Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies

Rekant, Julie; Fisher, Lee E.; Boninger, Michael L.; Gaunt, Robert A.; Collinger, Jennifer L.

doi:10.1080/10400435.2021.2020935

Cited by 11 publications

(12 citation statements)

References 67 publications

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“…Further, similar to other work, our ndings indicate that serious consideration must also be given to the risk of psychological and physical harm (28, 29,38,43) and concerns about data privacy and security (23,26,38). When not appropriately addressed, for example through clinical trials, these are signi cant barriers to the regulatory approval of technology, delivery by health service providers, and use among individuals with disability.…”

Section: Financial and Non-nancial Costs As Barriers To Technology Ad...supporting

confidence: 87%

Factors that Influence the Adoption of Rehabilitation Technologies: A Multi-Disciplinary Qualitative Exploration

Mitchell

Shirota

Clanchy

2022

Preprint

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Background Technological innovation is recognised as having the potential to enhance rehabilitation for people with disability. Yet, resistance to, and abandonment of, rehabilitation technology is prevalent and the successful translation of technology into rehabilitation settings remains limited. Therefore, the aim of this work was to develop an in-depth, multi-stakeholder perspective on what influences the adoption of rehabilitation technologies. Methods Semi-structured focus groups were conducted as part of a larger research project aiming to facilitate the co-design of a novel neurorestorative technology. Focus group data were analysed using a five-phase inductive approach to qualitative data analysis. Results Focus groups were attended by 43 stakeholders with expertise in one or more of the following fields: people with disability, allied health, human movement science, computer science, design, engineering, ethics, funding, marketing, business, product development, and research development. Six main themes influencing the adoption of technology in rehabilitation were identified: cost beyond the purchase price, benefits to all stakeholders, trust to be earned in technology, ease of technology operation, ability to access technology, and the ‘co’ in co-design. All six themes were found to be interrelated; in particular, the importance of direct stakeholder engagement in the development of rehabilitation technologies (the ‘co’ in co-design) was prevalent in all themes. Conclusions A range of complex and interrelated factors influence the adoption of rehabilitation technologies. Importantly, many of the issues that have the potential to negatively impact rehabilitation technology adoption may be addressed during development by utilising the experience and expertise of stakeholders who influence its supply and demand. Our findings state that a wider cohort of stakeholders needs to be actively engaged in the development of rehabilitation technologies to better address the factors that contribute to technology underutilisation and abandonment and facilitate better outcomes for people with disability.

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Section: Financial and Non-nancial Costs As Barriers To Technology Ad...supporting

confidence: 87%

Factors that Influence the Adoption of Rehabilitation Technologies: A Multi-Disciplinary Qualitative Exploration

Mitchell

Shirota

Clanchy

2022

Preprint

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“…Quality of Life. An individual's quality of life is mainly focused on emotional, psychological, religious, activities of daily living (ADLs), vocational and nonvocational factors, medical device appropriateness, giving confidence and comfort, being lightweight, cosmetic, and psychosocially acceptable to the individual [35,41,42].…”

Section: Social Changementioning

confidence: 99%

A Hybrid Fuzzy AHP/VIKOR Approach to Funding Strategy Selection for Advanced Prosthetic and Orthotic Medical Devices in Low-Income Countries: A Case of Pakistan

Ahmed

Feng

Abdul

et al. 2022

Mathematical Problems in Engineering

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In the context of advanced prosthetic and orthotic medical devices, funding is a major challenge, especially in low-income countries. This research aims to investigate the best funding solution for such medical devices to offer disabled people a better quality of life and improve their health and economic situation. This is the first time such methods are being used in a study based on related research involving a fuzzy analytic hierarchy process (FAHP)/VIekriterijumsko KOmpromisno Rangiranje (VIKOR) model to find the best funding source. A survey questionnaire created by the author and completed by Pakistan subject experts was used to analyze data via a weightage value ranking system as an assessment tool. Prioritization of funding alternatives was based on main criteria and subcriteria. Limitations include sample number of study participants, amount of data collected, number of models used, and time constraints. Potential funding sources were ranked based on a VIKOR weightage value model using a hybrid decision-making process that showed results as “private insurance” having a weightage value of (0.1956) as being the best funding source since they are having the minimum weightage and then next from best to least they were “need-based” with a weightage value of (0.2510), “self-pay” with a weightage value of (0.7970), and finally “government-based” having a weightage value of (0.9636). Implications of this study conclude that the proposed model efficiently finds the best funding sources for advanced prosthetic and orthotic (P&O) medical devices in low-income countries. Executing this model in low-income countries such as Pakistan can help solve P&O medical device coverage challenges and offer disabled people better opportunities to work and contribute to their quality of life and economy.

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“… 34 , 38 Additionally, Rekant et al, (2022) compared priorities of different stakeholder perspectives through a survey approach, showing subjects generally prioritized ADL performance improvements and safety for future device design. 35 Another study used semi-structured focus groups or interviews to learn about ideal prosthesis qualities, finding most interest in improving dexterity and durability of prosthetic options in their willingness to consider invasive prosthetic interfaces. 37 One study used a best worst scaling prioritization survey of 47 stakeholders, finding reliability of the device most important and outdating of device least important.…”

Section: Introductionmentioning

confidence: 99%

Prosthesis preferences for those with upper limb loss: Discrete choice study of PULLTY® for use in regulatory decisions

Wilson

Dohan

Garibaldi

et al. 2023

Journal of Rehabilitation and Assistive Technologies Engineerin

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Introduction The patient’s voice in shared decision-making has progressed from physician’s office to regulatory decision-making for medical devices with FDA’s Patient Preference Initiative. A discrete-choice preference measure for upper limb prosthetic devices was developed to investigate patient’s risk/benefit preference choices for regulatory decision making. Methods Rapid ethnographic procedures were used to design a discrete-choice measure describing risk and benefits of osseointegration with myoelectric control and test in a pilot preference study in adults with upper limb loss. Primary outcome is utility of each choice based conjoint (CBC) attribute using mixed-effects regression. Utilities with and without video, and between genders were compared. Results Strongest negative preference was for avoiding infection risk (B = −1.77, p < 0.001) and chance of daily pain (B = −1.22, p, 0.001). Strongest positive preference was for attaining complete independence when cooking dinner (B = 1.62, p < 0.001) and smooth grip patterns at all levels (B = 1.62, B = 1.28, B = 1.26, p < 0.001). Trade-offs showed a 1% increase in risk of serious/treatable infection resulted in a 1.77 decrease in relative preference. There were gender differences, and where video was used, preferences were stronger. Conclusions Strongest preferences were for attributes of functionality and independence versus connectedness and sensation but showed willingness to make risk-benefit trade-offs. Findings provide valuable information for regulatory benefit-risk decisions for prosthetic device innovations. Trial Registration This study is not a clinical trial reporting results of a health care intervention so is not registered.

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Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies

Cited by 11 publications

References 67 publications

Factors that Influence the Adoption of Rehabilitation Technologies: A Multi-Disciplinary Qualitative Exploration

Factors that Influence the Adoption of Rehabilitation Technologies: A Multi-Disciplinary Qualitative Exploration

A Hybrid Fuzzy AHP/VIKOR Approach to Funding Strategy Selection for Advanced Prosthetic and Orthotic Medical Devices in Low-Income Countries: A Case of Pakistan

Prosthesis preferences for those with upper limb loss: Discrete choice study of PULLTY® for use in regulatory decisions

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