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J Clin Epidemiol. 2006 Oct;59(10):1078-86. Epub 2006 Jun 23.

Racial/ethnic differences in preferences for total knee replacement surgery.

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  • 1Department of Epidemiology and Public Health, University of Miami, Miami, FL 33101, USA. mbyrne2@med.miami.edu

Abstract

OBJECTIVES:

To determine whether there are ethnic differences in preferences for surgery vs. medical treatment of knee osteoarthritis (OA).

STUDY DESIGN AND SETTING:

Cross-sectional in-person interviews using conjoint analysis methodology, a technique often used in marketing, involved individuals making choices between alternative hypothetical scenarios for medical or surgical treatment of knee OA. One hundred ninety-three individuals over the age of 20 were recruited through random digit dialing in Harris County, TX, and 198 individuals with knee OA were recruited from a large outpatient health care provider in Houston, TX.

RESULTS:

African Americans were significantly less likely to chose surgery than whites (odds ratio 0.63 [0.42, 0.93]). Women and older individuals were also less likely to choose surgery (0.69 [0.51, 0.94], 0.98 [0.97, 0.99]). Larger reductions in negative symptoms with surgery significantly increased the likelihood of choosing surgery. There was no difference between the public and patients, and no effect of income level.

CONCLUSIONS:

Disparities in knee replacement rates among ethnic groups may be partly due to differences in preferences for surgery. Conjoint analysis was shown to be a feasible methodology for collecting preferences in health research. This methodology has great promise in contributing to our knowledge of drivers of health care decision making in individuals.

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PMID:
16980148
[PubMed - indexed for MEDLINE]
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