The effect of patient involvement in surgical decision making for carpal tunnel release on patient-reported outcome

To investigate whether patient-reported outcomes are different according to patients' preference or experience in surgical decision making for carpal tunnel release.

METHODS:

We preoperatively surveyed 85 patients who underwent carpal tunnel release regarding their preferred role in the process of surgical decision making and assessed their experienced role in the actual decision making 6 months after surgery using a Control Preference Scale. For patient-reported surgical outcomes, we used the Disabilities of the Arm, Shoulder, and Hand questionnaire. We compared these outcomes with those of patients having different preferences or experiences in surgical decision making and also compared the outcomes according to whether the preferred roles match the experienced roles.

RESULTS:

The Disabilities of the Arm, Shoulder, and Hand scores were not significantly different between patients with different preferences for involvement in decision making for surgery or between those with different experiences in the actual decision making. However, those who experienced the same level of involvement as they had preferred were found to have better Disabilities of the Arm, Shoulder, and Hand scores than those who experienced a more active role or a more passive role than they had preferred.

CONCLUSIONS:

This study demonstrates that patient-reported outcomes were not different between those with different preferences or experiences in surgical decision making for carpal tunnel release. However, this study suggests that patients whose experience in decision making matched with their preference may have better subjective outcomes after carpal tunnelrelease. This suggests that patients with carpal tunnel syndrome may benefit from physicians' efforts of identifying patients' preferences for involvement in decision making and matching the identified preferences to the decision-making process.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Prognostic II.

Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Carpal tunnel syndrome, carpal tunnel release, decision making, involvement, outcomes