TY - JOUR
T1 - A comparison of patient and physician beliefs about infrainguinal bypass operation
T2 - What role should surgical optimism play?
AU - Schwarze, Margaret L.
AU - Sayla, Maliha A.
AU - Alexander, G. Caleb
N1 - Funding Information:
Dr Alexander was supported by the MacLean Center for Clinical Medical Ethics and a Geriatric Academic Program Award (K12AG00488) from the National Institutes of Aging to the University of Chicago. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
PY - 2007/2
Y1 - 2007/2
N2 - Background: Risk and outcomes of infrainguinal bypass operation vary by identifiable patient characteristics. Previously, we found that although patients appear willing to undertake considerable risk, they may have unrealistic expectations for operative benefits. Little is known about whether patients and physicians have similar beliefs regarding the risks and benefits of the operation. Methods: Cross-sectional paired surveys of 6 surgeons and 45 of their patients undergoing infrainguinal bypass operation at a large university medical center. Results: Similar proportions of physicians and patients reported risks associated with the operation. There was moderate agreement within patient-surgeon pairs regarding specific risks such as the likely need for additional operations or for amputation despite the procedure (agreement ranging from 60% to 69% of patient-physician pairs). In nearly two thirds (62%) of cases surgeons provided more optimistic prognostic estimates of 5-year mortality than is suggested by prior research (McNemar test, P < .001). In turn, patients tended to be more optimistic regarding their estimated 5-year survival than their surgeons, with 56% of patients estimating a lesser 5-year mortality than that predicted by their surgeon (McNemar test, P < .01). Conclusions: Although surgeons and patients generally agree regarding the risks of infrainguinal bypass operation, both groups appear more optimistic regarding likely 5-year survival than the outcomes suggested by prior research. This optimism may play an important role in the decision to proceed with infraninguinal bypass operation, as well as the preservation of hope regarding the potential long-term benefits of such intervention.
AB - Background: Risk and outcomes of infrainguinal bypass operation vary by identifiable patient characteristics. Previously, we found that although patients appear willing to undertake considerable risk, they may have unrealistic expectations for operative benefits. Little is known about whether patients and physicians have similar beliefs regarding the risks and benefits of the operation. Methods: Cross-sectional paired surveys of 6 surgeons and 45 of their patients undergoing infrainguinal bypass operation at a large university medical center. Results: Similar proportions of physicians and patients reported risks associated with the operation. There was moderate agreement within patient-surgeon pairs regarding specific risks such as the likely need for additional operations or for amputation despite the procedure (agreement ranging from 60% to 69% of patient-physician pairs). In nearly two thirds (62%) of cases surgeons provided more optimistic prognostic estimates of 5-year mortality than is suggested by prior research (McNemar test, P < .001). In turn, patients tended to be more optimistic regarding their estimated 5-year survival than their surgeons, with 56% of patients estimating a lesser 5-year mortality than that predicted by their surgeon (McNemar test, P < .01). Conclusions: Although surgeons and patients generally agree regarding the risks of infrainguinal bypass operation, both groups appear more optimistic regarding likely 5-year survival than the outcomes suggested by prior research. This optimism may play an important role in the decision to proceed with infraninguinal bypass operation, as well as the preservation of hope regarding the potential long-term benefits of such intervention.
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U2 - 10.1016/j.surg.2006.07.025
DO - 10.1016/j.surg.2006.07.025
M3 - Article
C2 - 17263981
AN - SCOPUS:33846433520
VL - 141
SP - 239
EP - 244
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 2
ER -