常见上肢疾病非手术治疗建议的差异。
Variation in Nonsurgical Treatment Recommendations for Common Upper Extremity Conditions.
机构信息
From the Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA (Dr. Smits, Dr. Wilkens, Dr. Chen), the Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX (Dr. Ring), and the Department of Plastic Surgery, University Medical Center Groningen, Groningen, The Netherlands (Dr. Guitton).
出版信息
J Am Acad Orthop Surg. 2019 Aug 1;27(15):575-580. doi: 10.5435/JAAOS-D-17-00882.
BACKGROUND
In orthopaedic surgery, there is known surgeon-to-surgeon variation in recommendations for surgery. Variation in recommendations for nonsurgical treatment of common upper extremity conditions for which surgery is discretionary remains unclear.
METHODS
One hundred eighty-three surgeons were included after completing six questions on six scenarios of upper extremity conditions regarding nonsurgical treatment recommendations. For one scenario, we measured the influence of reading a summary of preferred practice before making recommendations.
RESULTS
Variation in nonsurgical treatment recommendations was observed between surgeons and between upper extremity conditions. Surgeons that reviewed a decision support paragraph were more likely to opine that surgery would eventually be beneficial.
DISCUSSION
The notable variation in nonsurgical treatment recommendations indicates a substantial influence of surgeon bias in decision-making. To help ensure that decisions are consistent, surgeons may benefit from decision support and guidelines to help limit practice variation.
背景
在骨科手术中，不同医生之间对手术治疗的建议存在差异。对于一些可选择手术治疗的常见上肢疾病，目前尚不清楚非手术治疗建议是否存在差异。
方法
在完成关于上肢疾病非手术治疗建议的六个情景中的六个问题后，共有 183 名外科医生参与了研究。对于其中一个情景，我们测量了在做出建议之前阅读首选实践摘要对医生建议的影响。
结果
在非手术治疗建议方面，不同外科医生之间以及不同上肢疾病之间存在差异。阅读决策支持段落的外科医生更倾向于认为手术最终会有益处。
讨论
非手术治疗建议的显著差异表明，外科医生的决策存在很大的偏见。为了帮助确保决策的一致性，外科医生可能会受益于决策支持和指南，以帮助限制实践差异。
Zotero 插件