Development and acceptability of a patient decision aid for people with degenerative cervical myelopathy: an international mixed-methods study
Year: 2026
Type: article
Abstract: OBJECTIVES: To develop and user-test a patient decision aid for people diagnosed with degenerative cervical myelopathy and who are considering surgery. DESIGN: Mixed-methods study describing the development of a patient decision aid. SETTING: A draft decision aid was developed by a multidisciplinary steering group (including study authors with degenerative cervical myelopathy, health professionals and researchers) informed by the best available evidence, authorship consensus and existing patient decision aids. PARTICIPANTS: Patient-participants and health professional-participants who manage people with degenerative cervical myelopathy were recruited through social media and the steering group's research and practice network. Quantitative questionnaires were used to gather baseline data, descriptive feedback, refine the decision aid and assess its acceptability. Qualitative semi-structured interviews were conducted online to gather feedback on the decision aid and were analysed using reflexive thematic analysis. RESULTS: We conducted 32 interviews: 19 patient-participants and 13 health professional-participants who manage people with degenerative cervical myelopathy (neurosurgeons, neurologists, physiotherapists, orthopaedic surgeons, general practitioners, rehabilitation and pain specialists and consultant occupational physicians and chiropractors). Participants were from 10 countries (Australia, Canada, Cyprus, Germany, Ireland, New Zealand, Sweden, Switzerland, United Kingdom and USA). Most participants rated the decision aid's acceptability as good-to-excellent and agreed with most aspects of the decision aid (eg, defining degenerative cervical myelopathy, management recommendations, potential benefits and harms, questions to consider asking a health professional). CONCLUSION: Our patient decision aid was rated as an acceptable tool by both health professional-participants who treat degenerative cervical myelopathy and patient-participants with lived experience of degenerative cervical myelopathy. This decision aid can be used by clinicians and people with degenerative cervical myelopathy to help with shared decision making following a diagnosis of degenerative cervical myelopathy. A study testing the potential benefits of this decision aid in a clinical setting is recommended.
Source: BMJ Open
Authors: Andrew R Gamble, David B Anderson, Marnee J McKay, Benjamin Davies, Sophie Macpherson, James Van Gelder, Tammy Hoffmann, Kirsten McCaffery, Samuel X Stevens, Carlo Ammendolia, Rohil V Chauhan, Carl M Zipser, Timothy F Boerger, Lindsay A Tetreault, Michael G Fehlings, Elanor Dustan, Carolyn Nugent, Helen Holmgren, Andreas K Demetriades, Justin M Lantz, Rana Dhillon, Chris G Maher, Joshua R Zadro
Institutions: The University of Sydney, Institute for Musculoskeletal Health, University of Cambridge, Concord Repatriation General Hospital, UNSW Sydney, Bond University, Queen's University, University of Toronto, Auckland University of Technology, University of Zurich, University Hospital Zurich, Universitätsklinik Balgrist, Marquette University, Medical College of Wisconsin, Mass General Brigham, University Health Network, Toronto Western Hospital, Nottingham University Hospitals NHS Trust, Myelopathy.org, Edinburgh Royal Infirmary, University of Southern California, The University of Melbourne, St Vincent's Hospital Melbourne
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,839
OpenAlex ID: W7148911866