# Incorporating Patient-Reported Outcomes into Shared Decision Making with Patients with Osteoarthritis of the Hip or Knee

> **NIH AHRQ R21** · UNIVERSITY OF TEXAS AT AUSTIN · 2021 · $136,738

## Abstract

Osteoarthritis (OA) of the knee constitutes a major public health problem. Treatment options for knee OA range
from lifestyle changes to pharmacological management to total knee replacement surgery. As a “preference-
sensitive” condition, management of OA of the knee is ideally suited for shared decision making (SDM), taking
into consideration benefits, risks, and patients’ health status, values, and goals. Patient-reported outcomes
(PROs) reflect health status from the patient’s perspective. For knee OA, relevant PROs include pain and other
symptoms, functional status and limitations, and overall health. Prior research indicates that patients with
higher baseline physical function and/or poor baseline mental health do not benefit as much from total knee
replacement. Still, due to logistical challenges, costs, and disruptions in workflow, PROs have not yet achieved
their full potential in clinical care.
Musculoskeletal providers at Dell Medical School and UT Health Austin currently collect general and condition-
specific PROs from every patient seen in their Musculoskeletal Institute. PROs are collected via an electronic
interface and results are pulled into the Athena electronic health record (EHR). Given the promise of combining
PRO data with clinical and demographic data, musculoskeletal providers at UT Health Austin have begun
utilizing an innovative electronic PRO-based predictive analytic tool at the point of care to guide SDM in
patients with knee OA. To this point, however, the tool hasn’t been integrated into the EHR and the process
hasn’t been integrated seamlessly into clinic workflow. As such, it is not yet ready for dissemination.
In this 2-year effectiveness and implementation (hybrid type 2) project, we plan to: 1) evaluate the clinical
effectiveness and impact of the PRO-guided predictive analytic SDM tool and process in a randomized
controlled trial in Austin; and 2) implement and evaluate use of the PRO-guided predictive analytic SDM tool
and process in San Antonio, a setting with a different level of experience with PROs and SDM, different clinical
population, and different EHR. Outcomes will include decision quality, as reported by patients; treatment
decision (surgical vs. non-surgical); and stakeholder satisfaction with the tool and SDM process.
Our project contributes to AHRQ’s strategy to use health IT to improve quality and outcomes by evaluating a
tool and process for the use of PRO data at the point of care. The model we are testing puts patients at the
center of their care by enabling them to participate in informed decision making by using their personal health
data, preferences, and prognostic models. Knowledge gained will be critical to scaling and spreading use of
this PRO-guided SDM tool among patients with knee OA nationally.

## Key facts

- **NIH application ID:** 10129348
- **Project number:** 5R21HS027037-02
- **Recipient organization:** UNIVERSITY OF TEXAS AT AUSTIN
- **Principal Investigator:** KEVIN John BOZIC
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $136,738
- **Award type:** 5
- **Project period:** 2020-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10129348

## Citation

> US National Institutes of Health, RePORTER application 10129348, Incorporating Patient-Reported Outcomes into Shared Decision Making with Patients with Osteoarthritis of the Hip or Knee (5R21HS027037-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10129348. Licensed CC0.

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