Trigger Finger: Assessment of Surgeon and Patient Preferences and Priorities for Decision Making

Döring, Anne-Carolin; Hageman, Michiel G.J.S.; Mulder, Frans J.; Guitton, Thierry G.; Ring, David; Adams, Julie E.; Abzug, Joshua M.; Akabudike, Ngozi M.; Bainbridge, L. C.; Balfour, George W; Bamberger, H. Brent; Barreto, Camilo Jose Romero; Baskies, Michael A.; Baxamusa, Taizoon; Behrman, Michael; Benhaim, Prosper; Blazar, Philip; Boler, James M.; Boretto, Jorge G.; Boyer, Martin I.; Calfee, Ryan P.; Cassidy, Charles; Costanzo, Ralp M.; Darowish, Michael; Bedout, R. de; DeSilva, Gregory L.; Giovanni, Jose Fernando Di; Dodds, Seth D.; Erickson, John M.; Felipe, Naquira Escobar Luis; Fernandes, Carlos Henrique; Fricker, R.; Frykman, Gary K.; Garcia, Aida E.; Gaston, R. Glenn; Gilbert, Richard S.; Grafe, Michael; Greenberg, Jeffrey A.; Grünwald, Hans; Guidera, Paul M.; Hammert, Warren C.; Hauck, Randy M.; Helgemo, Steve; Hernández, Germán; Hofmeister, Eric P.; Hutchison, Richard L.; Ilyas, Asif M.; Jacoby, Sidney M.; Jebson, Peter J.L.; Jones, Christopher M.; Kakar, Sanjeev; Kaplan, F. Thomas D.; Kaplan, Saul J.; Katolik, Leonid I.; Kennedy, Stephen A.; Kessler, Michael W.; Kimball, Hervey L.; Kirkpatrick, Dan; Klinefelter, Ryan; Kraan, Gerald; Lane, Lewis B.; Lattanza, Lisa; Lee, Kendrick; Malone, Kevin J.; Manke, Chad; Martineau, Paul A.; Matiko, Jim; McAuliffe, John A.; McCabe, Steven J.; McKee, Desirae M.; Metzger, Charles; Mitchell, Scott G.; Wolf, Jennifer Moriatis; Nancollas, Michael; Nelson, David L.; Nolla, Jose; Nyszkiewicz, R.; Ortíz, José Alfredo Soto; Overbeck, Joachim P.; Owens, Patrick W.; Papandrea, Rick F.; Paz, Lior; Castillo, Alberto Pérez; Polatsch, Daniel B.; Press, Gary M.; Richard, Marc J.; Rizzo, Marco; Rozental, Tamara D.; Ruchelsman, David E.; Semenkin, Oleg M.; Shatford, Russell A.; Sierra, Fransisco Javier Aguilar; Siff, Todd E.; Spath, Catherine; Spruijt, S.; Sutker, Ben; Swigart, Carrie R.; Taras, John S.; Tavakolian, Jason D.; Terrono, Andrew L.; Tolo, Eric T.; Walsh, Christopher J.; Walter, Frank L.; Watkins, Barry; Weiss, Lawrence; Wills, Brian P.D.; Wilson, Chris; Wilson, Christophe J.; Wint, Jeffrey; Young, Colby

doi:10.1016/j.jhsa.2014.08.010

Cited by 34 publications

(28 citation statements)

References 19 publications

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“…As the very definition of SDM establishes it as a collaborative process between the doctor and patient in order to reach a satisfactory decision, 40 it is unclear whether researchers have illustrated the effect of SDM, or the effect of information-giving. It is further noted that one study reviewed in this paper did indicate that while doctors favor SDM in decision-making, patients actually prefer the provision of information and advice, without collaboration 41 . Although further research is needed in order to generalize these findings, results do indicate the importance of assessing the interplay between doctors and patients with use of SDM.…”

Section: Discussionmentioning

confidence: 73%

Shared Decision Making and Choice for Elective Surgical Care

Boss¹,

Mehta

Nagarajan³

et al. 2015

Otolaryngol.--head neck surg.

171

151

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Objective Shared Decision-Making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known however regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery. Data Sources Pubmed, CochraneCENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases Review Methods We searched for English-language studies (1/1/1990 to 8/9/2015) evaluating use of SDM in elective surgical care. Identified studies were independently screened by two reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias. Results Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7/24) followed by joint (5/24) and gynecological surgery (4/24). Twenty studies used decision aids/support tools, including modalities that were multimedia/video (13/20), written (3/20), or personal coaching (4/20). Effect of SDM on preference for surgery were mixed across studies, showing a decrease in surgery (9/24), no difference (8/24), or increase (1/24). SDM tended to improve decision quality (3/3) as well as knowledge/preparation (4/6), while decreasing decision conflict (4/6). Conclusion SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.

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Section: Discussionmentioning

confidence: 73%

Shared Decision Making and Choice for Elective Surgical Care

Boss¹,

Mehta

Nagarajan³

et al. 2015

Otolaryngol.--head neck surg.

171

151

View full text Add to dashboard Cite

show abstract

“…Treatment preferences among patients and physicians are extensively studied and preferences differ between groups for many conditions [10,16,20]. The direction and magnitude of this effect are not consistent, but it highlights the importance of shared decision-making as opposed to the health provider-as-agent model [20,28].…”

Section: Discussionmentioning

confidence: 99%

Do Surgeons Treat Their Patients Like They Would Treat Themselves?

Janssen

Teunis

Guitton

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. Questions/purposes (1) Are surgeons more likely to recommend surgery when choosing for a patient than for themselves? (2) Are surgeons less confident in deciding for patients than for themselves?Methods Two hundred fifty-four (32%) of 790 Science of Variation Group (SOVG) members reviewed 21 fictional upper extremity cases (eg, distal radius fracture, De Quervain tendinopathy) for which surgery is optional answering two questions: (1) What treatment would you choose/recommend: operative or nonoperative? (2) On a scale from 0 to 10, how confident are you about this decision? Confidence is the degree that one believes that his or her decision is the right one (ie, most appropriate). Participants were orthopaedic, trauma, and plastic surgeons, all with an interest in 123 Clin Orthop Relat Res (2015) 473:3564-3572 DOI 10.1007/s11999-015-4304-z Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® treating upperextremity conditions. Half of the participants were randomized to choose for themselves if they had this injury or illness. The other half was randomized to make treatment recommendations for a patient of their age and gender. For the choice of operative or nonoperative, the overall recommendation for treatment was expressed as a surgery score per surgeon by dividing the number of cases they would operate on by the total number of cases (n = 21), where 100% is when every surgeon recommended surgery for every case. For confidence, we calculated the mean confidence for all 21 cases per surgeon; overall score ranges from 0 to 10 with a higher score indicating more confidence in the decision for treatment. Results Surgeons were more likely to recommend surgery for a patient (44.2% ± 14.0%) than they were to choose surgery for themselves (38.5% ± 15.4%) with a mean difference of 6% (95% confidence interval [CI], 2.1%-9.4%; p = 0.002). Surgeons were more confident in deciding for themselves than they were for a patient of similar age and gender (self: 7.9 ± 1.0, patient: 7.5 ± 1.2, mean difference: 0.35 [CI, 0.075-0.62], p = 0.012). Conclusions Surgeons are slightly more likely to recommend surgery for a patient than they are to choose surgery for themselves and they choose for themselves with a little more confidence. Different perspectives, preferences, circumstantial information, and cognitive biases might explain the observed differences. This emphasizes the importance of (1) understanding patients' preferences and their considerations for treatment; (2) being aware that surgeons and patients might weigh various factors differently; (3) giving patients more autonomy by letting them balance risks and benefits themselves (ie, shared decisionmaking); and (4) assessing how dispassionate evidencebased decision aids help...

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“…No strong preference for one treatment option [29] Support evidence in favor of one specific treatment option [31,30,3] Physician mentors do not support the use of SDM [33] Patient-related Cognitively able [34] Cognitively unable to participate [31,37,35,23,36] Poor adherence [37] Poor adherence [23] Desire to be involved in decision [34,23] Unwilling to participate [37] Informed about condition [23] Limited insight into condition OR treatment [23,45,33] Less educated [33] Children [35] Condition-and treatmentrelated Chronic disease [31,34,66] Chronic pain [35] Cancer screening and treatment [58,64,59,63,44,65] Emergency medicine [31,34] End of life care [31] Hospital care [specific to psychiatry] [23] Severe disease [34] Diagnostic procedures [23] Multiple treatment options exist [34,38,39,55] Pediatric intensive care [45] Treatment options may affect patient's lifestyle [38,36] support SDM,...…”

Section: Physicianrelatedmentioning

confidence: 99%

“…Physicians reported support for SDM in scenarios where multiple treatment options exist, where treatment options were likely to impact the patient's lifestyle and/or self-image, in cases of severe disease, chronic disease or end of life decisions, where the available treatment options carry significant risks, or where treatment stopping is common among patients [31,37,38,34,39]. Physicians surveyed about their comfort with SDM within the context of rehabilitation medicine expressed doubt that patients with chronic pain would be able to actively engage in the decision making process [35].…”

Section: Condition-and Treatment-related That Factors Affect Physiciamentioning

confidence: 99%