Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Department of Biostatistics, Weill Cornell Medicine, New York, NY, USA.
Foot Ankle Int. 2023 Aug;44(8):710-718. doi: 10.1177/10711007231177035. Epub 2023 Jun 2.
There has been growing interest in patient-reported outcomes in foot and ankle surgery, and the fulfillment of patient expectations is a potentially powerful tool that compares preoperative expectations and perceived postoperative improvement. Prior work has validated the use of expectation fulfillment in foot and ankle surgery. However, given the wide spectrum of pathologies and treatments in foot and ankle, no study has examined the association between expectation fulfillment and specific diagnosis.
This is a retrospective cohort study consisting of 266 patients who completed the Foot & Ankle Expectations Survey and the Foot and Ankle Outcome Survey (FAOS) preoperatively and 2 years postoperatively. A fulfillment proportion (FP) was calculated using the pre- and postoperative Foot & Ankle Expectations Survey scores. An estimated mean fulfillment proportion for each diagnosis was calculated using a multivariable linear regression model, and pairwise comparisons were used to compare the FP between diagnoses.
All diagnoses had an FP less than 1, indicating partially fulfilled expectations. Ankle arthritis had the highest FP (0.95, 95% CI 0.81-1.08), whereas neuromas and mid/hindfoot diagnoses had the lowest FPs (0.46, 95% CI 0.23-0.68; 0.62, 95% CI 0.45-0.80). Higher preoperative expectations were correlated with lower fulfillment proportions.
FP varied with diagnosis and preoperative expectations. An understanding of current expectation fulfillment among different diagnoses in foot and ankle surgery helps highlight areas for improvement in the management of expectations for presumed diagnoses.
Level III, retrospective review of prospective cohort study.
患者报告的结局在足踝外科中越来越受到关注，而满足患者的期望是一种潜在的有力工具，可以比较术前期望和术后感知的改善。先前的研究已经验证了期望满足在足踝外科中的使用。然而，鉴于足踝疾病和治疗方法的广泛范围，尚无研究探讨期望满足与特定诊断之间的关系。
这是一项回顾性队列研究，共纳入 266 例患者，他们在术前和术后 2 年完成了足部和踝关节期望调查（Foot & Ankle Expectations Survey）和足部和踝关节结局调查（Foot and Ankle Outcome Survey，FAOS）。使用术前和术后 Foot & Ankle Expectations Survey 评分计算满足比例（fulfillment proportion，FP）。使用多变量线性回归模型计算每个诊断的估计平均满足比例，并使用两两比较比较诊断之间的 FP。
所有诊断的 FP 均小于 1，表明期望部分得到满足。关节炎的 FP 最高（0.95，95%置信区间 0.81-1.08），而神经瘤和中/后足诊断的 FP 最低（0.46，95%置信区间 0.23-0.68；0.62，95%置信区间 0.45-0.80）。术前期望越高，满足比例越低。
FP 因诊断和术前期望而异。了解足踝外科中不同诊断的当前期望满足情况有助于突出预期诊断管理中需要改进的领域。
III 级，前瞻性队列研究的回顾性研究。
