title: Assessment of Decisional Conflict about the Treatment of carpal tunnel syndrome, Comparing Patients and Physicians.
abstract: BACKGROUND
  As part of the process of developing a decision aid for carpal tunnel syndrome (CTS) according to the Ottawa Decision Support Framework, we were interested in the level of 'decisional conflict' of hand surgeons and patients with CTS. This study addresses the null hypothesis that there is no difference between surgeon and patient decisional conflict with respect to test and treatment options for CTS. Secondary analyses assess the impact of patient and physician demographics and the strength of the patient-physician relationship on decisional conflict.
  
  
  METHODS
  One-hundred-twenty-three observers of the Science of Variation Group (SOVG) and 84 patients with carpal tunnel syndrome completed a survey regarding the Decisional Conflict Scale. Patients also filled out the Pain Self-efficacy Questionnaire (PSEQ) and the Patient Doctor Relationship Questionnaire (PDRQ-9).
  
  
  RESULTS
  On average, patients had significantly greater decision conflict and scored higher on most subscales of the decisional conflict scale than hand surgeons. Factors associated with greater decision conflict were specific hand surgeon, less self-efficacy (confidence that one can achieve one's goals in spite of pain), and higher PDRQ (relationship between patient and doctor). Surgeons from Europe have--on average--significantly more decision conflict than surgeons in the United States of America.
  
  
  CONCLUSIONS
  Patients with CTS have more decision conflict than hand surgeons. Decision aids might help narrow this gap in decisional conflict.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, USA.
authors.forename: Michiel Gjs
authors.initials: MG
authors.lastname: Hageman
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, USA.
authors.forename: Jeroen K
authors.initials: JK
authors.lastname: Bossen
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, USA.
authors.forename: Valentin
authors.initials: V
authors.lastname: Neuhaus
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, USA.
authors.forename: Chaitanya S
authors.initials: CS
authors.lastname: Mudgal
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Massachusetts General Hospital, Boston, USA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
keywords: Carpal Tunnel Syndrome; Decision aids; Hand surgery; Shared decision makin