Lack of evidence for arthroscopy not obvious to consumers

The evidence might have changed years ago regarding knee arthroscopy for osteoarthritis but the content and quality of information available to consumers has yet to catch up.

In an analysis of 93 documents – including leaflets from orthopaedic surgeons or downloadable/print friendly information sheets from websites – only eight made a clear recommendation against arthroscopy for all or most people with osteoarthritis of the knee.

Documents were sourced from a wide range of practices and organisations including professional societies, hospitals, health insurers, government agencies and consumer groups.

Only about a third of documents with the most complete information about knee arthroscopy specified the authors or when the information had been written or updated.

Reference to clinical guidelines was largely absent however most resources did mention potential harms associated with the procedures.

Professor Rachelle Buchbinder, from the Monash Department of Clinical Epidemiology and chair of the ANZ Musculoskeletal Clinical Trials Network (ANZMUSC), said poor information made it difficult for consumers to make fully informed, evidence-based decisions.

“The main thing that can be improved is to provide accurate information about the evidence for the effectiveness and safety of arthroscopy; maybe mentioning the guidelines although patients may not be as interested in that,” she told the limbic.

“In addition and very importantly, there are now Clinical Care Standards for Knee Osteoarthritis developed by the Australian Commission on Safety and Quality in Health Care and there are already very good information for clinicians, and for consumers, that people can freely download and use.”

The analysis found the often-berated Wikipedia was actually a good source of accurate information.

“In contrast to all the other sources of information we reviewed, Wikipedia’s content is continuously updated and its information is required to be verifiable from a published reliable source,” the study said.

Professor Buchbinder said ANZMUSC was developing a decision tool that they planned to test with consumers and GPs.

“GPs are interested in having a decision tool that they can use in their consultations and we also want to make it available online so that patients can take the tool to their GP or specialist.”

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