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Variation in Nonsurgical Treatment Recommendations for Common Upper Extremity Conditions

Sci Variation Grp, Smits, L. J. H., Wilkens, S. C., Ring, D., Guitton, T. G. & Chen, N., 1-Aug-2019, In : The Journal of the American Academy of Orthopaedic Surgeons. 27, 15, p. 575-580 6 p.

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  • Variation in Nonsurgical Treatment Recommendations for Common Upper Extremity Conditions

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DOI

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.

Original languageEnglish
Pages (from-to)575-580
Number of pages6
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume27
Issue number15
Publication statusPublished - 1-Aug-2019

    Keywords

  • INTEROBSERVER RELIABILITY, SURGEONS, CLASSIFICATION, DIAGNOSIS

ID: 97355010