Decision for reconstructive interventions of the upper limb in individuals with tetraplegia: the effect of treatment characteristics

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Snoek, Govert J. and Til, Janine A. van and Krabbe, Paul F.M. and IJzerman, Maarten J. (2008) Decision for reconstructive interventions of the upper limb in individuals with tetraplegia: the effect of treatment characteristics. Spinal Cord, 46 (3). pp. 228-233. ISSN 1362-4393

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Abstract:Objective: To determine the effect of treatment characteristics on the
decision for reconstructive interventions for the upper extremities (UE) in
subjects with tetraplegia. -
Setting: Seven specialized spinal cord injury centres in the Netherlands. -
Method: Treatment characteristics for UE reconstructive interventions were
determined. Conjoint analysis (CA) was used to determine the contribution
and the relative importance of the treatment characteristics on the decision
for therapy. Therefore, a number of different treatment scenarios using these
characteristics were established. Different pairs of scenarios were presented
to subjects who were asked to choose the preferred scenario of each set. -
Results: forty nine subjects with tetraplegia with a stable C5, C6 or C7
lesion were selected. All treatment characteristics significantly influenced
the choice for treatment. Relative importance of treatment characteristics
were: intervention type (surgery or surgery with FES implant) 13%, number
of operations 15%, in patient rehabilitation period 22%, ambulant
rehabilitation period 9%, complication rate 15%, improvement of elbow
function 10%, improvement of hand function 15%. In deciding for therapy
40% of the subjects focused on one characteristic. -
Conclusion: CA is applicable in Spinal Cord Injury medicine to study the
effect of health outcomes and non-health outcomes on the decision for
treatment. Non-health outcomes which relate to the intensity of treatment
are equally important or even more important than functional outcome in the
decision for reconstructive UE surgery in subjects with tetraplegia.
Item Type:Article
Faculty:
Management and Governance (SMG)
Research Group:
Link to this item:http://purl.utwente.nl/publications/76574
Official URL:http://dx.doi.org/10.1038/sj.sc.3102110
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