Personalized video of arthroscopic shoulder surgery may not improve patient satisfaction
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Published results showed providing patients with a personalized video of their arthroscopic shoulder surgery may not improve patient satisfaction with the surgery.
Researchers randomly assigned 97 patients undergoing arthroscopic shoulder decompression, rotator cuff repair or labral repair to either receive a video recording of their surgery (intervention group; n=50) or not (control group; n=47). Researchers assessed patient satisfaction at 3 months with VAS scores, Likert scale and QuickDASH scores.
With an 18% loss to follow-up, the final analysis included 80 patients (41 patients in the intervention group and 39 patients in the control group). Results showed no significant difference in mean VAS scores between the two groups, with a mean VAS score of approximately 8.5 for the control group and of approximately 9 for the intervention group. Researchers also noted no statistically significant differences between the two groups for Likert scale scores and QuickDASH scores. The two groups had no significant differences regarding sex, age group, surgeon and surgical procedure, according to results of a subgroup analysis.
“Satisfaction after surgical procedures is challenging to measure, and it is possible that the authors lack the best tools for assessing this outcome after arthroscopic shoulder surgery,” the authors wrote. “The current findings suggest that there is no known benefit to providing patients with personalized videos of their surgery, and surgeons should consider the pros and cons of using these videos in their practice. Further research is needed to determine which factors are most important in influencing patient satisfaction after arthroscopic shoulder surgery and to identify the most sensitive assessment tools.”
Perspective
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Christopher R. Chuinard, MD, MPH
The authors should be applauded for a well-done study with a surprise result. It is a novel approach to determine if more information influences patient satisfaction. The study design even allowed for the patients to be aware of their “interventions,” seemingly biasing the patients. The fact that there was no observed difference may be a testament to thorough preoperative education by the providers or a sign of well-informed patients.
Because the follow-up is short, a real difference in satisfaction may not present itself, although one would expect the influence to present itself if the patients watched their videos shortly after surgery. Furthermore, the participating surgeons do not specifically confirm if the video had been watched.
Being a patient is challenging; it can be frightening, confusing and fraught with uncertainty. The patient experience is a gestalt of the preoperative encounter(s), the perioperative care and the procedure itself. Oftentimes, the surgeon may be judged by the scar on the skin, not the work underneath, or the bedside manner with which he or she comports themselves. Critical to a positive patient experience is feeling educated about their disease and treatment options and being involved in the decision-making process, as the authors highlight with the discussion of video informed consent. However, the knowledge disparity between physician and patient may be a barrier to meaningful insight by watching one’s surgical video. For now, it seems that giving a patient his or her surgical video may not improve subjective satisfaction.
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