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首页> 外文期刊>Journal of Health Services Research & Policy >What is the relationship between patients' and clinicians' reports of the outcomes of elective surgery?
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What is the relationship between patients' and clinicians' reports of the outcomes of elective surgery?

机译：患者和临床医生关于择期手术结果的报告之间有什么关系？

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Objectives: To identify studies in which patients' and clinicians' reports of health status and complications of one of four elective operations – hip and knee replacement, varicose vein surgery and groin hernia repair – are reported, and to describe the associations that have been reported between clinicians' and patients' reports. nnMethods: Systematic search of several bibliographic databases and review of citations of articles meeting inclusion criteria. A narrative summary of the findings was conducted. nnResults: Most of the 62 studies of health status identified were for hip (23) or knee (33) disease. The literature on complications was even more limited with 12 studies of surgical site infection, one for urinary tract infection and none for lower respiratory tract infections. Procedure-specific complications were restricted to one for arthroplasties and three for hernia repair. Despite considerable variation in the findings of studies, some clear patterns emerge, albeit they are largely based on arthroplasty. Patients' and clinicians' views of health status generally correlate moderately (0.5–0.6) when both are reporting on the same dimension of health status. Inevitably this is confined to disability, though patients' and clinicians' reports of symptoms are also moderately correlated. In contrast, comparisons of different dimensions, such as patients' reports of disability and clinicians' reports of impairment, result in poor correlation (0.3). There is huge variation in the way postoperative complications are measured which limits the extent to which an overview can be undertaken. Despite that, moderate to strong correlations have been reported between patients' and clinicians' views of complications. nnConclusions: Patients' views of their level of disability reflect clinicians' views and can be relied upon to assess this dimension of health status. In addition, patients are the ‘gold standard’ judges of symptoms and quality of life. Given these findings, clinicians, provider managers, commissioners and politicians can be confident that patients' reports provide an accurate indication of the outcome of elective surgery.
机译：目的：确定哪些研究报告了患者和临床医生关于健康状况和四种择期手术之一的并发症（髋和膝关节置换术，静脉曲张手术和腹股沟疝修补术）的报告，并描述已报道的关联在临床医生和患者报告之间。 nnMethods：系统搜索几个书目数据库，并审查符合纳入标准的文章的引用。对调查结果进行叙述性总结。结果：在所确定的62例健康状况研究中，大多数是针对髋部疾病（23）或膝部疾病（33）。有关并发症的文献受到12项外科手术部位感染的研究的限制更为明显，一项涉及尿路感染，没有一项涉及下呼吸道感染。特定于手术的并发症仅限于一种置换术，而三种则用于疝气修补术。尽管研究结果差异很大，但还是出现了一些明显的模式，尽管它们主要是基于关节置换术。当患者和临床医生都报告相同的健康状况维度时，他们的健康状况观点通常具有中等程度的相关性（0.5-0.6）。不可避免地，这仅限于残疾，尽管患者和临床医生的症状报告也有中等程度的相关性。相反，不同维度的比较（例如患者的残疾报告和临床医生的损伤报告）导致相关性较差（0.3）。术后并发症的测量方法差异很大，这限制了可以进行概述的程度。尽管如此，已经报道了患者和临床医生对并发症的看法之间的中等至强相关性。结论：患者对其残疾程度的看法反映了临床医生的看法，可以用来评估健康状况的这一方面。此外，患者是症状和生活质量的“黄金标准”判断者。有了这些发现，临床医生，提供者经理，专员和政客就可以确信患者的报告可以准确地表明择期手术的结果。

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