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Choosing a prosthesis can be maddeningly complex for even the savviest, most seasoned amputee. For first-time shoppers, the journey can feel downright bewildering.
Enter the Decision-Making Aid for Lower Limb Prosthetics. Developed by a group of rehab specialists, prosthetists, and other clinicians in collaboration with amputees, the tool—which is still in beta form—gives patients and practitioners a framework for setting shared priorities and selecting appropriate hardware.
“The feedback we got from amputees was that this would be a wonderful resource for improving prosthetic care,” says Chelsey Anderson, a certified prosthetist and rehabilitation scientist who spearheaded the project. “There are so many options that it can be really overwhelming. We’re trying to help make that information digestible, especially for people who are getting their first prosthesis and contending with all the health complications and emotions that come with losing a limb.”
Healthcare decision aids have gained traction in recent years as part of a broader trend toward shared decision making. They help clinicians and patients sort through knotty choices on a wide range of issues, including surgery, cancer treatment, prenatal care, rehabilitation, and elder care. They’ve become common enough that there’s now a published set of patient decision-aid standards to guide the development of these tools.
Based on those standards, Anderson’s prosthetic decision aid not only informs users about their options but, more importantly, requires them to think carefully about the quality-of-life outcomes that matter most to them. It captures their needs and wants about prosthetic function, aesthetics, ease of use, hygiene, and other factors. It even includes a section about their preferred style of communication with healthcare providers.
The resulting portrait of the patient’s wishes is far richer, more detailed, and more structured than prosthetists are likely to glean from a conventional exam, says Anderson.
“Prosthetists are already doing this assessment at a subconscious level,” she notes. “They’re asking questions, they’re reading body language, they’re discussing options. But they’re also making assumptions about what points to discuss, what to emphasize, and what to leave out. The purpose of this tool is to help patients focus on what they actually want and state that more clearly.”
Anderson’s prototype addresses issues that clinicians often neglect and that prosthesis users (especially first-timers) rarely inquire about—for example, how much cleaning and maintenance a device requires, or whether a given suspension system is prone to unwelcome sounds (such as “leg farts”).
“When we got this tool in front of our working group, some people’s response was, ‘What is this sound thing about?’” Anderson says. “That’s exactly what I’m hoping this tool will do—spark questions so users can learn things they might not have thought to ask about.”
To learn more about the Decision-Making Aid for Lower Limb Prosthetics, read our Q+A with Chelsey Anderson.
