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Limited data exists on second opinion programs for elective surgeries. While agreement rates vary, further research is needed to inform new legislation regarding patient rights to a second opinion.

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Area of Science:

  • Health Services Research
  • Medical Policy
  • Evidence-Based Medicine

Background:

  • New legislation in 2016 grants patients the right to a second opinion for elective surgeries.
  • The Federal Joint Committee is tasked with identifying specific surgical indications for this right.
  • Existing data on the efficacy and agreement rates of second opinion programs is scarce.

Purpose of the Study:

  • To systematically review available data on second opinion programs for elective surgical, orthopedic, and gynecological procedures.
  • To analyze indications that should be included under the new legislation.
  • To assess the agreement rates between initial and second opinions in various surgical contexts.

Main Methods:

  • Systematic literature search of Medline, Embase, Proquest, and Google Scholar conducted in March 2015.
  • Inclusion criteria: primary studies on elective surgical, orthopedic, or gynecological procedures with reported agreement rates.
  • Independent review, critical appraisal, and data extraction by two reviewers.

Main Results:

  • Seventeen studies met inclusion criteria, predominantly from the United States and published before 2000.
  • Agreement rates between first and second opinions ranged widely from 43.0% to 95.5%.
  • High median agreement rates were observed for hysterectomy (77.9%) and cholecystectomy (92.0%) in obligatory second opinion programs.

Conclusions:

  • Current evidence on second opinion programs is limited, with no specific data for Germany.
  • The findings suggest potential benefits of second opinion programs, warranting further investigation.
  • Controlled trials are recommended to provide robust data for informing future healthcare policy and legislation.