Mannion
Fakultäten » Medizinische Fakultät » Rheumaklinik und Institut für physikalische Medizin » PD Dr. Anne Mannion » Mannion
Completed research project
| Title / Titel | Comparison of patient versus surgeon ratings of outcome after spinal surgery | ||||||||
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| Abstract (PDF, 14 KB) | |||||||||
| Summary / Zusammenfassung | INTRODUCTION Patient-orientated questionnaires are becoming increasingly popular in the assessment of outcome and are considered to provide a less biased assessment of the surgical result than traditional surgeon-based ratings. The present study quantified the level of agreement between patients’ and doctors’ global outcome ratings after lumbar spine surgery. METHODS 937 German-speaking patients (60.5 ± 15.6 y; 540 F, 397 M) who had undergone lumbar spine surgery 3-months earlier rated global outcome of the operation on a Likert scale (operation helped a lot…made things worse). They also completed the Core Outcome Measures Index and rated their overall satisfaction with treatment. The surgeon completed a SSE Spine Tango Follow-up form, blind to the patient’s evaluation, rating the outcome with the McNab criteria (excellent…poor). RESULTS There was a significant correlation (Rho=0.58, p<0.0001) between the surgeons’ and patients’ ratings. However, their ratings matched exactly in only 50.7% of the cases; the surgeon gave better ratings than the patient (“overrated”) in 25.3% cases and worse ratings (“underrated”) in 24.0% cases. There were significant differences between the 6 surgeons in the degree to which their ratings matched those of the patients, with senior surgeons “overrating” significantly more often than junior surgeons (p<0.001). “Overrating” was significantly more prevalent for patients with a poor self-rated outcome (measured as global outcome, COMI score, or satisfaction; each p<0.001). In a multivariate model controlling for age and gender, “low satisfaction” and “senior surgeon” were the most significant unique predictors of surgeon “overrating” (p<0.0001; adjusted R2=0.20). Comorbidity, first time/repeat surgery, one-level/multilevel surgery had no unique significant influence. DISCUSSION The study highlights the potential bias in studies that rely solely on surgeon ratings of outcome and indicates the importance of collecting data from both the patient and the surgeon, in order to provide a balanced view of the outcome of spine surgery. | ||||||||
| Publications / Publikationen | Grob D, Lattig F, Kleinstueck FS, Jeszenszky D, Bartanusz V, Porchet F and Mannion AF. Outcome after cervical spine surgery: do the patient and surgeon see eye-to-eye? Cervical Spine Reearch Society, Austin, Texas, 4.12.08-6.12.08.Porchet F, Lattig F, Grob D, Kleinstück F, Jeszenszky D, Bartanusz V, Mannion AF (2009). Comparison of patient and surgeon ratings of global outcome after lumbar spinal surgery. Congress of Neurological Surgeons, Phoenix Arizona, March 11-14, 2009Lattig F, Grob D, Kleinstueck FS, Porchet F, Jeszenszky D,Bartanusz V, O'Riordan D, Mannion AF (2009) Ratings of global outcome at the first post-operative assessment after spinal surgery: how often do the surgeon and patient agree? Eur Spine J. 18 (Suppl 3): 386-94Porchet F, Lattig F, Grob D, Kleinstueck FS, Jeszenszky D, Paus C, O'Riordan D, Mannion AF (2010) Comparison of patient and surgeon ratings of outcome 12 months after spine surgery: presented at the 2009 Joint Spine Section Meeting. J Neurosurg Spine. 2010 May;12(5):447-55 | ||||||||
| Keywords / Suchbegriffe | global outcome, surgery, patient-rated, surgeon-rated | ||||||||
| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
Foundation Stiftung Wilhelm Schulthess Forschungsfonds |
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| Duration of Project / Projektdauer | Mar 2006 to Dec 2009 |