How Do Open-Ended Interview and Closed-Ended Questionnaire Responses Compare? A Matched Mixed-Methods Study Examining Treatment Attitudes of Patients With Meniscal Tear and Persistent Pain

Objective: Despite receiving physical therapy (PT), some patients with meniscal tear still experience persistent knee pain. Understanding their treatment preferences is essential for clinicians to engage in shared decision-making. Self-reported questionnaires are often used to gauge patients’ experiences and preferences, but questionnaires may not fully capture their attitudes. We conducted a mixed-methods study to compare patients’ treatment preferences collected from closed-ended questionnaires and open-ended interviews. Methods: Participants included 20 patients with physician-suspected meniscal tear and persistent knee pain following a course of PT. Participants participated in interviews and completed questionnaires that assessed their preferences for five treatment modalities such as PT, arthroscopic partial meniscectomy (APM), injections, medications, and educational support. Subsequently, we scored the qualitative data from interviews and compared the qualitative and questionnaire responses. Results: Although most participants indicated a preference to avoid APM in the questionnaires, many expressed a conditional willingness to receive APM in the interviews, particularly if their physician recommended it. Many participants endorsed a preference to receive injections, medications, and additional PT in written questionnaires, but several expressed a conditional willingness to receive these modalities in interviews. For example, some participants described cost and location as important factors to consider before agreeing to additional PT, whereas others voiced a preference to avoid frequent medication use in the interviews. Conclusion: Our results suggest that closed-ended questionnaires may not fully capture patient attitudes. Supplementation of questionnaires with qualitative interviews or open-ended questions may allow researchers and clinicians to fully understand the nuances of patient concerns and preferences.