Ministries of Health consider wait lists for total joint replacement a top priority. Research
priorities to manage wait lists indicate the need to establish benchmarks that consider
patient preferences. However, patients' preferences for hip or knee replacements are strongly
associated with their misperceptions of the indicators for, and the risks and benefits of,
these procedures. These misperceptions can be corrected with the use of patient decision
aids. When decision aids are used in combination with assessing surgical eligibility, there
may be a reduction in unnecessary referrals for surgery either because the patient is
ineligible or because the eligible candidates make informed decisions to forgo this option.
The primary study objective is to evaluate the effect of patient decision aids (PtDAs) on
total wait times (wait times for surgical consultation, plus wait times for surgery) when
used in combination with a general practitioner run clinic to screen patients with hip or
knee osteoarthritis for surgical eligibility. Major secondary objectives include determining
(a) the effect of PtDAs on surgery rates within two years, (b) the effect of PtDAs on
decision quality, and (c) cost-effectiveness of PtDAs for total joint arthroplasty.