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Do Orthopaedic Surgeons Acknowledge Uncertainty?

Teun Teunis¹, Stein Janssen², Thierry G Guitton³

¹General Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.

Clinical Orthopaedics and Related Research

|November 11, 2015

Summary

This summary is machine-generated.

Orthopaedic surgeons show low recognition of uncertainty, unaffected by experience but linked to confidence and trust in evidence. Improving statistical training may enhance awareness of knowledge gaps.

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Area of Science:

Orthopaedic Surgery
Medical Decision-Making
Evidence-Based Medicine

Background:

Clinical decision-making in orthopaedics often relies on limited evidence, leading to inherent uncertainty.
Physician uncertainty can negatively impact patient health outcomes.
Factors beyond evidence, such as confidence and beliefs, may influence physician uncertainty.

Purpose of the Study:

To investigate if physician uncertainty and overconfidence decrease with practice experience.
To identify sociodemographic factors associated with lower recognition of uncertainty, including religious beliefs.
To determine the correlation between confidence bias, trust in evidence, and statistical sophistication with uncertainty recognition.

Main Methods:

A survey assessed recognition of uncertainty, trust in evidence, confidence bias, and statistical understanding.
The survey was administered to 706 members of the Science of Variation Group (orthopaedic surgeons).
242 surgeons completed the survey, with analysis using multivariable regression.

Main Results:

Recognition of uncertainty did not vary significantly with years of practice.
Overconfidence bias positively correlated with years in practice.
Lower recognition of uncertainty was independently associated with multispecialty group practice, belief in God, higher confidence bias, and greater trust in evidence.

Conclusions:

Low recognition of uncertainty and high confidence bias among orthopaedic surgeons contrast with the limited evidence base.
This may hinder adequate patient information, informed decision-making, and consent.
Modifiable factors like confidence bias, trust in evidence, and statistical understanding are linked to uncertainty recognition, suggesting areas for improvement.