Challenges in Outcome Measurement: Discrepancies Between Patient and Provider Definitions of Success
Background Some orthopaedic procedures, including TKA, enjoy high survivorship but leave many patients dissatisfied because of residual pain and functional limitations. An important cause of patient dissatisfaction is unfulfilled preoperative expectations. This arises, in part, from differences betw...
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description | Background
Some orthopaedic procedures, including TKA, enjoy high survivorship but leave many patients dissatisfied because of residual pain and functional limitations. An important cause of patient dissatisfaction is unfulfilled preoperative expectations. This arises, in part, from differences between provider and patient in their definition of a successful outcome.
Where Are We Now?
Patients generally are less satisfied with their outcomes than surgeons. While patients are initially concerned with symptom relief, their long-term expectations include return of symptom-free function, especially in terms of activities that are personally important. While surgeons share their patients’ desire to achieve their goals, they are aware this will not always occur. Conversely, patients do not always realize some of their expectations cannot be met by current orthopaedic procedures, and this gap in understanding is an important source of discrepancies in expectations and patient dissatisfaction.
Where Do We Need to Go?
An essential prerequisite for mutual understanding is information that is accurate, objective, and relevant to the patient’s condition and lifestyle. This critical information must also be understandable within the educational and cultural background of each patient to enable informed participation in a shared decision making process. Once this is achieved, it will become easier to formulate similar expectations regarding the likely level of function and symptom relief and the risk of adverse events, including persistent pain, complications, and revision surgery.
How Do We Get There?
Predictive models of patient outcomes, based on objective data, are needed to inform decision making on the individual level. This can be achieved once comprehensive data become available capturing the lifestyles of patients of diverse ages and backgrounds, including data documenting the frequency and intensity of participation in sporting and recreational activities. There is also a need for greater attention to the process of informing patients of the outcome of orthopaedic procedures, not simply for gaining more meaningful consent, but so that patients and providers may achieve greater alignment of expectations and increased acceptance of both the benefits and limitations of alternative treatments. |
doi_str_mv | 10.1007/s11999-013-3198-x |
format | Article |
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Some orthopaedic procedures, including TKA, enjoy high survivorship but leave many patients dissatisfied because of residual pain and functional limitations. An important cause of patient dissatisfaction is unfulfilled preoperative expectations. This arises, in part, from differences between provider and patient in their definition of a successful outcome.
Where Are We Now?
Patients generally are less satisfied with their outcomes than surgeons. While patients are initially concerned with symptom relief, their long-term expectations include return of symptom-free function, especially in terms of activities that are personally important. While surgeons share their patients’ desire to achieve their goals, they are aware this will not always occur. Conversely, patients do not always realize some of their expectations cannot be met by current orthopaedic procedures, and this gap in understanding is an important source of discrepancies in expectations and patient dissatisfaction.
Where Do We Need to Go?
An essential prerequisite for mutual understanding is information that is accurate, objective, and relevant to the patient’s condition and lifestyle. This critical information must also be understandable within the educational and cultural background of each patient to enable informed participation in a shared decision making process. Once this is achieved, it will become easier to formulate similar expectations regarding the likely level of function and symptom relief and the risk of adverse events, including persistent pain, complications, and revision surgery.
How Do We Get There?
Predictive models of patient outcomes, based on objective data, are needed to inform decision making on the individual level. This can be achieved once comprehensive data become available capturing the lifestyles of patients of diverse ages and backgrounds, including data documenting the frequency and intensity of participation in sporting and recreational activities. There is also a need for greater attention to the process of informing patients of the outcome of orthopaedic procedures, not simply for gaining more meaningful consent, but so that patients and providers may achieve greater alignment of expectations and increased acceptance of both the benefits and limitations of alternative treatments.</description><identifier>ISSN: 0009-921X</identifier><identifier>EISSN: 1528-1132</identifier><identifier>DOI: 10.1007/s11999-013-3198-x</identifier><identifier>PMID: 23955192</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Attitude of Health Personnel ; Conservative Orthopedics ; Health Knowledge, Attitudes, Practice ; Health Services Research ; Humans ; Medicine ; Medicine & Public Health ; Orthopedic Procedures - adverse effects ; Orthopedic Procedures - standards ; Orthopedics ; Outcome and Process Assessment (Health Care) - standards ; Patient Satisfaction ; Predictive Value of Tests ; Quality Indicators, Health Care - standards ; Recovery of Function ; Risk Assessment ; Risk Factors ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Surveys and Questionnaires - standards ; Symposium: ABJS Carl T. Brighton Workshop on Outcome Measures ; Treatment Outcome</subject><ispartof>Clinical orthopaedics and related research, 2013-11, Vol.471 (11), p.3437-3445</ispartof><rights>The Association of Bone and Joint Surgeons® 2013</rights><rights>The Association of Bone and Joint Surgeons 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-p282t-71991ffa456bf4f8c9c9d296bcc68489ff1bcca1cb545a473d68f6ffcb1d1dbc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11999-013-3198-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11999-013-3198-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23955192$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Noble, Philip C.</creatorcontrib><creatorcontrib>Fuller-Lafreniere, Sophie</creatorcontrib><creatorcontrib>Meftah, Morteza</creatorcontrib><creatorcontrib>Dwyer, Maureen K.</creatorcontrib><title>Challenges in Outcome Measurement: Discrepancies Between Patient and Provider Definitions of Success</title><title>Clinical orthopaedics and related research</title><addtitle>Clin Orthop Relat Res</addtitle><addtitle>Clin Orthop Relat Res</addtitle><description>Background
Some orthopaedic procedures, including TKA, enjoy high survivorship but leave many patients dissatisfied because of residual pain and functional limitations. An important cause of patient dissatisfaction is unfulfilled preoperative expectations. This arises, in part, from differences between provider and patient in their definition of a successful outcome.
Where Are We Now?
Patients generally are less satisfied with their outcomes than surgeons. While patients are initially concerned with symptom relief, their long-term expectations include return of symptom-free function, especially in terms of activities that are personally important. While surgeons share their patients’ desire to achieve their goals, they are aware this will not always occur. Conversely, patients do not always realize some of their expectations cannot be met by current orthopaedic procedures, and this gap in understanding is an important source of discrepancies in expectations and patient dissatisfaction.
Where Do We Need to Go?
An essential prerequisite for mutual understanding is information that is accurate, objective, and relevant to the patient’s condition and lifestyle. This critical information must also be understandable within the educational and cultural background of each patient to enable informed participation in a shared decision making process. Once this is achieved, it will become easier to formulate similar expectations regarding the likely level of function and symptom relief and the risk of adverse events, including persistent pain, complications, and revision surgery.
How Do We Get There?
Predictive models of patient outcomes, based on objective data, are needed to inform decision making on the individual level. This can be achieved once comprehensive data become available capturing the lifestyles of patients of diverse ages and backgrounds, including data documenting the frequency and intensity of participation in sporting and recreational activities. There is also a need for greater attention to the process of informing patients of the outcome of orthopaedic procedures, not simply for gaining more meaningful consent, but so that patients and providers may achieve greater alignment of expectations and increased acceptance of both the benefits and limitations of alternative treatments.</description><subject>Attitude of Health Personnel</subject><subject>Conservative Orthopedics</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health Services Research</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedic Procedures - adverse effects</subject><subject>Orthopedic Procedures - standards</subject><subject>Orthopedics</subject><subject>Outcome and Process Assessment (Health Care) - standards</subject><subject>Patient Satisfaction</subject><subject>Predictive Value of Tests</subject><subject>Quality Indicators, Health Care - standards</subject><subject>Recovery of Function</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Surveys and Questionnaires - standards</subject><subject>Symposium: ABJS Carl T. Brighton Workshop on Outcome Measures</subject><subject>Treatment Outcome</subject><issn>0009-921X</issn><issn>1528-1132</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkctqHDEQRYVJsMePD_AmCLLJpm2VpH4ou2T8BBsPOIHshFpdimW61ROpO7b_PhrGBpNVVXEPRdW9hBwDOwHG6tMEoJQqGIhCgGqK5x2ygJI3BYDgH8iCMaYKxeHXHtlP6TGPQpZ8l-xxocoSFF-Qbvlg-h7Db0zUB3o3T3YckN6iSXPEAcP0lZ75ZCOuTbA-U99xekIMdGUmn2VqQkdXcfzrO4z0DJ0PfvJjSHR09H62FlM6JB-d6RMevdYD8vPi_Mfyqri5u7xefrsp1rzhU1Hnb8A5I8uqddI1VlnVcVW11laNbJRzkFsDti1laWQtuqpxlXO2hQ661ooD8mW7dx3HPzOmSQ_5dOx7E3CckwYphQSm6jKjn_9DH8c5hnxdpkR2VdVKZerTKzW3A3Z6Hf1g4ot-8y8DfAukLGUT47s1TG9C0tuQdA5Jb0LSz-IfcrWD_w</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Noble, Philip C.</creator><creator>Fuller-Lafreniere, Sophie</creator><creator>Meftah, Morteza</creator><creator>Dwyer, Maureen K.</creator><general>Springer US</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20131101</creationdate><title>Challenges in Outcome Measurement: Discrepancies Between Patient and Provider Definitions of Success</title><author>Noble, Philip C. ; Fuller-Lafreniere, Sophie ; Meftah, Morteza ; Dwyer, Maureen K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p282t-71991ffa456bf4f8c9c9d296bcc68489ff1bcca1cb545a473d68f6ffcb1d1dbc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Attitude of Health Personnel</topic><topic>Conservative Orthopedics</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health Services Research</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedic Procedures - adverse effects</topic><topic>Orthopedic Procedures - standards</topic><topic>Orthopedics</topic><topic>Outcome and Process Assessment (Health Care) - standards</topic><topic>Patient Satisfaction</topic><topic>Predictive Value of Tests</topic><topic>Quality Indicators, Health Care - standards</topic><topic>Recovery of Function</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Surveys and Questionnaires - standards</topic><topic>Symposium: ABJS Carl T. Brighton Workshop on Outcome Measures</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Noble, Philip C.</creatorcontrib><creatorcontrib>Fuller-Lafreniere, Sophie</creatorcontrib><creatorcontrib>Meftah, Morteza</creatorcontrib><creatorcontrib>Dwyer, Maureen K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical orthopaedics and related research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Noble, Philip C.</au><au>Fuller-Lafreniere, Sophie</au><au>Meftah, Morteza</au><au>Dwyer, Maureen K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Challenges in Outcome Measurement: Discrepancies Between Patient and Provider Definitions of Success</atitle><jtitle>Clinical orthopaedics and related research</jtitle><stitle>Clin Orthop Relat Res</stitle><addtitle>Clin Orthop Relat Res</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>471</volume><issue>11</issue><spage>3437</spage><epage>3445</epage><pages>3437-3445</pages><issn>0009-921X</issn><eissn>1528-1132</eissn><abstract>Background
Some orthopaedic procedures, including TKA, enjoy high survivorship but leave many patients dissatisfied because of residual pain and functional limitations. An important cause of patient dissatisfaction is unfulfilled preoperative expectations. This arises, in part, from differences between provider and patient in their definition of a successful outcome.
Where Are We Now?
Patients generally are less satisfied with their outcomes than surgeons. While patients are initially concerned with symptom relief, their long-term expectations include return of symptom-free function, especially in terms of activities that are personally important. While surgeons share their patients’ desire to achieve their goals, they are aware this will not always occur. Conversely, patients do not always realize some of their expectations cannot be met by current orthopaedic procedures, and this gap in understanding is an important source of discrepancies in expectations and patient dissatisfaction.
Where Do We Need to Go?
An essential prerequisite for mutual understanding is information that is accurate, objective, and relevant to the patient’s condition and lifestyle. This critical information must also be understandable within the educational and cultural background of each patient to enable informed participation in a shared decision making process. Once this is achieved, it will become easier to formulate similar expectations regarding the likely level of function and symptom relief and the risk of adverse events, including persistent pain, complications, and revision surgery.
How Do We Get There?
Predictive models of patient outcomes, based on objective data, are needed to inform decision making on the individual level. This can be achieved once comprehensive data become available capturing the lifestyles of patients of diverse ages and backgrounds, including data documenting the frequency and intensity of participation in sporting and recreational activities. There is also a need for greater attention to the process of informing patients of the outcome of orthopaedic procedures, not simply for gaining more meaningful consent, but so that patients and providers may achieve greater alignment of expectations and increased acceptance of both the benefits and limitations of alternative treatments.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23955192</pmid><doi>10.1007/s11999-013-3198-x</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Attitude of Health Personnel Conservative Orthopedics Health Knowledge, Attitudes, Practice Health Services Research Humans Medicine Medicine & Public Health Orthopedic Procedures - adverse effects Orthopedic Procedures - standards Orthopedics Outcome and Process Assessment (Health Care) - standards Patient Satisfaction Predictive Value of Tests Quality Indicators, Health Care - standards Recovery of Function Risk Assessment Risk Factors Sports Medicine Surgery Surgical Orthopedics Surveys and Questionnaires - standards Symposium: ABJS Carl T. Brighton Workshop on Outcome Measures Treatment Outcome |
title | Challenges in Outcome Measurement: Discrepancies Between Patient and Provider Definitions of Success |
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