title: Gender differences in questions asked in an online preoperative patient education program.
abstract: BACKGROUND
  Although osteoarthritis more commonly affects women than men, women are 3 times less likely to undergo hip or knee replacement surgery compared with men. Disparity in the appropriate utilization of surgery between men and women is a complex subject that must take into account the willingness of a patient to proceed with the operation. Adequately addressing patient concerns before surgery may influence such willingness.
  
  
  OBJECTIVE
  We examined if a gender difference can be identified in the frequency and types of questions submitted by patients scheduled for total hip or total knee arthroplasty.
  
  
  METHODS
  Patients completed an online interactive preoperative educational program and a database was created containing deidentified information on surgical procedure, sex, year of birth, and any questions that were submitted. Data were also available regarding the total number of patients issued the program, the number of patients who started the program, and the number of patients who completed the program. The results were analyzed by Wilcoxon rank sum test. P values ≤0.05 were considered statistically significant.
  
  
  RESULTS
  Among the 2770 women and 1708 men included in the study, 935 (34%) and 462 (27%) asked at least 1 question, respectively. Compared with men, women asked a significantly greater number of questions overall (P < 0.001). Women also asked a significantly greater number of questions in the categories Your Condition (P = 0.031), Your Procedure (P < 0.001), and Risks and Benefits (P < 0.001).
  
  
  CONCLUSIONS
  Gender differences in concerns and physicians' ability to adequately address these concerns may contribute to disparity in use of hip and knee replacement surgery between men and women. Effective preoperative counseling for women may require additional resources to address their higher level of questions.
authors.affiliation: Wexner Medical Center, The Ohio State University, Columbus, OH, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Mora
authors.forename: Jasmine E
authors.initials: JE
authors.lastname: Shell
authors.forename: Colleen S
authors.initials: CS
authors.lastname: Thomas
authors.forename: Cedric J
authors.initials: CJ
authors.lastname: Ortiguera
authors.forename: Mary I
authors.initials: MI
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010361:Patients / Q000523:psychology*; D012737:Sex Factors; D018709:Statistics, Nonparametric