Outcomes and Preferences for Decision-Making for Upper Limb Prosthetic Care: The Patient Journey: A Scoping Literature Review.
Leslie Wilson, Mark Gutin, Timothy Banh and 6 others
PMID 40678278WHAT IT FOUND
Most upper-limb prosthetic research compares device technology, not patient preference.
Only six studies examined preference, and just four used robust choice methods. Clinicians should expect that evidence guiding shared decision-making is sparse, so direct discussion of individual goals remains essential.
Key findings
01The literature is dominated by comparisons of prosthetic technology, while studies specifically examining patient preference are rare.
02Outcome measurement is inconsistent, using a mix of validated and unvalidated tools with different goals.
03Abandonment rates have not improved over the last ten years despite technological advances.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review included only studies published in English, which may exclude relevant research from other regions. The included studies were often small or medium-sized, with sample sizes frequently under 50 participants. The review excluded papers focused solely on technology development if they did not address decision-making, potentially missing context on device capabilities. There is no standardization in how outcomes are measured across the literature, making direct comparisons between studies difficult.
Declared interests
The investigators have no financial or nonfinancial disclosures to make in relation to this project.
The easy way to misread this
Do not interpret the scarcity of preference studies as evidence that patient preference is unimportant. It reflects a gap in research methods, not a lack of clinical relevance. Clinicians should not rely on existing outcome measures alone to guide decision-making, as they often fail to capture the psychosocial and aesthetic factors that drive abandonment.