Parental preferences for brace weaning in developmental dysplasia of the hip: a discrete choice experiment

Listen to Simon and Amy discuss the paper 'Parental preferences for brace weaning in developmental dysplasia of the hip: a discrete choice experiment' published in the December 2025 issue of Bone & Joint Open.

Click here to read the paper.

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Transcript

[00:00:00] Welcome back to another episode of AI Talks with Bone & Joint from the publishers of Bone & Joint Open. Today we're discussing the paper 'Parental preferences for brace weaning in developmental dysplasia of the hip: a discrete choice experiment', published in December 2025 by J Craven, H Wise, DC Perry, and C Plumpton. I am Simon and I'm joined by my co-host, Amy.

I'm really looking forward to discussing this study with you. Developmental dysplasia of the hip or DDH is such an important topic in pediatric orthopaedics. To start, could you give us a little background on why this research was undertaken?

Of course, the study aimed to understand and quantify how parents feel about different strategies for weaning their infants off braces used to treat DDH. While early bracing is generally effective, there's no consensus on the best way to manage the weaning period. 

So they wanted to see how parents balance the treatment burden against the risk of further intervention, such as more bracing or even surgery. What methods [00:01:00] did they use to gather this information?

They used a discreet choice experiment, which is quite a sophisticated method for eliciting preferences. Parents were presented with a series of hypothetical scenarios comparing different weaning regimens, including immediate cessation. They had to choose between options with varying timings, durations, and associated risks of further intervention.

The study recruited 195 parents via STEPS Worldwide, a patient charity. Most of these participants were mothers and they were from various countries, mainly the UK, USA, Australia and Canada. They had children who were treated for DDH with bracing, so they were certainly familiar with the process.

One fascinating finding was that night-time-only weaning was the most preferred strategy among parents, even when the risk of further intervention was the same as immediate cessation.

This preference was statistically significant. Parents seem to favor this method over options that involved bracing during the day or gradually reducing the hours of brace wear. The researchers speculated that night-time [00:02:00] weaning might feel less abrupt and more manageable to parents compared to stopping bracing immediately.

The preference could also relate to giving parents a sense of control and emotional reassurance during a stressful period. Parents were willing to trade longer brace wear for a lower risk of requiring further treatment.

That makes sense, what about the unacceptable options? Any insights there? Yes. The study found that daytime brace wear and gradual reduction in brace wearing were less preferred. In fact, any strategy that required more daytime intervention seemed to be less favored, possibly due to the higher visibility and inconvenience it causes in daily life.

In the secondary analysis, they excluded participants who gave irrational responses like choosing more burdensome options without a decrease in risk. This analysis showed that all weaning strategies were less preferred than immediate cessation when choices were rationalized. The stronger preference indicates a clearer versions to the treatment burden of longer brace wear. So essentially parents are trying to minimize further interventions while considering the [00:03:00] practicality and emotional impact of weaning strategies.

Precisely. The study's take home message was that parents prioritize reducing the risk of further treatments and are willing to accept additional brace wear, particularly night-time use if the perceived benefit is sufficient. These findings can inform future research and clinical trials regarding brace women strategies.

This really highlights the importance of involving parents in the decision-making process and understanding their perspectives in treatment planning. Exactly. It's crucial to ensure that clinical practices align with family priorities as they are the ones navigating the day-to-day challenges of treatment adherence.

Well, that wraps up our discussion for today, Simon, would you like to summarize the main takeaways?

Sure Amy. The main takeaways are that night-time-only brace weaning is generally preferred by parents even without a reduction in the risk of further intervention. Parents are willing to trade longer durations of brace wear for decreased risk of subsequent treatments, especially when it comes to more manageable weaning strategies. These insights can greatly inform future [00:04:00] clinical trials and practices.

Thanks Simon, and thank you to our listeners for tuning into this episode of AI Talks with Bone & Joint. We hope you found today's discussion both informative and engaging. Take care everyone.