title: The impact of patient expectations on outcome following treatment for spinal trauma: Part 1: What are spine surgeons telling their patients?
abstract: METHODS
  Surgeon completed questionnaire.
  
  
  OBJECTIVE
  To determine information provided by spine surgeons to patients, part of a 4-part study determining the impact of patient expectations on outcome following spinal trauma.
  
  
  BACKGROUND
  An important goal of treatment is patient satisfaction, which may be influenced by patient expectations. Impact of patient expectations on outcome has been demonstrated in various elective orthopedic populations. It is anticipated that there will be similar, if not greater, impact on outcome in a trauma setting.
  
  
  METHODS
  A questionnaire was developed, in a case-based format, to determine the information provided by spine surgeons to their patients. There were 3 questionnaires, each consisting of 5 cases and grouped by cervical spine trauma, thoracolumbar spine trauma, and spinal cord injury. These questionnaires were distributed to members of the Spine Trauma Study Group and our division. Statistical analysis consisted of a single-factor random effects model. In this analysis, the degree of variability was quantified as the ratio of surgeon induced variance over total variance for the questions.
  
  
  RESULTS
  Questionnaires were distributed to 54 surgeons and 31 responses received (57%). There was substantial variability in responses ranging from a ratio of 9% [95% confidence interval (CI): 0-26] for the regaining range of motion 1 year following cervical spine trauma domain to a ratio of 84% (95% CI: 69-92) for the early postoperative spasticity following spinal cord injury domain.
  
  
  CONCLUSIONS
  This study demonstrated substantial variability in the information provided by spine surgeons to spine trauma patients and the need to improve the quality of information provided, allowing patient expectations to be more appropriate, potentially maximizing their outcome. Further areas for study include, assessment of the best available evidence on which to base information provided to spinal trauma patients, determination of what information spinal trauma patients view as relevant and the effect appropriate expectations have on outcome.
authors.affiliation: Department of Orthopaedics, Division of Spine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Darin
authors.initials: D
authors.lastname: Davidson
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Noonan
authors.forename: Marcel F
authors.initials: MF
authors.lastname: Dvorak
authors.forename: Hongbin
authors.initials: H
authors.lastname: Zhang
authors.forename: Charles G
authors.initials: CG
authors.lastname: Fisher
mesh_terms: D001291:Attitude of Health Personnel; D001955:British Columbia; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015233:Models, Statistical; D019637:Orthopedic Procedures / Q000523:psychology*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011787:Quality of Health Care; D013124:Spinal Injuries / Q000523:psychology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome