{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:19:02Z","timestamp":1788286742176,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patients with a bone-anchored prosthesis (BAP) previously expressed preferences regarding (i.e., indicated the importance of) 5 treatment attributes: change in quality of life (QoL), short- and long-term complications, implant survival, and out-of-pocket contributions (costs). However, preference heterogeneity is unclear. We aimed to identify latent preference subgroups, quantify attribute importance per subgroup, and describe background characteristics associated with each subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A discrete choice experiment to reveal preferences for BAP characteristics among 247 patients from The Netherlands was analyzed using a latent class logit model. Subgroups (classes) were interpreted using relative attribute weights and patient characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A model with 3 classes (with 49% [n = 121], 27% [n = 67], and 24% [n = 59] of the patients in Classes 1, 2, and 3, respectively) fit best. Across classes, short-term complications were least important, and patients considered opting out of BAP treatment when outcomes were unfavorable. Within the classes, when BAP was selected, QoL remained a key driver (31% of decision weight in Class 1, 53% in Class 2, and 26% in Class 3). Class 1 weighted QoL and out-of-pocket contributions most; Class 2 prioritized QoL and disregarded short-term complications; Class 3 placed the most weight on long-term complications and was sensitive to out-of-pocket contributions mainly at high cost levels (\u20ac20,000 to \u20ac25,000) and to osseointegrated implant survival only when survival dropped from 20 to 5 years. Background profiles differed: compared with the other classes, Class 1 (66% male) had a greater proportion of patients with transtibial amputations and longer BAP experience; Class 2 (48% male) included a greater proportion with higher education and income levels and worse pre-treatment mobility, pain, and anxiety; and Class 3 (80% male) had a greater proportion with lower education and income levels, and the highest proportion awaiting surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patient preferences for key aspects of BAP treatment are heterogeneous. We identified 3 distinct subgroups, and a patient\u2019s background characteristics can help estimate membership in a particular subgroup. Patient-reported outcomes should be interpreted in light of these preference differences. Future work should integrate preference assessment into pre-treatment triage to better align counseling and selection with what patients value, ideally using a brief choice-task screening tool; the optimal screening tasks remain to be established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.25.01426","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:00:30Z","timestamp":1788285630000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Heterogeneity of Patients\u2019 Preferences for Bone-Anchored Prostheses After Lower-Extremity Amputation (PREFER-BAP-2)"],"prefix":"10.2106","author":[{"given":"Sarathiel-Kyrillos M.","family":"Saleib","sequence":"first","affiliation":[{"name":"Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Osseointegration Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Department of Orthopaedics, The Sint Maartenskliniek, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8433-1402","authenticated-orcid":false,"given":"Marcel F.","family":"Jonker","sequence":"additional","affiliation":[{"name":"Erasmus Choice Modelling Centre, Erasmus University Rotterdam, Rotterdam, The Netherlands"},{"name":"Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8448-5903","authenticated-orcid":false,"given":"Michael H.J.","family":"Verhofstad","sequence":"additional","affiliation":[{"name":"Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0741-3751","authenticated-orcid":false,"given":"Maria A.","family":"Paping","sequence":"additional","affiliation":[{"name":"Osseointegration Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Rijndam Rehabilitation, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Van Vledder","sequence":"additional","affiliation":[{"name":"Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Osseointegration Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6158-6901","authenticated-orcid":false,"given":"Ruud A.","family":"Leijendekkers","sequence":"additional","affiliation":[{"name":"Orthopedic Research Laboratory, Radboud University Medical Center, Nijmegen, The Netherlands"},{"name":"Department of Rehabilitation, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar J.F.","family":"Van Waes","sequence":"additional","affiliation":[{"name":"Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Osseointegration Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"bib1-20260901","article-title":"Past, present and future of injury prevalence in high-income countries: insights and projections up to 2030 from the Global Burden of Disease Study","volume":"14","author":"Saleib","year":"2026","journal-title":"Inj Prev."},{"issue":"5","key":"bib2-20260901","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1097\/PXR.0000000000000410","article-title":"Analyzing research trends and developments in osseointegration in patients with extremity amputations: Systematic bibliometric analysis and research recommendations","volume":"49","author":"Saleib","year":"2025","journal-title":"Prosthet Orthot Int."},{"issue":"13","key":"bib3-20260901","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1002\/bjs.11005","article-title":"Systematic review of the safety and efficacy of osseointegration prosthesis after limb amputation","volume":"105","author":"Kunutsor","year":"2018","journal-title":"Br J Surg."},{"key":"bib4-20260901","doi-asserted-by":"crossref","first-page":"S83","DOI":"10.1016\/j.ijsu.2017.08.426","article-title":"Bionic Man? 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