Decision-making in the prescription of orthotics and prosthetics for partial-foot amputees

Prosthetists face a daunting number of decisions that directly affect an amputee’s ability to walk and indirectly affect the overall quality of life of that amputee. In addition, the lack of resources in low-income countries provides a barrier to receive care after an amputation, and approximately 80% of amputees in low-income countries lack appropriate prosthetic care. In this research, we are motivated to understand what factors affect the decision-making strategies of prosthetists and podiatrists when prescribing prosthetics and orthotics to partial foot amputees. This work establishes a decision-making framework as a step towards automated methods that may reduce the complexities and decision-making burden of prosthetic prescription, ultimately increasing the efficiency of prosthetic prescription in low-resourced areas. A decision-making model is proposed based on an extensive literature review of over 100 papers. The proposed model is compared to qualitative data regarding decision-making strategies during prosthetic or orthotic prescription collected from nine prosthetists, surgeons, and other healthcare professionals directly involved in amputee care. Changes to the proposed model are described and future work exploring the role of automated methods to support decision-making in the context of prosthetics is discussed.