Understanding Patient Preferences When Deciding on a Voluntary Musculoskeletal Test

The University of Texas System (UT)

Status: Not yet enrolling

Conditions: Non-traumatic Musculoskeletal Conditions; De Quervain Disease; Osteoarthritis; Dupuytren Contracture; Trigger Digit; Lateral Epicondylitis; Rotator Cuff Tendinopathy; Carpal Tunnel Syndrome (CTS)

Treatments: Behavioral: Informational Statement Only; Behavioral: Diagnostic Advance Care Planning Discussion

Study type: Interventional

Funder types: Other

Identifiers

NCT07158892

STUDY00004831(2)

Details and patient eligibility

About

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.

Enrollment: 220 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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220 participants in 2 patient groups

Intervention (Group 1)

Experimental group

Description:

Participants randomized to the intervention group will engage in a structured, scenario-based conversation simulating a diagnostic decision-making discussion. This conversation will be guided by a trained researcher using branching scripted prompts designed to reflect an Advance Care Planning (ACP)-style approach. The discussion will explore the participant's values, goals, and understanding of potential benefits and harms of the proposed hypothetical imaging test. No actual diagnostic tests will be ordered.

Treatment:

Behavioral: Diagnostic Advance Care Planning Discussion

Control (Group 2)

Active Comparator group

Description:

Participants randomized to the control group will receive the same hypothetical clinical scenario, including mention of a proposed diagnostic imaging test. Instead of a structured discussion, they will be presented with a brief, standardized informational statement describing what the test involves, what it may show, and general risks or limitations. No values-based discussion or simulated conversation will occur.

Treatment:

Behavioral: Informational Statement Only