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The variability of patient preferences.
1Department of Orthopaedic Surgery, University of Pennsylvania, 424 Stemmler Hall, Philadelphia, PA 19104, USA. orthodoc@post.harvard.edu
Clinical Orthopaedics and Related Research
|January 27, 2012
Summary
Patient preferences for surgical outcomes vary widely, influencing treatment decisions. Many individuals inaccurately estimate their personal treatment thresholds for medical procedures.
Area of Science:
- Decision analysis
- Medical economics
- Patient-reported outcomes
Background:
- Procedure utilization varies significantly, suggesting potential inconsistencies in surgical indications or differing patient valuations of outcomes.
- Patient preferences for successful results or indifference to ineffective treatment costs can lower the treatment threshold, leading to increased surgical recommendations.
Purpose of the Study:
- To investigate the extent of variation in patient preferences and treatment thresholds.
- To determine if individuals can accurately estimate their own treatment thresholds.
Main Methods:
- A hypothetical meniscus injury scenario was presented to 100 college students.
- Participants rated the value of four endpoints related to treatment choice and diagnostic outcomes.
- Treatment thresholds were calculated, and participants also estimated their own thresholds directly.
Main Results:
- Calculated treatment thresholds demonstrated a wide range, from 4% to 88%.
- A significant discrepancy of at least 20% between calculated and self-estimated thresholds was observed in 61% of subjects.
Conclusions:
- Substantial variability exists in reported treatment thresholds among individuals.
- Many participants showed poor accuracy in predicting their own calculated treatment thresholds.
- Understanding patient preferences is crucial for shared decision-making and developing effective clinical guidelines.
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