Effects of viewing an evidence-based video decision aid on patients' treatment preferences for spine surgery

Jon D. Lurie*, Kevin F. Spratt, Emily A. Blood, Tor D. Tosteson, Anna N.A. Tosteson, James Neil Weinstein

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    30 Scopus citations


    Study Design.: Secondary analysis within a large clinical trial. Objective.: To evaluate the changes in treatment preference before and after watching a video decision aid as part of an informed consent process. Summary of Background Data.: A randomized trial with a similar decision aid in herniated disc patients had shown decreased rate of surgery in the video group, but the effect of the video on expressed preferences is not known. Methods.: Subjects enrolling in the Spine Patient Outcomes Research Trial (SPORT) with intervertebral disc herniation, spinal stenosis, or degenerative spondylolisthesis at 13 multidisciplinary spine centers across the United States were given an evidence-based videotape decision aid viewed prior to enrollment as part of informed consent. Results.: Of the 2505 patients, 86% (n = 2151) watched the video and 14% (n = 354) did not. Watchers shifted their preference more often than nonwatchers (37.9% vs. 20.8%, P < 0.0001) and more often demonstrated a strengthened preference (26.2% vs. 11.1%, P < 0.0001). Among the 806 patients whose preference shifted after watching the video, 55% shifted toward surgery (P = 0.003). Among the 617 who started with no preference, after the video 27% preferred nonoperative care, 22% preferred surgery, and 51% remained uncertain. Conclusion.: After watching the evidence-based patient decision aid (video) used in SPORT, patients with specific lumbar spine disorders formed and/or strengthened their treatment preferences in a balanced way that did not appear biased toward or away from surgery.

    Original languageEnglish (US)
    Pages (from-to)1501-1504
    Number of pages4
    Issue number18
    StatePublished - Aug 15 2011


    • decision aid
    • degenerative spondylolisthesis
    • intervertebral disc herniation
    • patient preferences
    • shared decision-making
    • spinal stenosis
    • surgery

    ASJC Scopus subject areas

    • Clinical Neurology
    • Orthopedics and Sports Medicine


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