Doctors' versus patients' evaluation of results after neurosurgery

A comparison between doctors' and patients' judgements of results after treatment for various neurosurgical conditions has been made. Ninety consecutive patients (41 women and 49 men) treated for trauma, vascular diseases, tumours, pain, and malformations were included in the study. The physicians responsible for the treatment and the patients rated the result of the therapeutic efforts (operative or nonoperative) independently from each other on a five grade scale at the time for discharge. A follow-up study was also made 8-24 months after the treatment. Three different groups of paired observations were distinguished: (1) "identical opinion", (2) "pessimistic opinion" (physician's score lower than patient's) and (3) "optimistic opinion" (physician's score higher than patient's). At the time of discharge identical opinion about the result of treatment was present in 83% (75 cases) whereas 9% (8 cases) and 8% (7 cases) were referred to the groups of pessimistic and optimistic opinions respectively. In the follow up series the corresponding values were 57%, 12%, and 31%. The increase of non-identical judgements in the follow-up study was found almost exclusively in the group of patients treated for painful conditions. Also the spread of judgements was largest in the group of painful conditions. Otherwise there was no correlation between the actual result of treatment and diagnosis, sex or age.