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Focus on patient values may lessen variation in rates of surgery for extensor carpi radialis brevis
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Variation in surgery rates for extensor carpi radialis brevis may be decreased when patient preferences and values are emphasized compared with surgeon preferences, according to results.
Using a database from three academic hospitals, researchers identified 5,964 patients diagnosed with extensor carpi radialis brevis from 2001 to 2007. Of these patients, 244 (4%) underwent surgery. Researchers considered the earliest office visit date associated with the extensor carpi radialis brevis diagnosis as the date of diagnosis. They recorded the date of the first local corticosteroid injection and the date of surgery.
David C. Ring
Operative treatment was significantly associated with younger age, white race, no diabetes mellitus, no anxiety disorder, corticosteroid injection, orthopedic surgeon provider and hospital two (of the two studied), according to results of a bivariate analysis. Similarly, results of a multivariate analysis showed younger age, hospital two and orthopedic surgeon provider had an independent association with operative treatment.
Results showed patients were 12-times more likely to have surgery if the initial provider was an orthopedic surgeon vs. a non-surgeon and 1.7-times more likely to have surgery at hospital one of the two hospitals. Researchers noted orthopedic surgeons accounted for both the highest and lowest rates of surgery, which varied substantially from 0% to 22% among providers.
Although corticosteroid injection delayed the time to surgery, it was ultimately associated with a higher rate of surgery, according to results. Researchers also found 86% of surgeries were performed within the first year of the first documented office visit for diagnosis. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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