A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons
Objective: To assess communication between vascular neurosurgeons and their patients with unruptured cerebral aneurysms about treatment options and expected outcomes. Methods: Vascular neurosurgeons and their patients with cerebral aneurysms were surveyed immediately following outpatient appointment...
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| Veröffentlicht in: | Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2005-04, Vol.76 (4), p.550-554 |
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| description | Objective: To assess communication between vascular neurosurgeons and their patients with unruptured cerebral aneurysms about treatment options and expected outcomes. Methods: Vascular neurosurgeons and their patients with cerebral aneurysms were surveyed immediately following outpatient appointments in a neurosurgery clinic. Data collected included how well the patient understood their aneurysm treatment options, the risks of a poor outcome from various treatments, and the consensus “best” treatment. Patient and neurosurgeon responses were measured using Likert scales, multiple choice questions, and visual analogue scales. Agreement between patient and neurosurgeon was assessed with kappa scores. The Wilcoxon sign rank test was used to compare visual analogue scale responses. Results: Data for 44 patient–neurosurgeon pairs were collected. Only 61% of patient–neurosurgeon pairs agreed on the best treatment plan for the patient’s aneurysm (κ = 0.51, moderate agreement). Among the neurosurgeons, agreement with their patients ranged from 82% (κ = 0.77, almost perfect agreement) to 52% (κ = 0.37, fair agreement). Patients estimated much higher risks of stroke or death from surgical clipping, endovascular embolisation, or no intervention compared with the estimates offered by their neurosurgeons (surgical clipping: patient 36% v neurosurgeon 13%, p |
| doi_str_mv | 10.1136/jnnp.2004.051649 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1739590</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67522933</sourcerecordid><originalsourceid>FETCH-LOGICAL-b527t-67f548f67481efdff44c8f8b29d33ee98c32ec51eac7fac9dbef655c3f93802d3</originalsourceid><addsrcrecordid>eNqFkctrFTEUxoMo9ra6dyUBwY3MNc9J4qJQLj4pSsGW7kImc9LOdR7XZKa1_70Z5lIfm2aTkPM733l8CL2gZE0pL99u-363ZoSINZG0FOYRWlFR6oJzcvkYrQhhrOBEkgN0mNKWzEebp-iASqVEPit0foKDa9opAh4H7Ieum_rGuxHe4Z0bG-jHhG-b8Rp7iFBF12LXwxTvUpfyq8Y3LvmpdRHPv0Oa4hUMfXqGngTXJni-v4_Q-Yf33zefitNvHz9vTk6LSjI1FqUKUuhQKqEphDoEIbwOumKm5hzAaM8ZeEnBeRWcN3UFoZTS82C4JqzmR-h40d1NVQe1z-3mFu0uNp2Ld3Zwjf030jfX9mq4sVRxIw3JAq_3AnH4OUEabdckD22bpxymZEslGTOcPwjSLKcV1xl89R-4HabY5y3kopoyroWgmSIL5fPSUoRw3zMldrbWztba2Vq7WJtTXv4965-EvZcZKBagSSP8uo-7-COPwZW0Xy829uJMXJbmrLRfMv9m4atu-3D533Aqvy8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1781238441</pqid></control><display><type>article</type><title>A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>King, J T ; Yonas, H ; Horowitz, M B ; Kassam, A B ; Roberts, M S</creator><creatorcontrib>King, J T ; Yonas, H ; Horowitz, M B ; Kassam, A B ; Roberts, M S</creatorcontrib><description>Objective: To assess communication between vascular neurosurgeons and their patients with unruptured cerebral aneurysms about treatment options and expected outcomes. Methods: Vascular neurosurgeons and their patients with cerebral aneurysms were surveyed immediately following outpatient appointments in a neurosurgery clinic. Data collected included how well the patient understood their aneurysm treatment options, the risks of a poor outcome from various treatments, and the consensus “best” treatment. Patient and neurosurgeon responses were measured using Likert scales, multiple choice questions, and visual analogue scales. Agreement between patient and neurosurgeon was assessed with kappa scores. The Wilcoxon sign rank test was used to compare visual analogue scale responses. Results: Data for 44 patient–neurosurgeon pairs were collected. Only 61% of patient–neurosurgeon pairs agreed on the best treatment plan for the patient’s aneurysm (κ = 0.51, moderate agreement). Among the neurosurgeons, agreement with their patients ranged from 82% (κ = 0.77, almost perfect agreement) to 52% (κ = 0.37, fair agreement). Patients estimated much higher risks of stroke or death from surgical clipping, endovascular embolisation, or no intervention compared with the estimates offered by their neurosurgeons (surgical clipping: patient 36% v neurosurgeon 13%, p<0.001; endovascular embolisation: patient 35% v neurosurgeon 19%, p = 0.040; and no intervention: patient 63% v neurosurgeon 25%, p<0.001). Conclusions: Following consultation with a vascular neurosurgeon, many patients with cerebral aneurysms have an inaccurate understanding of their aneurysm treatment plan and an exaggerated sense of the risks of aneurysmal disease and treatment.</description><identifier>ISSN: 0022-3050</identifier><identifier>EISSN: 1468-330X</identifier><identifier>DOI: 10.1136/jnnp.2004.051649</identifier><identifier>PMID: 15774444</identifier><identifier>CODEN: JNNPAU</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Agreements ; Aneurysms ; Carotid Stenosis - surgery ; cerebral ; Clinical Protocols ; Cognition ; Cognitive ability ; Communication ; Decision making ; Demographics ; Disclosure ; Education ; Embolization, Therapeutic ; Estimates ; Family medical history ; Female ; Humans ; Hypertension ; Intervention ; Intracranial Aneurysm - surgery ; Intracranial Aneurysm - therapy ; Likert scale ; Male ; Middle Aged ; Neurosurgery ; Patient Education as Topic ; physician ; Physician-Patient Relations ; Polls & surveys ; Questionnaires ; Stroke ; Studies ; Surveys and Questionnaires ; VAS ; visual analogue scale</subject><ispartof>Journal of neurology, neurosurgery and psychiatry, 2005-04, Vol.76 (4), p.550-554</ispartof><rights>Copyright 2005 Journal of Neurology Neurosurgery and Psychiatry</rights><rights>Copyright: 2005 Copyright 2005 Journal of Neurology Neurosurgery and Psychiatry</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b527t-67f548f67481efdff44c8f8b29d33ee98c32ec51eac7fac9dbef655c3f93802d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1739590/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1739590/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15774444$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>King, J T</creatorcontrib><creatorcontrib>Yonas, H</creatorcontrib><creatorcontrib>Horowitz, M B</creatorcontrib><creatorcontrib>Kassam, A B</creatorcontrib><creatorcontrib>Roberts, M S</creatorcontrib><title>A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons</title><title>Journal of neurology, neurosurgery and psychiatry</title><addtitle>J Neurol Neurosurg Psychiatry</addtitle><description>Objective: To assess communication between vascular neurosurgeons and their patients with unruptured cerebral aneurysms about treatment options and expected outcomes. Methods: Vascular neurosurgeons and their patients with cerebral aneurysms were surveyed immediately following outpatient appointments in a neurosurgery clinic. Data collected included how well the patient understood their aneurysm treatment options, the risks of a poor outcome from various treatments, and the consensus “best” treatment. Patient and neurosurgeon responses were measured using Likert scales, multiple choice questions, and visual analogue scales. Agreement between patient and neurosurgeon was assessed with kappa scores. The Wilcoxon sign rank test was used to compare visual analogue scale responses. Results: Data for 44 patient–neurosurgeon pairs were collected. Only 61% of patient–neurosurgeon pairs agreed on the best treatment plan for the patient’s aneurysm (κ = 0.51, moderate agreement). Among the neurosurgeons, agreement with their patients ranged from 82% (κ = 0.77, almost perfect agreement) to 52% (κ = 0.37, fair agreement). Patients estimated much higher risks of stroke or death from surgical clipping, endovascular embolisation, or no intervention compared with the estimates offered by their neurosurgeons (surgical clipping: patient 36% v neurosurgeon 13%, p<0.001; endovascular embolisation: patient 35% v neurosurgeon 19%, p = 0.040; and no intervention: patient 63% v neurosurgeon 25%, p<0.001). Conclusions: Following consultation with a vascular neurosurgeon, many patients with cerebral aneurysms have an inaccurate understanding of their aneurysm treatment plan and an exaggerated sense of the risks of aneurysmal disease and treatment.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Agreements</subject><subject>Aneurysms</subject><subject>Carotid Stenosis - surgery</subject><subject>cerebral</subject><subject>Clinical Protocols</subject><subject>Cognition</subject><subject>Cognitive ability</subject><subject>Communication</subject><subject>Decision making</subject><subject>Demographics</subject><subject>Disclosure</subject><subject>Education</subject><subject>Embolization, Therapeutic</subject><subject>Estimates</subject><subject>Family medical history</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intervention</subject><subject>Intracranial Aneurysm - surgery</subject><subject>Intracranial Aneurysm - therapy</subject><subject>Likert scale</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Patient Education as Topic</subject><subject>physician</subject><subject>Physician-Patient Relations</subject><subject>Polls & surveys</subject><subject>Questionnaires</subject><subject>Stroke</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>VAS</subject><subject>visual analogue scale</subject><issn>0022-3050</issn><issn>1468-330X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkctrFTEUxoMo9ra6dyUBwY3MNc9J4qJQLj4pSsGW7kImc9LOdR7XZKa1_70Z5lIfm2aTkPM733l8CL2gZE0pL99u-363ZoSINZG0FOYRWlFR6oJzcvkYrQhhrOBEkgN0mNKWzEebp-iASqVEPit0foKDa9opAh4H7Ieum_rGuxHe4Z0bG-jHhG-b8Rp7iFBF12LXwxTvUpfyq8Y3LvmpdRHPv0Oa4hUMfXqGngTXJni-v4_Q-Yf33zefitNvHz9vTk6LSjI1FqUKUuhQKqEphDoEIbwOumKm5hzAaM8ZeEnBeRWcN3UFoZTS82C4JqzmR-h40d1NVQe1z-3mFu0uNp2Ld3Zwjf030jfX9mq4sVRxIw3JAq_3AnH4OUEabdckD22bpxymZEslGTOcPwjSLKcV1xl89R-4HabY5y3kopoyroWgmSIL5fPSUoRw3zMldrbWztba2Vq7WJtTXv4965-EvZcZKBagSSP8uo-7-COPwZW0Xy829uJMXJbmrLRfMv9m4atu-3D533Aqvy8</recordid><startdate>200504</startdate><enddate>200504</enddate><creator>King, J T</creator><creator>Yonas, H</creator><creator>Horowitz, M B</creator><creator>Kassam, A B</creator><creator>Roberts, M S</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7TK</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>200504</creationdate><title>A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons</title><author>King, J T ; Yonas, H ; Horowitz, M B ; Kassam, A B ; Roberts, M S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b527t-67f548f67481efdff44c8f8b29d33ee98c32ec51eac7fac9dbef655c3f93802d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Agreements</topic><topic>Aneurysms</topic><topic>Carotid Stenosis - surgery</topic><topic>cerebral</topic><topic>Clinical Protocols</topic><topic>Cognition</topic><topic>Cognitive ability</topic><topic>Communication</topic><topic>Decision making</topic><topic>Demographics</topic><topic>Disclosure</topic><topic>Education</topic><topic>Embolization, Therapeutic</topic><topic>Estimates</topic><topic>Family medical history</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Intervention</topic><topic>Intracranial Aneurysm - surgery</topic><topic>Intracranial Aneurysm - therapy</topic><topic>Likert scale</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Patient Education as Topic</topic><topic>physician</topic><topic>Physician-Patient Relations</topic><topic>Polls & surveys</topic><topic>Questionnaires</topic><topic>Stroke</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>VAS</topic><topic>visual analogue scale</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>King, J T</creatorcontrib><creatorcontrib>Yonas, H</creatorcontrib><creatorcontrib>Horowitz, M B</creatorcontrib><creatorcontrib>Kassam, A B</creatorcontrib><creatorcontrib>Roberts, M S</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</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 Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</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>Psychology Database</collection><collection>Science 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>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>King, J T</au><au>Yonas, H</au><au>Horowitz, M B</au><au>Kassam, A B</au><au>Roberts, M S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons</atitle><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle><addtitle>J Neurol Neurosurg Psychiatry</addtitle><date>2005-04</date><risdate>2005</risdate><volume>76</volume><issue>4</issue><spage>550</spage><epage>554</epage><pages>550-554</pages><issn>0022-3050</issn><eissn>1468-330X</eissn><coden>JNNPAU</coden><abstract>Objective: To assess communication between vascular neurosurgeons and their patients with unruptured cerebral aneurysms about treatment options and expected outcomes. Methods: Vascular neurosurgeons and their patients with cerebral aneurysms were surveyed immediately following outpatient appointments in a neurosurgery clinic. Data collected included how well the patient understood their aneurysm treatment options, the risks of a poor outcome from various treatments, and the consensus “best” treatment. Patient and neurosurgeon responses were measured using Likert scales, multiple choice questions, and visual analogue scales. Agreement between patient and neurosurgeon was assessed with kappa scores. The Wilcoxon sign rank test was used to compare visual analogue scale responses. Results: Data for 44 patient–neurosurgeon pairs were collected. Only 61% of patient–neurosurgeon pairs agreed on the best treatment plan for the patient’s aneurysm (κ = 0.51, moderate agreement). Among the neurosurgeons, agreement with their patients ranged from 82% (κ = 0.77, almost perfect agreement) to 52% (κ = 0.37, fair agreement). Patients estimated much higher risks of stroke or death from surgical clipping, endovascular embolisation, or no intervention compared with the estimates offered by their neurosurgeons (surgical clipping: patient 36% v neurosurgeon 13%, p<0.001; endovascular embolisation: patient 35% v neurosurgeon 19%, p = 0.040; and no intervention: patient 63% v neurosurgeon 25%, p<0.001). Conclusions: Following consultation with a vascular neurosurgeon, many patients with cerebral aneurysms have an inaccurate understanding of their aneurysm treatment plan and an exaggerated sense of the risks of aneurysmal disease and treatment.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>15774444</pmid><doi>10.1136/jnnp.2004.051649</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Agreements Aneurysms Carotid Stenosis - surgery cerebral Clinical Protocols Cognition Cognitive ability Communication Decision making Demographics Disclosure Education Embolization, Therapeutic Estimates Family medical history Female Humans Hypertension Intervention Intracranial Aneurysm - surgery Intracranial Aneurysm - therapy Likert scale Male Middle Aged Neurosurgery Patient Education as Topic physician Physician-Patient Relations Polls & surveys Questionnaires Stroke Studies Surveys and Questionnaires VAS visual analogue scale |
| title | A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons |
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