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Measuring Expectations in Orthopaedic Surgery: A Systematic Review

  • Symposium: ABJS Carl T. Brighton Workshop on Outcome Measures
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Advances in the surgical treatment of musculoskeletal conditions have resulted in an interest in better defining and understanding patients’ expectations of these procedures, but the best ways to do this remain a topic of considerable debate.

Questions/purposes

(1) What validated instruments for the assessment of patient expectations of orthopaedic surgery have been used in published studies to date? (2) How were these expectation measures developed and validated? (3) What unvalidated instruments for the assessment of patient expectations have been used in published studies to date?

Methods

A systematic literature search was performed using the OVID Medline and EMBASE databases, in duplicate, to identify all studies that assessed patient expectations in orthopaedic surgery. Sixty-six studies were ultimately included in the present review.

Results

Seven validated expectation instruments were identified, all of which use patient-reported questionnaires. Five were specific to a particular procedure or affected anatomic location, whereas two were broadly applicable. Details of reliability and validity testing were available for all but one of these instruments. Forty additional unvalidated expectation assessment tools were identified. Thirteen were based on existing clinical outcome tools, and the others were study-specific, custom-developed tools. Only one of the unvalidated tools was used in more than one study.

Conclusions

Several validated expectation instruments have been developed for use by patients undergoing orthopaedic surgery. However, many tools have been reported without evidence of testing and validation. The wide range of untested instruments used in single studies substantially limits the interpretation and comparison of data concerning patient expectations.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Toronto Western Hospital, University of Toronto, Toronto, Ontario, M5T 2S8, Canada

    Michael G. Zywiel MD, Anisah Mahomed, Rajiv Gandhi MSc, MD, Anthony V. Perruccio PhD & Nizar N. Mahomed MD, ScD

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  1. Michael G. Zywiel MD
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  2. Anisah Mahomed
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  3. Rajiv Gandhi MSc, MD
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  4. Anthony V. Perruccio PhD
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  5. Nizar N. Mahomed MD, ScD
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Correspondence to Michael G. Zywiel MD.

Additional information

One or more of the authors (MGZ) serves on the editorial board of Expert Review of Medical Devices. One of the authors certifies that she (AM), or a member of her immediate family, has or may receive payments or benefits, during the study period, an amount of amount of less than USD 10,000 from Smith & Nephew, Inc (Memphis, TN, USA) and an amount of less than USD 10,000 from Biomet (Warsaw, IN, USA). One of the authors certifies that he (NNM), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of less than USD 10,000 from Smith & Nephew and an amount of less than $10,000 from Biomet.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

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Zywiel, M.G., Mahomed, A., Gandhi, R. et al. Measuring Expectations in Orthopaedic Surgery: A Systematic Review. Clin Orthop Relat Res 471, 3446–3456 (2013). https://doi.org/10.1007/s11999-013-3013-8

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  • DOI: https://doi.org/10.1007/s11999-013-3013-8

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