Surgeon confidence in planning total shoulder arthroplasty improves after consulting a clinical decision support tool

Surgeons exhibited increased confidence after reviewing CDST reports, regardless of the recommended procedure or their experience. The study suggests that CDST can inform decision-making and boost confidence in preoperative planning for shoulder arthroplasty.

Purpose: Software algorithms are increasingly available as clinical decision support tools (CDSTs) to support shared decision-making. We sought to understand if patient-specific predictions from a CDST would impact orthopedic surgeons’ preoperative planning decisions and corresponding confidence.

Methods: We performed a survey study of orthopedic surgeons with at minimum of 2 years of independent shoulder arthroplasty experience. We generated patient profiles for 18 faux cases presenting with glenohumeral osteoarthritis and emailed 93 surgeons requesting their recommendation for anatomic or reverse total shoulder arthroplasty for each case and their certainty in their recommendation on a 4-point Likert scale. The thirty respondents were later sent a second survey with the same cases that now included predicted patient-specific outcomes and complication rates generated by a CDST.

Results: Initial recommendations and changes in recommendation varied widely by surgeon and by case. After viewing the results of the CDST, surgeons switched from anatomic to reverse recommendations in 46 instances (12% of initial anatomic) and from reverse to anatomic in 22 instances (6% of initial reverse). Overall, surgeon change in confidence increased significantly across all responses (p = 0.0001), with certain cases and certain surgeons having significant changes. Change in confidence did not correlate with surgeon-specific factors, including years in practice.

Conclusion: The addition of CDST reports to preoperative planning for anatomic and reverse total shoulder arthroplasty informed decision-making but did not direct recommendations uniformly. However, the CDST information provided did increase surgeon confidence regardless of implant selection and irrespective of surgeon experience.

Success Stories

Real Patients, Real Results

Our patients are talking and sharing the good news about the excellent care and superior results they experienced our surgery center in Stratham, NH.

Watch and listen to our patients describe their individual orthopedic situations and experience with A.V.A.T.A.R®.

Have your own story to share?
Review us on Google

Don’t Live With Pain – Tell Us What’s Wrong

Guides and Advice

Patient Resources and Learning

Ongoing care is the name of the game. Recovery is a long-term process, and while our team strives to maintain a same-day outpatient surgery experience, it doesn't mean we leave you to figure out healing on your own.

First Visit Guide

Come prepared for your first visit by reading up on what to expect during your visit.

Learn More

Prescriptions

Learn more about our prescription policy and how to ask questions about existing medications.

Learn More

Payments

Explore our payment options including bundled payments and get help regarding eligibility.

Learn More

Recent King & Parsons Insights

Recognized By