TY - JOUR
T1 - Comparison between patient and surgeon perception of degenerative spine disease outcomes-a prospective blinded database study
AU - Roitberg, Ben Z.
AU - Thaci, Bart
AU - Auffinger, Brenda
AU - Kaplan, Laura
AU - Shen, Jingjing
AU - Brown, Frederick D.
AU - Lam, Sandi
PY - 2013/5
Y1 - 2013/5
N2 - Background Few have studied the correlation between patients' and spine surgeons' perception on outcomes, or compared these with patient-reported outcome scores. Outcomes studies are increasingly important in evaluating costs and benefits to patients and surgeons, and in developing metrics for payer evaluation and health care policy-making. Objective To compare patients' and surgeons' assessment of spine treatment outcome in a prospective blinded patientdriven spine surgery outcomes registry, and to correlate perceived outcomes ratings to validated outcomes scores. Methods Patients filled out surveys at baseline, 3 months and 6 months postoperatively, including Visual Analog Scale (VAS), and Neck Disability Index (NDI) or Oswestry Disability Index (ODI). Outcome was rated independently by patients and surgeons on a 7-point Likert-type scale. Results Two-hundred and sixty-five consecutive adult patients were surgical candidates. Of these, 154 (58.1 %) opted for surgery, with 69 (44.8 %) cervical and 85 (55.2 %) lumbar patients. One hundred and thirty-five (87.7 %) had both patient and surgeon postoperative ratings. Surgeons' and patients' ratings correlated strongly (Spearman rho=0.53, p≤0.0001, 45.9%identical, 88.2%+/- 1 grade). The surgeon rated outcomes were better than patients in 29.8 % and worse in 21.15 %. Patient rating correlated better with the most recent NDI/ODI and pain scores than with incremental change from baseline. In multivariate analysis, age, location (cervical vs lumbar), pain ratings, and functional scores (NDI, ODI) did not have significant impact on the discrepancy between patient and surgeon ratings. Conclusions Patients' and surgeons' global outcome ratings for spinal disease correlate highly. Patients' ratings correlate better with most recent functional scores, rather than incremental change from baseline.
AB - Background Few have studied the correlation between patients' and spine surgeons' perception on outcomes, or compared these with patient-reported outcome scores. Outcomes studies are increasingly important in evaluating costs and benefits to patients and surgeons, and in developing metrics for payer evaluation and health care policy-making. Objective To compare patients' and surgeons' assessment of spine treatment outcome in a prospective blinded patientdriven spine surgery outcomes registry, and to correlate perceived outcomes ratings to validated outcomes scores. Methods Patients filled out surveys at baseline, 3 months and 6 months postoperatively, including Visual Analog Scale (VAS), and Neck Disability Index (NDI) or Oswestry Disability Index (ODI). Outcome was rated independently by patients and surgeons on a 7-point Likert-type scale. Results Two-hundred and sixty-five consecutive adult patients were surgical candidates. Of these, 154 (58.1 %) opted for surgery, with 69 (44.8 %) cervical and 85 (55.2 %) lumbar patients. One hundred and thirty-five (87.7 %) had both patient and surgeon postoperative ratings. Surgeons' and patients' ratings correlated strongly (Spearman rho=0.53, p≤0.0001, 45.9%identical, 88.2%+/- 1 grade). The surgeon rated outcomes were better than patients in 29.8 % and worse in 21.15 %. Patient rating correlated better with the most recent NDI/ODI and pain scores than with incremental change from baseline. In multivariate analysis, age, location (cervical vs lumbar), pain ratings, and functional scores (NDI, ODI) did not have significant impact on the discrepancy between patient and surgeon ratings. Conclusions Patients' and surgeons' global outcome ratings for spinal disease correlate highly. Patients' ratings correlate better with most recent functional scores, rather than incremental change from baseline.
KW - Cervical spine
KW - Clinical outcomes
KW - Lumbar spine
KW - Outcome registry
KW - Patient rating
KW - Spine surgery
KW - Surgeon rating
UR - http://www.scopus.com/inward/record.url?scp=84886483663&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84886483663&partnerID=8YFLogxK
U2 - 10.1007/s00701-013-1664-6
DO - 10.1007/s00701-013-1664-6
M3 - Article
C2 - 23468038
AN - SCOPUS:84886483663
SN - 0001-6268
VL - 155
SP - 757
EP - 764
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
IS - 5
ER -