STUDY DESIGN: Prospective lumbar and cervical surgery cohorts. OBJECTIVE: Compare fulfillment of expectations with traditional global outcomes and provide evidence for its validity. SUMMARY OF BACKGROUND DATA: New lumbar and cervical spine surgery Expectations Surveys can be used to measure fulfillment of expectations and their performance should be compared with existing outcomes. METHODS: Three hundred thirty-six lumbar and 133 cervical spine surgery patients preoperatively completed valid 20-item Expectations Surveys measuring symptoms, function, and psychological well-being. Approximately 2 years postoperatively patients rated how much improvement they received for each item. The proportion of expectations fulfilled was compared with traditional outcomes, including global satisfaction and change in standard spine questionnaires, with correlation coefficients (r) and areas under receiver operator characteristic curves (AUC). RESULTS: Ninety percent of lumbar patients had some expectations fulfilled (24% had all expectations fulfilled completely or exceeded). The mean proportion of expectations fulfilled was 0.66 and was associated with satisfaction (r = 0.73 (95% CI 0.68-0.78); AUC = 0.92 (95% CI 0.89-0.95) (P < 0.0001)). Based on the association with satisfaction, a clinically important proportion of expectations fulfilled for lumbar surgery is approximately 0.60 (sensitivity 0.90, specificity 0.79).Ninety-one percent of cervical patients had some expectations fulfilled (31% had all expectations fulfilled completely or exceeded). The mean proportion of expectations fulfilled was 0.78 and was associated with satisfaction (r = 0.62 (95% CI 0.50-0.72); AUC = 0.92 (95% CI 0.87-0.97) (P < 0.0001)). Based on the association with satisfaction, a clinically important proportion of expectations fulfilled for cervical surgery is approximately 0.62 (sensitivity 0.91, specificity 0.80). CONCLUSION: The proportion of expectations fulfilled is a new patient-centered outcome that measures results of spine surgery. Unique features of this novel outcome are that it requires prospectively acquired pre- and postoperative data, provides details about in what ways patients believe surgery did and did not meet goals, and offers surgeons opportunities to address unfilled expectations directly. LEVEL OF EVIDENCE: 1.
STUDY DESIGN: Prospective lumbar and cervical surgery cohorts. OBJECTIVE: Compare fulfillment of expectations with traditional global outcomes and provide evidence for its validity. SUMMARY OF BACKGROUND DATA: New lumbar and cervical spine surgery Expectations Surveys can be used to measure fulfillment of expectations and their performance should be compared with existing outcomes. METHODS: Three hundred thirty-six lumbar and 133 cervical spine surgery patients preoperatively completed valid 20-item Expectations Surveys measuring symptoms, function, and psychological well-being. Approximately 2 years postoperatively patients rated how much improvement they received for each item. The proportion of expectations fulfilled was compared with traditional outcomes, including global satisfaction and change in standard spine questionnaires, with correlation coefficients (r) and areas under receiver operator characteristic curves (AUC). RESULTS: Ninety percent of lumbar patients had some expectations fulfilled (24% had all expectations fulfilled completely or exceeded). The mean proportion of expectations fulfilled was 0.66 and was associated with satisfaction (r = 0.73 (95% CI 0.68-0.78); AUC = 0.92 (95% CI 0.89-0.95) (P < 0.0001)). Based on the association with satisfaction, a clinically important proportion of expectations fulfilled for lumbar surgery is approximately 0.60 (sensitivity 0.90, specificity 0.79).Ninety-one percent of cervical patients had some expectations fulfilled (31% had all expectations fulfilled completely or exceeded). The mean proportion of expectations fulfilled was 0.78 and was associated with satisfaction (r = 0.62 (95% CI 0.50-0.72); AUC = 0.92 (95% CI 0.87-0.97) (P < 0.0001)). Based on the association with satisfaction, a clinically important proportion of expectations fulfilled for cervical surgery is approximately 0.62 (sensitivity 0.91, specificity 0.80). CONCLUSION: The proportion of expectations fulfilled is a new patient-centered outcome that measures results of spine surgery. Unique features of this novel outcome are that it requires prospectively acquired pre- and postoperative data, provides details about in what ways patients believe surgery did and did not meet goals, and offers surgeons opportunities to address unfilled expectations directly. LEVEL OF EVIDENCE: 1.
Authors: Christopher M Brusalis; Roland Duculan; Frank P Cammisa; Andrew A Sama; Alexander P Hughes; Carol A Mancuso; Federico P Girardi Journal: HSS J Date: 2021-05-12
Authors: Kai-Uwe Lewandrowski; José-Antonio Soriano-Sánchez; Xifeng Zhang; Jorge Felipe Ramírez León; Sergio Soriano Solis; José Gabriel Rugeles Ortíz; Carolina Ramírez Martínez; Gabriel Oswaldo Alonso Cuéllar; Kaixuan Liu; Qiang Fu; Marlon Sudário de Lima E Silva; Paulo Sérgio Teixeira de Carvalho; Stefan Hellinger; Álvaro Dowling; Nicholas Prada; Gun Choi; Girish Datar; Anthony Yeung Journal: J Spine Surg Date: 2020-01
Authors: Matthew Thomas Sims; Byron Nice Detweiler; Jared Thomas Scott; Benjamin McKinnley Howard; Grant Richard Detten; Matt Vassar Journal: PLoS One Date: 2017-11-10 Impact factor: 3.240
Authors: Kai-Uwe Lewandrowski; José-Antonio Soriano-Sánchez; Xifeng Zhang; Jorge Felipe Ramírez León; Sergio Soriano Solis; José Gabriel Rugeles Ortíz; Gabriel Oswaldo Alonso Cuéllar; Marlon Sudário de Lima E Silva; Stefan Hellinger; Álvaro Dowling; Nicholas Prada; Gun Choi; Girish Datar; Anthony Yeung Journal: J Spine Surg Date: 2020-01
Authors: Kai-Uwe Lewandrowski; José-Antonio Soriano-Sánchez; Xifeng Zhang; Jorge Felipe Ramírez León; Sergio Soriano Solis; José Gabriel Rugeles Ortíz; Carolina Ramírez Martínez; Gabriel Oswaldo Alonso Cuéllar; Kaixuan Liu; Qiang Fu; Marlon Sudário de Lima E Silva; Paulo Sérgio Teixeira de Carvalho; Stefan Hellinger; Álvaro Dowling; Nicholas Prada; Gun Choi; Girish Datar; Anthony Yeung Journal: J Spine Surg Date: 2020-01
Authors: Marie-Jacqueline Reisener; Alexander P Hughes; Paul Schadler; Alexa Forman; Oliver C Sax; Jennifer Shue; Frank P Cammisa; Andrew A Sama; Federico P Girardi; Carol A Mancuso Journal: Asian Spine J Date: 2020-08-20