Carpal Tunnel Syndrome (CTS), De Quervain Disease, Dupuytren Contracture, Lateral Epicondylitis, Non-traumatic Musculoskeletal Conditions, Osteoarthritis, Rotator Cuff Tendinopathy, Trigger Digit
Conditions
Keywords
Musculoskeletal disorders, Diagnostic imaging, Shared decision making, Advance care planning (ACP), Patient preferences, Health communication, Decision conflict, Scenario-Based Study, Orthopedic care
Brief summary
The goal of this clinical trial is to understand how people make decisions about imaging tests for common musculoskeletal problems (like arthritis, tendon problems, or nerve compression). The study involves adult patients attending a musculoskeletal specialty clinic. The main questions it aims to answer are: 1. Does having a structured conversation about the pros and cons of a test affect how much a person wants to have that test? 2. Does that conversation help people feel more confident and less conflicted about their decision? Researchers will compare patients who have a values-based discussion with a researcher to those who receive brief written information about the test, to see if these approaches affect how people feel about having the test. Participants will: * Read a brief scenario about a proposed diagnostic imaging test (like an X-ray, MRI, CT, or ultrasound). * Either take part in a short structured conversation or read brief information about the test. * Answer a short survey about their thoughts on the test. This study does not involve actual medical testing or affect your clinical care. It is for research purposes only.
Interventions
BEHAVIORALDiagnostic Advance Care Planning Discussion
The intervention consists of a structured, values-based conversation modeled after Advance Care Planning (ACP) principles, adapted for diagnostic decision-making. Participants will receive a hypothetical clinical vignette involving a musculoskeletal diagnostic test (e.g., MRI, X-ray, CT, or ultrasound), followed by a simulated discussion facilitated by a trained researcher. The conversation is guided by branching scripted prompts designed to elicit the participant's values, goals, expectations, and understanding of the potential benefits and harms of testing. Responses are transcribed using verbal-to-text technology. Unlike standard decision aids or educational materials, this intervention emphasizes patient reflection and shared decision-making by prompting participants to consider what matters most to them before making a decision about the test. The discussion does not involve actual test ordering or clinical decisions but is intended to simulate a real-world ACP discussion process.
BEHAVIORALInformational Statement Only
Participants will be presented with a brief, standardized informational statement describing what the test involves, what it may show, and general risks or limitations. No individualized values-based discussion or simulated conversation will occur.
Sponsors
University of Texas at Austin
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults (18+ years) * English literacy * Seeking musculoskeletal specialty care * Diagnosis of non-traumatic musculoskeletal condition (including but not limited to: carpal tunnel syndrome, lateral epicondylitis, osteoarthritis, trigger digit, Dupuytren's, De Quervain, or rotator cuff tendinopathy)
Exclusion criteria
* Cognitive or physical impairment or severe psychiatric illness that would interfere with participation in the scenario-based discussion or completion of the survey instruments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Enthusiasm for proposed hypothetical diagnostic test | Measured using survey on tablet immediately following intervention/control (i.e., ACP-style discussion [Group 1] or informational statement [Group 2]) | Measured using 11-point Likert scale: 0=I would definitely decline this test, 5=I am not sure if I would accept this test, 10=I would definitely proceed with this test. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Decisional conflict regarding the diagnostic test | Measured using survey on tablet immediately following intervention/control (i.e., ACP-style discussion [Group 1] or informational statement [Group 2]) | Assessed using the validated 'SURE' scale (0-4 score; higher scores indicate greater certainty and lower decisional conflict). Please refer to Appendix 2 of PDF study protocol. |
Countries
United States
Contacts
Primary ContactEmily H Jaarsma, MD
Outcome results
None listed