022","journal-title":"Bone Joint J"},{"issue":"1","key":"zoi240062r2","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s42836-022-00118-7","article-title":"Artificial intelligence in diagnosis of knee osteoarthritis and prediction of arthroplasty outcomes: a review.","volume":"4","author":"Lee","year":"2022","journal-title":"Arthroplasty"},{"issue":"10","key":"zoi240062r3","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.1016\/j.arth.2022.10.039","article-title":"The impact of machine learning on total joint arthroplasty patient outcomes: a systemic review.","volume":"38","author":"Karlin","year":"2023","journal-title":"J Arthroplasty"},{"issue":"7","key":"zoi240062r4","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1530\/EOR-21-0107","article-title":"The current role of the virtual elements of artificial intelligence in total knee arthroplasty.","volume":"7","author":"Rodr\u00edguez-Merch\u00e1n","year":"2022","journal-title":"EFORT Open Rev"},{"issue":"1","key":"zoi240062r5","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s42836-022-00119-6","article-title":"Artificial intelligence in knee arthroplasty: current concept of the available clinical applications.","volume":"4","author":"Batailler","year":"2022","journal-title":"Arthroplasty"},{"issue":"2","key":"zoi240062r6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.37107","article-title":"Comparison of an artificial intelligence-enabled patient decision aid vs educational material on decision quality, shared decision-making, patient experience, and functional outcomes in adults with knee osteoarthritis: a randomized clinical trial.","volume":"4","author":"Jayakumar","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"3","key":"zoi240062r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocarto.2022.100286","article-title":"An online individualised patient decision aid improves the quality of decisions in patients considering total knee arthroplasty in routine care: a randomized controlled trial.","volume":"4","author":"Bansback","year":"2022","journal-title":"Osteoarthr Cartil Open"},{"issue":"12","key":"zoi240062r8","doi-asserted-by":"publisher","first-page":"3854","DOI":"10.1016\/j.arth.2017.07.021","article-title":"Patient dissatisfaction following total knee arthroplasty: a systematic review of the literature.","volume":"32","author":"Gunaratne","year":"2017","journal-title":"J Arthroplasty"},{"issue":"3","key":"zoi240062r9","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1016\/j.arth.2022.10.011","article-title":"Are 20% of patients actually dissatisfied following total knee arthroplasty? a systematic review of the literature.","volume":"38","author":"DeFrance","year":"2023","journal-title":"J Arthroplasty"},{"issue":"1","key":"zoi240062r10","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s11999-009-1119-9","article-title":"Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?","volume":"468","author":"Bourne","year":"2010","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"zoi240062r11","doi-asserted-by":"publisher","first-page":"135","DOI":"10.5694\/mja2.v210.3","article-title":"Selecting and optimising patients for total knee arthroplasty.","volume":"210","author":"Adie","year":"2019","journal-title":"Med J Aust"},{"issue":"8","key":"zoi240062r12","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.3899\/jrheum.190467","article-title":"Use of recommended non-surgical knee osteoarthritis management in patients prior to total knee arthroplasty: a cross-sectional study.","volume":"47","author":"King","year":"2020","journal-title":"J Rheumatol"},{"issue":"3","key":"zoi240062r13","doi-asserted-by":"publisher","first-page":"212","DOI":"10.5312\/wjo.v13.i3.212","article-title":"Conservative treatment of knee osteoarthritis: a review of the literature.","volume":"13","author":"Lim","year":"2022","journal-title":"World J Orthop"},{"issue":"5","key":"zoi240062r14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.12968\/hmed.2021.0407","article-title":"The non-operative management of primary osteoarthritis.","volume":"83","author":"Furey","year":"2022","journal-title":"Br J Hosp Med (Lond)"},{"issue":"5","key":"zoi240062r15","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1136\/jisakos-2016-000094","article-title":"Non-operative treatment options for knee osteoarthritis: current concepts.","volume":"3","author":"Parker","year":"2018","journal-title":"J ISAKOS"},{"key":"zoi240062r16","doi-asserted-by":"publisher","first-page":"S245","DOI":"10.21037\/atm","article-title":"Non-operative treatment options for knee osteoarthritis.","volume":"7","author":"DeRogatis","year":"2019","journal-title":"Ann Transl Med"},{"issue":"11","key":"zoi240062r17","first-page":"709","article-title":"Management of primary knee osteoarthritis and indications for total knee arthroplasty for general practitioners.","volume":"112","author":"Van Manen","year":"2012","journal-title":"J Am Osteopath Assoc"},{"issue":"1-2","key":"zoi240062r18","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1111\/ans.v93.1-2","article-title":"SMART choice (knee) tool: a patient-focused predictive model to predict improvement in health-related quality of life after total knee arthroplasty.","volume":"93","author":"Zhou","year":"2023","journal-title":"ANZ J Surg"},{"issue":"1","key":"zoi240062r19","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1186\/s12891-022-05123-0","article-title":"Evaluating willingness for surgery using the SMART Choice (Knee) patient prognostic tool for total knee arthroplasty: study protocol for a pragmatic randomised controlled trial.","volume":"23","author":"Zhou","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"issue":"2","key":"zoi240062r20","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1097\/00006199-200503000-00007","article-title":"The Consolidated Standards of Reporting Trials (CONSORT): guidelines for reporting randomized trials.","volume":"54","author":"Bennett","year":"2005","journal-title":"Nurs Res"},{"issue":"1","key":"zoi240062r21","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-040408","article-title":"Cohort profile: the St Vincent\u2019s Melbourne Arthroplasty Outcomes (SMART) Registry, a pragmatic prospective database defining outcomes in total hip and knee replacement patients.","volume":"11","author":"Gould","year":"2021","journal-title":"BMJ Open"},{"key":"zoi240062r23","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1186\/1471-2474-12-149","article-title":"Decision quality instrument for treatment of hip and knee osteoarthritis: a psychometric evaluation.","volume":"12","author":"Sepucha","year":"2011","journal-title":"BMC Musculoskelet Disord"},{"issue":"3","key":"zoi240062r24","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1177\/1536867X1301300304","article-title":"Computing adjusted risk ratios and risk differences in Stata.","volume":"13","author":"Norton","year":"2013","journal-title":"Stata J"},{"issue":"15","key":"zoi240062r25","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.1503\/cmaj.131353","article-title":"Randomized trials with missing outcome data: how to analyze and what to report.","volume":"186","author":"Groenwold","year":"2014","journal-title":"CMAJ"},{"issue":"1","key":"zoi240062r26","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s00402-020-03612-2","article-title":"Early post-operative oxford knee score and knee society score predict patient satisfaction 2 years after total knee arthroplasty.","volume":"141","author":"Goh","year":"2021","journal-title":"Arch Orthop Trauma Surg"},{"issue":"1","key":"zoi240062r27","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.arth.2016.06.009","article-title":"Predictors of patient-reported pain and functional outcomes over 10 years after primary total knee arthroplasty: a prospective cohort study.","volume":"32","author":"Jiang","year":"2017","journal-title":"J Arthroplasty"},{"issue":"9","key":"zoi240062r28","doi-asserted-by":"publisher","first-page":"735","DOI":"10.2106\/JBJS.15.00280","article-title":"Age and preoperative Knee Society score are significant predictors of outcomes among Asians following total knee arthroplasty.","volume":"98","author":"Bin Abd Razak","year":"2016","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"zoi240062r29","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.3390\/jcm11061649","article-title":"A nomogram for predicting non-response to surgery one year after elective total hip replacement.","volume":"11","author":"Dowsey","year":"2022","journal-title":"J Clin Med"},{"issue":"2","key":"zoi240062r30","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.arth.2016.07.036","article-title":"Predicting the long-term gains in health-related quality of life after total knee arthroplasty.","volume":"32","author":"Schilling","year":"2017","journal-title":"J Arthroplasty"},{"key":"zoi240062r31","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1016\/j.jor.2020.10.003","article-title":"Modelling the cost-effectiveness of total knee arthroplasty: a systematic review.","volume":"22","author":"Kamaraj","year":"2020","journal-title":"J Orthop"},{"issue":"12","key":"zoi240062r32","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1001\/archinternmed.2009.136","article-title":"Cost-effectiveness of total knee arthroplasty in the United States: patient risk and hospital volume.","volume":"169","author":"Losina","year":"2009","journal-title":"Arch Intern Med"},{"issue":"1","key":"zoi240062r34","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1093\/ije\/dyh299","article-title":"Regression to the mean: what it is and how to deal with it.","volume":"34","author":"Barnett","year":"2005","journal-title":"Int J Epidemiol"},{"issue":"1","key":"zoi240062r35","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/1471-2474-14-143","article-title":"Trends in knee arthroscopy and subsequent arthroplasty in an Australian population: a retrospective cohort study.","volume":"14","author":"Harris","year":"2013","journal-title":"BMC Musculoskelet Disord"},{"key":"zoi240062r33","first-page":"f4313","article-title":"Practices and impact of primary outcome adjustment in randomized controlled trials: meta-epidemiologic study.","volume-title":"BMJ","author":"Saquib","year":"2013"},{"key":"zoi240062r22","unstructured":"Knee replacement: what you need to know. HCF; 2018. Accessed July 31, 2023. https:\/\/www.hcf.com.au\/health-agenda\/health-care\/common-conditions\/knee-replacement"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2815842\/zhou_2024_oi_240062_1709046825.5389.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T16:31:18Z","timestamp":1709915478000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2815842"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2024,3,8]]},"references-count":35,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3,4]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.0890","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,8]]}}}