Surgeons' decision making in patients with chronic wrist pain: role of bilateral three-compartment wrist arthrography--prospective study. 1996

Y Yin, and B A Evanoff, and L A Gilula, and B Littenberg, and T K Pilgram, and R Y Kanterman
Beijing Ji Shui Tan Hospital, People's Republic of China.

OBJECTIVE To determine if wrist arthrography changes surgeons' diagnoses and treatment plans for patients with chronic wrist pain. METHODS Bilateral, three-compartment wrist arthrography was performed in 64 patients. Prospective questionnaires evaluated surgeons' diagnoses and management plans at three stages: before arthrography, after arthrography of the symptomatic wrist, and after arthrography of the asymptomatic wrist. RESULTS Surgeons tended to plan more conservative management after receiving the results of arthrography. The number of patients for whom the reported treatment plan included surgery dropped from 28 of 64 patients (44%) to 19 of 64 patients (30%) after review of the arthrography results (P = .05). The number of patients for whom the treatment plan included treatment of any kind dropped from 55 of 64 patients (86%) to 49 of 64 patients (77%) after review of the arthrography results (P = .09). An overall change in treatment plan occurred in 29 of 64 patients (45%). CONCLUSIONS Wrist arthrography influences surgeons' decision making. After reviewing the results of arthrography, surgeons tended to change treatment plans toward more conservative, less invasive treatment.

UI MeSH Term Description Entries
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001175 Arthrography Roentgenography of a joint, usually after injection of either positive or negative contrast medium. Arthrographies
D014955 Wrist Joint The joint that is formed by the distal end of the RADIUS, the articular disc of the distal radioulnar joint, and the proximal row of CARPAL BONES; (SCAPHOID BONE; LUNATE BONE; triquetral bone). Joint, Wrist,Joints, Wrist,Wrist Joints

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