PURPOSE: Our prior national study showed gender differences in the rates of rheumatoid arthritis hand surgery. This project evaluated whether men's versus women's preferences, as opposed to physician biases, contribute to these variations. METHODS: A self-administered questionnaire was administered to 126 patients with rheumatoid arthritis at our institution; 117 (93%) of these patients completed the questionnaire. Chi-square tests, t tests, the Wilcoxon rank sum test, and multiple logistic regressions were used for the analyses. The results were compared with our national mailed survey of 500 rhematologists and 500 hand surgeons in the United States that evaluated physicians' attitudes toward the indications and outcomes of rheumatoid hand surgery. RESULTS: When we asked physicians who values hand aesthetics more, 378 (73%) chose women compared with less than 2 (1%) who chose men; when asked who values hand function more, 35 (7%) chose women, 83 (16%) chose men, and 396 (77%) thought there was no difference; and when asked who is more willing to have hand surgery, 219 (43%) chose women compared with 6% who chose men. In this patient survey, however, women and men were equally willing to have hand surgery, and they placed equal value in hand appearance, function, and pain. Women, however, appeared more risk adverse and concerned about the potential pain and inconvenience from surgery. CONCLUSIONS: Physicians' biases appear to conflict with patient preferences regarding rheumatoid hand surgery. Physicians should understand patients' preferences during the shared decision-making process for surgery.
PURPOSE: Our prior national study showed gender differences in the rates of rheumatoid arthritis hand surgery. This project evaluated whether men's versus women's preferences, as opposed to physician biases, contribute to these variations. METHODS: A self-administered questionnaire was administered to 126 patients with rheumatoid arthritis at our institution; 117 (93%) of these patients completed the questionnaire. Chi-square tests, t tests, the Wilcoxon rank sum test, and multiple logistic regressions were used for the analyses. The results were compared with our national mailed survey of 500 rhematologists and 500 hand surgeons in the United States that evaluated physicians' attitudes toward the indications and outcomes of rheumatoid hand surgery. RESULTS: When we asked physicians who values hand aesthetics more, 378 (73%) chose women compared with less than 2 (1%) who chose men; when asked who values hand function more, 35 (7%) chose women, 83 (16%) chose men, and 396 (77%) thought there was no difference; and when asked who is more willing to have hand surgery, 219 (43%) chose women compared with 6% who chose men. In this patient survey, however, women and men were equally willing to have hand surgery, and they placed equal value in hand appearance, function, and pain. Women, however, appeared more risk adverse and concerned about the potential pain and inconvenience from surgery. CONCLUSIONS: Physicians' biases appear to conflict with patient preferences regarding rheumatoid hand surgery. Physicians should understand patients' preferences during the shared decision-making process for surgery.
Authors: Jennifer F Waljee; Kevin C Chung; H Myra Kim; Patricia B Burns; Frank D Burke; E F Shaw Wilgis; David A Fox Journal: Arthritis Care Res (Hoboken) Date: 2010-06-02 Impact factor: 4.794
Authors: Stéphanie J E Becker; Teun Teunis; Johann Blauth; Joost T P Kortlever; George S M Dyer; David Ring Journal: Clin Orthop Relat Res Date: 2014-08-30 Impact factor: 4.176
Authors: Kevin C Chung; Sandra V Kotsis; David A Fox; Marian Regan; Frank D Burke; E F Shaw Wilgis; H Myra Kim Journal: Clin Rheumatol Date: 2010-04 Impact factor: 2.980
Authors: Kevin C Chung; Patricia B Burns; E F Shaw Wilgis; Frank D Burke; Marian Regan; H Myra Kim; David A Fox Journal: J Hand Surg Am Date: 2009 May-Jun Impact factor: 2.230