title: Carpal tunnel syndrome: assessment of surgeon and patient preferences and priorities for decision-making.
abstract: OBJECTIVE
  This study tested the null hypothesis that there are no differences between the preferences of hand surgeons and those patients with carpal tunnel syndrome (CTS) facing decisions about management of CTS (ie, the preferred content of a decision aid).
  
  
  METHODS
  One hundred three hand surgeons of the Science of Variation Group and 79 patients with CTS completed a survey about their priorities and preferences in decision making regarding the management of CTS. The questionnaire was structured according the Ottawa Decision Support Framework for the development of a decision aid.
  
  
  RESULTS
  Important areas on which patient and hand surgeon interests differed included a preference for nonpainful, nonoperative treatment and confirmation of the diagnosis with electrodiagnostic testing. For patients, the main disadvantage of nonoperative treatment was that it was likely to be only palliative and temporary. Patients preferred, on average, to take the lead in decision making, whereas physicians preferred shared decision making. Patients and physicians agreed on the value of support from family and other physicians in the decision-making process.
  
  
  CONCLUSIONS
  There were some differences between patient and surgeon priorities and preferences regarding decision making for CTS, particularly the risks and benefits of diagnostic and therapeutic procedures.
  
  
  CONCLUSIONS
  Information that helps inform patients of their options based on current best evidence might help patients understand their own preferences and values, reduce decisional conflict, limit surgeon-to-surgeon variations, and improve health.
authors.affiliation: Orthopaedic Hand Service, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Michiel G J S
authors.initials: MG
authors.lastname: Hageman
authors.affiliation: Orthopaedic Hand Service, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kinaci
authors.affiliation: Orthopaedic Hand Service, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Kevin
authors.initials: K
authors.lastname: Ju
authors.affiliation: Orthopaedic Hand Service, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Thierry G
authors.initials: TG
authors.lastname: Guitton
authors.affiliation: Orthopaedic Hand Service, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Chaitanya S
authors.initials: CS
authors.lastname: Mudgal
authors.affiliation: Orthopaedic Hand Service, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: dring@partners.org.
authors.forename: David
authors.initials: D
authors.lastname: Ring
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires
keywords: Assessment of needs; carpal tunnel syndrome; shared decision-making