Boersma Emily Z, Kortlever Joost T P, Loeb Michael D, McDonald John, Vagner Gregg A, Ring David, Driscoll Matt
Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
Texas orthopedics, Midtown Medical II Building, Austin, TX, USA.
J Patient Exp. 2020 Dec;7(6):1595-1601. doi: 10.1177/2374373519897761. Epub 2020 Jan 23.
To determine whether greater patient-reported symptom intensity and functional limitation influence expressed preferences for discretionary diagnostic and treatment interventions, we studied the association of patient factors and several Patient Reported Outcome Measure (PROM) scores with patient preferences for diagnostic and treatment interventions before and after the visit, a cross-sectional cohort study. One hundred and forty-three adult patients who completed several PROMs were asked their preferences for diagnostic and treatment interventions before and after a visit with an orthopedic surgeon. Patients with better physical function had fewer preferences for specific diagnostic interventions after the visit ( = .02), but PROM scores had no association with preferences for treatment interventions before or after the visit. A greater percentage of patients expressed the preference for no diagnostic or treatment intervention after the visit with a physician than before (diagnostic intervention; 2.1% before vs 30% after the visit; ≤ .001 and treatment intervention; 2.1% before vs 17% after the visit; ≤ .001). This study suggests that physician expertise may be more reassuring to people with more adaptive mind sets.
为了确定患者报告的更高症状强度和功能限制是否会影响对可自由选择的诊断和治疗干预措施的偏好表达，我们进行了一项横断面队列研究，研究患者因素和几个患者报告结局量表（PROM）得分与患者在就诊前后对诊断和治疗干预措施的偏好之间的关联。143名完成了多个PROM的成年患者被询问了他们在拜访骨科医生前后对诊断和治疗干预措施的偏好。身体功能较好的患者在就诊后对特定诊断干预措施的偏好较少（P = 0.02），但PROM得分与就诊前后对治疗干预措施的偏好无关。与就诊前相比，更多患者在看过医生后表示倾向于不进行任何诊断或治疗干预（诊断干预；就诊前2.1%，就诊后30%；P≤0.001；治疗干预；就诊前2.1%，就诊后17%；P≤0.001）。这项研究表明，医生的专业知识可能会让心态更适应的人更安心。
