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Carpal Tunnel Syndrome: Assessment of Surgeon and Patient Preferences and Priorities for Decision-Making

2014; Elsevier BV; Volume: 39; Issue: 9 Linguagem: Inglês

10.1016/j.jhsa.2014.05.035

1531-6564

Michiel G.J.S. Hageman, Ahmet Kinaci, Kevin L. Ju, Thierry G. Guitton, Chaitanya S. Mudgal, David Ring, Joshua M. Abzug, Julie E. Adams, Gallo Fabio Arbelaez, T. Aspard, George W Balfour, H. Brent Bamberger, Romero Jose Camilo Barreto, Michael A. Baskies, W. Arnold Batson, Taizoon Baxamusa, Ramon de Bedout, Steven Beldner, Prosper Benhaim, Leon S. Benson, G. Jorge Boretto, Martin I. Boyer, Gregory Dee Byrd, Ryan P. Calfee, Gladys Cecilia Zambrano, Charles Cassidy, Louis W. Catalano, Karel Chivers, Ralph M. Costanzo, Phani K. Dantuluri, Gregory L. DeSilva, Seth D. Dodds, John Evans, Naquira Escobar Luis Felipe, Carlos Henrique Fernandes, Thomas J. Fischer, Jochen Fischer, M. Renato Fricker, Gary K. Frykman, Aida E. Garcia, R. Glenn Gaston, José Fernando Di Giovanni, Charles A. Goldfarb, Michael Grafe, Hans Grünwald, Warren C. Hammert, Randy M. Hauck, Ricardo German Hernandez, Erik H. Hofmeister, Richard L. Hutchison, Asif M. Ilyas, Jonathan Isaacs, Sidney M. Jacoby, Peter Jebson, Christopher M. Jones, Michael Jones, Sanjeev Kakar, David M. Kalainov, Thomas D. Kaplan, Saul J. Kaplan, Leonid I. Katolik, Stephen A. Kennedy, Michael W. Kessler, Hervey L. Kimball, Gerald Kraan, Paul A. Martineau, John A. McAuliffe, Steven J. McCabe, Desirae McKee, Gregory A. Merrell, Charles Metzger, Michael Nancollas, David L. Nelson, R. Nyszkiewicz, José Alfredo Soto Ortíz, Patrick Owens, Jason Palmer, Lior Paz, Gary M. Pess, Daniel B. Polatsch, Frank J. Raia, Marc J. Richard, Marco Rizzo, Rozental, David E. Ruchelsman, Oleg M. Semenkin, Aguilar Javier Francisco Sierra, Todd E. Siff, Samir Sodha, Catherine Spath, S. Spruijt, Thomas F. Stackhouse, Carrie R. Swigart, R. Szabó, John S. Taras, Jason D. Tavakolian, Andrew L. Terrono, Thomas F. Varecka, Abhijeet L. Wahegaonkar, Christopher J. Walsh, Frank L. Walter, Lawrence Weiss, Brian P.D. Wills, Chris Wilson, Christopher Wilson, Jennifer Moriatis Wolf, Megan M. Wood, Colby Young,

Peripheral Nerve Disorders

This study tested the null hypothesis that there are no differences between the preferences of hand surgeons and those patients with carpal tunnel syndrome (CTS) facing decisions about management of CTS (ie, the preferred content of a decision aid).One hundred three hand surgeons of the Science of Variation Group and 79 patients with CTS completed a survey about their priorities and preferences in decision making regarding the management of CTS. The questionnaire was structured according the Ottawa Decision Support Framework for the development of a decision aid.Important areas on which patient and hand surgeon interests differed included a preference for nonpainful, nonoperative treatment and confirmation of the diagnosis with electrodiagnostic testing. For patients, the main disadvantage of nonoperative treatment was that it was likely to be only palliative and temporary. Patients preferred, on average, to take the lead in decision making, whereas physicians preferred shared decision making. Patients and physicians agreed on the value of support from family and other physicians in the decision-making process.There were some differences between patient and surgeon priorities and preferences regarding decision making for CTS, particularly the risks and benefits of diagnostic and therapeutic procedures.Information that helps inform patients of their options based on current best evidence might help patients understand their own preferences and values, reduce decisional conflict, limit surgeon-to-surgeon variations, and improve health.