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The Association Between Risk Aversion of Surgeons and Their Clinical Decision-Making.

Greg D Sacks1, Aaron J Dawes2, Yusuke Tsugawa3

  • 1Department of Surgery, NYU Langone Health, New York, New York.

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|August 9, 2021
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Summary
This summary is machine-generated.

Surgeon risk aversion impacts surgical recommendations. This effect is primarily driven by how surgeons perceive potential post-operative complications, not by their inherent risk tolerance.

Keywords:
Decision-makingRisk attitudeRisk aversionSurgery

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Area of Science:

  • Medical Decision Making
  • Surgical Practice
  • Risk Perception in Healthcare

Background:

  • Surgeon risk aversion's influence on clinical decisions is not well understood.
  • Investigating the link between a surgeon's attitude toward risk and their surgical choices is crucial.
  • Understanding if perceived treatment risks and benefits mediate this relationship is key.

Purpose of the Study:

  • To assess if surgeon risk aversion influences clinical decisions.
  • To determine if perceived risks and benefits explain the relationship between risk aversion and surgical recommendations.

Main Methods:

  • A national sample of 1,769 surgeons completed clinical vignettes.
  • Surgeons rated their risk aversion using a validated scale (6-36).
  • Participants judged the likelihood of recommending surgery and patient outcomes (complications vs. recovery).

Main Results:

  • Surgeon risk aversion scores varied widely (median=25), with no difference based on experience or gender.
  • Risk-averse surgeons were slightly less likely to recommend operations (65.5% vs. 62.3%, P=0.02).
  • This association disappeared when controlling for perceived complication likelihood (P=0.96).

Conclusions:

  • Surgeon risk aversion shows significant variability.
  • While risk-averse surgeons were less likely to recommend surgery, this was explained by their higher perceived risk of complications.
  • Perceived post-operative complications, rather than risk aversion itself, appear to drive surgical recommendation differences.