title: Comparison between patient and surgeon perception of degenerative spine disease outcomes--a prospective blinded database study.
abstract: BACKGROUND
  Few have studied the correlation between patients' and spine surgeons' perception on outcomes, or compared these with patient-reported outcome scores. Outcomes studies are increasingly important in evaluating costs and benefits to patients and surgeons, and in developing metrics for payer evaluation and health care policy-making.
  
  
  OBJECTIVE
  To compare patients' and surgeons' assessment of spine treatment outcome in a prospective blinded patient-driven spine surgery outcomes registry, and to correlate perceived outcomes ratings to validated outcomes scores.
  
  
  METHODS
  Patients filled out surveys at baseline, 3 months and 6 months postoperatively, including Visual Analog Scale (VAS), and Neck Disability Index (NDI) or Oswestry Disability Index (ODI). Outcome was rated independently by patients and surgeons on a 7-point Likert-type scale.
  
  
  RESULTS
  Two-hundred and sixty-five consecutive adult patients were surgical candidates. Of these, 154 (58.1 %) opted for surgery, with 69 (44.8 %) cervical and 85 (55.2 %) lumbar patients. One hundred and thirty-five (87.7 %) had both patient and surgeon postoperative ratings. Surgeons' and patients' ratings correlated strongly (Spearman rho = 0.53, p < 0.0001, 45.9 % identical, 88.2 % +/- 1 grade). The surgeon rated outcomes were better than patients in 29.8 % and worse in 21.15 %. Patient rating correlated better with the most recent NDI/ODI and pain scores than with incremental change from baseline. In multivariate analysis, age, location (cervical vs lumbar), pain ratings, and functional scores (NDI, ODI) did not have significant impact on the discrepancy between patient and surgeon ratings.
  
  
  CONCLUSIONS
  Patients' and surgeons' global outcome ratings for spinal disease correlate highly. Patients' ratings correlate better with most recent functional scores, rather than incremental change from baseline.
authors.affiliation: Section of Neurosurgery, Department of Surgery, University of Chicago, Chicago, IL, USA.
authors.forename: Ben Z
authors.initials: BZ
authors.lastname: Roitberg
authors.forename: Bart
authors.initials: B
authors.lastname: Thaci
authors.forename: Brenda
authors.initials: B
authors.lastname: Auffinger
authors.forename: Laura
authors.initials: L
authors.lastname: Kaplan
authors.forename: Jingjing
authors.initials: J
authors.lastname: Shen
authors.forename: Frederick D
authors.initials: FD
authors.lastname: Brown
authors.forename: Sandi
authors.initials: S
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D013122:Spinal Diseases / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome