{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:49:03Z","timestamp":1781718543362,"version":"3.54.5"},"reference-count":44,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T00:00:00Z","timestamp":1714348800000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,8]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To develop and user test an evidence-based patient decision aid for children and adolescents who are considering anterior cruciate ligament (ACL) reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Mixed-methods study describing the development of a patient decision aid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A draft decision aid was developed by a multidisciplinary steering group (including various types of health professionals and researchers, and consumers) informed by the best available evidence and existing patient decision aids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>People who ruptured their ACL when they were under 18 years old (ie, adolescents), their parents, and health professionals who manage these patients. Participants were recruited through social media and the network outreach of the steering group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>Semistructured interviews and questionnaires were used to gather feedback on the decision aid. The feedback was used to refine the decision aid and assess acceptability. An iterative cycle of interviews, refining the aid according to feedback and further interviews, was used. Interviews were analysed using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We conducted 32 interviews; 16 health professionals (12 physiotherapists, 4 orthopaedic surgeons) and 16 people who ruptured their ACL when they were under 18 years old (7 were adolescents and 9 were adults at the time of the interview). Parents participated in 8 interviews. Most health professionals, patients and parents rated the aid\u2019s acceptability as good-to-excellent. Health professionals and patients agreed on most aspects of the decision aid, but some health professionals had differing views on non-surgical management, risk of harms, treatment protocols and evidence on benefits and harms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our patient decision aid is an acceptable tool to help children and adolescents choose an appropriate management option following ACL rupture with their parents and health professionals. A clinical trial evaluating the potential benefit of this tool for children and adolescents considering ACL reconstruction is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-081421","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T14:10:19Z","timestamp":1714399819000},"page":"e081421","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Development of a patient decision aid for children and adolescents following anterior cruciate ligament rupture: an international mixed-methods study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5578-4779","authenticated-orcid":false,"given":"Andrew R","family":"Gamble","sequence":"first","affiliation":[{"name":"School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marnee J","family":"McKay","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B","family":"Anderson","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Pappas","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignatius","family":"Alvarez Cooper","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry, Griffith University, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Macpherson","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian A","family":"Harris","sequence":"additional","affiliation":[{"name":"Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie R","family":"Filbay","sequence":"additional","affiliation":[{"name":"Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2696-5006","authenticated-orcid":false,"given":"Kirsten","family":"McCaffery","sequence":"additional","affiliation":[{"name":"Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1009-0746","authenticated-orcid":false,"given":"Rachel","family":"Thompson","sequence":"additional","affiliation":[{"name":"Discipline of Behavioural and Social Sciences in Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy C","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G","family":"Maher","sequence":"additional","affiliation":[{"name":"Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8981-2125","authenticated-orcid":false,"given":"Joshua R","family":"Zadro","sequence":"additional","affiliation":[{"name":"Sydney Musculoskeletal Health and Institute for Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"2025121514095882000_14.4.e081421.1","doi-asserted-by":"crossref","first-page":"354","DOI":"10.5694\/mja17.00974","article-title":"Increasing rates of anterior Cruciate ligament reconstruction in young Australians, 2000\u20132015","volume":"208","author":"Zbrojkiewicz","year":"2018","journal-title":"Med J Aust"},{"key":"2025121514095882000_14.4.e081421.2","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-1877","article-title":"ACL tears in school-aged children and adolescents over 20 years","volume":"139","author":"Beck","year":"2017","journal-title":"Pediatrics"},{"key":"2025121514095882000_14.4.e081421.3","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph14060599","article-title":"Trends in pediatric and adolescent anterior Cruciate ligament injuries in Victoria, Australia 2005\u20132015","volume":"14","author":"Shaw","year":"2017","journal-title":"Int J Environ Res Public Health"},{"key":"2025121514095882000_14.4.e081421.4","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ocl.2019.08.009","article-title":"Pediatric anterior Cruciate ligament reconstruction","volume":"51","author":"Perkins","year":"2020","journal-title":"Orthop Clin North Am"},{"key":"2025121514095882000_14.4.e081421.5","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515617742"},{"key":"2025121514095882000_14.4.e081421.6","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513518412"},{"key":"2025121514095882000_14.4.e081421.7","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000482"},{"key":"2025121514095882000_14.4.e081421.8","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001222"},{"key":"2025121514095882000_14.4.e081421.9","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1007\/s00167-018-4865-y","article-title":"International Olympic committee consensus statement on prevention, diagnosis and management of Paediatric anterior Cruciate ligament (ACL) injuries","volume":"26","author":"Ardern","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"2025121514095882000_14.4.e081421.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907797"},{"key":"2025121514095882000_14.4.e081421.11","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.n375","article-title":"Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior Cruciate ligament rupture: COMPARE randomised controlled trial","volume":"372","author":"Reijman","year":"2021","journal-title":"BMJ"},{"key":"2025121514095882000_14.4.e081421.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01424-6"},{"key":"2025121514095882000_14.4.e081421.13","doi-asserted-by":"crossref","first-page":"4008","DOI":"10.1177\/0363546521990817","article-title":"Early operative versus delayed operative versus Nonoperative treatment of pediatric and adolescent anterior Cruciate ligament injuries: A systematic review and meta-analysis","volume":"49","author":"James","year":"2021","journal-title":"Am J Sports Med"},{"key":"2025121514095882000_14.4.e081421.14","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-092066"},{"key":"2025121514095882000_14.4.e081421.15","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509354055"},{"key":"2025121514095882000_14.4.e081421.16","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2019-100956"},{"key":"2025121514095882000_14.4.e081421.17","article-title":"Decision AIDS for people facing health treatment or screening decisions","volume":"4","author":"Stacey","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121514095882000_14.4.e081421.18","doi-asserted-by":"crossref","DOI":"10.1186\/s40463-016-0170-2","article-title":"Decision aid prototype development for parents considering Adenotonsillectomy for their children with sleep disordered breathing","volume":"45","author":"Maguire","year":"2016","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"2025121514095882000_14.4.e081421.19","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-105359"},{"key":"2025121514095882000_14.4.e081421.20","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X211035681"},{"key":"2025121514095882000_14.4.e081421.21","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-072553","article-title":"Developing a patient decision aid for Achilles tendon rupture management: a mixed-methods study","volume":"13","author":"Gan","year":"2023","journal-title":"BMJ Open"},{"key":"2025121514095882000_14.4.e081421.22","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-054032","article-title":"Development of a patient decision aid on Subacromial decompression surgery and rotator cuff repair surgery: an international mixed-methods study","volume":"11","author":"Zadro","year":"2021","journal-title":"BMJ Open"},{"key":"2025121514095882000_14.4.e081421.23","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2040"},{"key":"2025121514095882000_14.4.e081421.24","doi-asserted-by":"crossref","unstructured":"O\u2019Connor D , Hoffmann T , McCaffery K , et al . 85 evaluating a patient decision aid for people with degenerative knee disease considering Arthroscopic surgery: protocol for a randomised controlled trial. Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia; December 2019 doi:10.1136\/bmjebm-2019-POD.98","DOI":"10.1136\/bmjebm-2019-POD.98"},{"key":"2025121514095882000_14.4.e081421.25","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1177\/0272989X21996622","article-title":"Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: an update from the International patient decision aid standards","volume":"41","author":"Hoffmann","year":"2021","journal-title":"Med Decis Making"},{"key":"2025121514095882000_14.4.e081421.26","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1177\/0272989X211021397","article-title":"Providing balanced information about options in patient decision AIDS: an update from the International patient decision aid standards","volume":"41","author":"Martin","year":"2021","journal-title":"Med Decis Making"},{"key":"2025121514095882000_14.4.e081421.27","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1177\/0272989X21996328","article-title":"Current best practice for presenting probabilities in patient decision AIDS: fundamental principles","volume":"41","author":"Bonner","year":"2021","journal-title":"Med Decis Making"},{"key":"2025121514095882000_14.4.e081421.28","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1177\/0272989X21996342","article-title":"Current challenges when using numbers in patient decision AIDS: advanced concepts","volume":"41","author":"Trevena","year":"2021","journal-title":"Med Decis Making"},{"key":"2025121514095882000_14.4.e081421.29","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X211014163"},{"key":"2025121514095882000_14.4.e081421.30","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1177\/0272989X211011120","article-title":"Are we improving? update and critical appraisal of the reporting of decision process and quality measures in trials evaluating patient decision AIDS","volume":"41","author":"Trenaman","year":"2021","journal-title":"Med Decis Making"},{"key":"2025121514095882000_14.4.e081421.31","unstructured":"O\u2019Connor AC . A. User manual - acceptability, Available: http:\/\/www.ohri.ca\/decisionaid\/"},{"key":"2025121514095882000_14.4.e081421.32","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"2025121514095882000_14.4.e081421.33","first-page":"1","article-title":"Thematic analysis","volume":"12","author":"Clarke","year":"2016","journal-title":"J Posit Psychol"},{"key":"2025121514095882000_14.4.e081421.34","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X13501721"},{"key":"2025121514095882000_14.4.e081421.35","doi-asserted-by":"crossref","DOI":"10.2196\/15032","article-title":"An 11-item measure of User- and human-centered design for personal health tools (UCD-11): development and validation","volume":"23","author":"Witteman","year":"2021","journal-title":"J Med Internet Res"},{"key":"2025121514095882000_14.4.e081421.36","doi-asserted-by":"crossref","first-page":"e287","DOI":"10.1016\/j.asmr.2021.09.042","article-title":"Self-identity and adolescent return to sports post-ACL injury and rehabilitation: will anyone listen? Arthrosc","volume":"4","author":"Nyland","year":"2022","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"2025121514095882000_14.4.e081421.37","doi-asserted-by":"crossref","DOI":"10.1186\/s13012-018-0851-5","article-title":"Barriers and Facilitators of pediatric shared decision-making: a systematic review","volume":"14","author":"Boland","year":"2019","journal-title":"Implement Sci"},{"key":"2025121514095882000_14.4.e081421.38","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-0516E"},{"key":"2025121514095882000_14.4.e081421.39","doi-asserted-by":"crossref","first-page":"e221","DOI":"10.1016\/j.asmr.2021.09.037","article-title":"Unique considerations for the pediatric athlete during rehabilitation and return to sport after anterior Cruciate ligament reconstruction","volume":"4","author":"Matsuzaki","year":"2022","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"2025121514095882000_14.4.e081421.40","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1016\/j.arthro.2017.01.049","article-title":"Patient understanding, expectations, outcomes, and satisfaction regarding anterior Cruciate ligament injuries and surgical management","volume":"33","author":"Cole","year":"2017","journal-title":"Arthroscopy"},{"key":"2025121514095882000_14.4.e081421.41","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ptsp.2020.10.011","article-title":"Patient expectations and perceived social support related to return to sport after anterior Cruciate ligament reconstruction in adolescent athletes","volume":"47","author":"Armento","year":"2021","journal-title":"Phys Ther Sport"},{"key":"2025121514095882000_14.4.e081421.42","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1177\/0363546518819454","article-title":"Expectations for return to Preinjury sport before and after anterior Cruciate ligament reconstruction","volume":"47","author":"Webster","year":"2019","journal-title":"Am J Sports Med"},{"key":"2025121514095882000_14.4.e081421.43","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18179267","article-title":"Psychological and social components of recovery following anterior Cruciate ligament reconstruction in young athletes: A narrative review","volume":"18","author":"Vutescu","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2025121514095882000_14.4.e081421.44","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1177\/0272989X211011101","article-title":"Addressing health literacy in patient decision AIDS: an update from the International patient decision aid standards","volume":"41","author":"Muscat","year":"2021","journal-title":"Med Decis Making"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-081421","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T22:10:14Z","timestamp":1765836614000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-081421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":44,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,29]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/bmjopen-2023-081421"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-081421","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}