Melio Anna A, Johnson Meredith, Kaplan Jennifer A, Moonka Ravi, Simianu Vlad V
Department of Surgery, Virginia Mason Medical Center, Seattle, WA, United States.
Center for Digestive Health, Virginia Mason Franciscan Health, Seattle, WA, United States.
Surg Open Sci. 2024 May 9;19:212-216. doi: 10.1016/j.sopen.2024.04.010. eCollection 2024 Jun.
With the increasing prevalence of diverticulitis, professional guidelines encourage the individualization of treatment. However, the frequency of treatment preferences of both surgeons, and patients, and the resultant impact of that preference on diverticulitis management is underexplored. We reviewed 27 consecutive patient visits of 3 colorectal surgeons at our institution to evaluate factors that drove their treatment, as well as their equipoise for patient randomization into medical or surgical treatments. Using standardized pre- and post-visit questionnaires, we investigated the impact of the clinic visit on treatment recommendations. Our results demonstrate that our surgeons have a practice bias towards complicated disease, and have a preference towards operative management of diverticulitis, in both complicated and uncomplicated disease. This preference was frequently unchanged after clinic visit, which has implications for guiding truly shared decision making, as it continues to be the recommendation.
随着憩室炎患病率的不断上升,专业指南鼓励治疗个体化。然而,外科医生和患者的治疗偏好频率以及该偏好对憩室炎管理的最终影响尚未得到充分研究。我们回顾了本机构3位结直肠外科医生连续27次的患者就诊情况,以评估推动他们治疗的因素,以及他们将患者随机分为药物治疗或手术治疗的平衡状态。通过使用标准化的就诊前和就诊后问卷,我们调查了门诊就诊对治疗建议的影响。我们的结果表明,我们的外科医生对复杂疾病存在实践偏见,并且在复杂和非复杂疾病中都倾向于对憩室炎进行手术治疗。这种偏好在门诊就诊后通常没有改变,这对指导真正的共同决策有影响,因为这仍然是推荐的方案。