Lauren E Franzblau1, Keming Wang2, Xuebing Liang2, Yang Guo3, Yingni Li4, Yu-Chieh Jay Lin5, Sunghee Lee6, Beth-Ellen Pennell5, Melissa J Shauver7, Kevin C Chung7. 1. University of Michigan Medical School, Ann Arbor, MI, USA. 2. 17th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. 3. Department of Hand Surgery, Jishuitan Hospital, Beijing, China. 4. Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China. 5. Survey Research Center, Ann Arbor, MI, USA. 6. Survey Methodology Program, Institute for Social Research, Ann Arbor, MI, USA. 7. Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, USA.
Abstract
AIM: In China, hand surgeons treat fewer rheumatoid arthritis (RA) patients compared to other countries. We investigated whether physician and surgeon knowledge, attitudes and practices regarding RA hand deformities reflect current evidence and may contribute to the low utilization of surgery. METHOD: We surveyed hand surgeons and rheumatologists at three tertiary hospitals in Beijing, China. Questionnaires were developed from literature and expert review to assess their knowledge, attitudes and practice patterns related to rheumatoid hand surgery. RESULTS: Thirty-five hand surgeons and 59 rheumatologists completed the survey. Roughly one-third felt that the rheumatologists and hand surgeons agree on how to manage RA hand deformities. One-fifth of rheumatologists and 29% of hand surgeons believed that drug therapy can correct hand deformities, which contradicts current evidence. Likewise, 30% and 14%, respectively, recommended surgery for early-stage hand sequelae that do not meet current indications for surgery. Over 80% of surgeons and rheumatologists had no exposure to the other specialty during training and felt their training on the treatment of rheumatoid hand deformities was inadequate. CONCLUSION: Although we found similar interspeciality disagreement in China as is seen in the United States, there appears to be less interaction through training and consultations. Our results also indicate potential deficits in training and unawareness of evidence and indications for rheumatoid hand surgery. These findings help to explain why surgery for rheumatoid hand deformities is rare in China; doctors have fewer opportunities to collaborate across specialties and may not be able to select appropriate candidates for surgery.
AIM: In China, hand surgeons treat fewer rheumatoid arthritis (RA) patients compared to other countries. We investigated whether physician and surgeon knowledge, attitudes and practices regarding RA hand deformities reflect current evidence and may contribute to the low utilization of surgery. METHOD: We surveyed hand surgeons and rheumatologists at three tertiary hospitals in Beijing, China. Questionnaires were developed from literature and expert review to assess their knowledge, attitudes and practice patterns related to rheumatoid hand surgery. RESULTS: Thirty-five hand surgeons and 59 rheumatologists completed the survey. Roughly one-third felt that the rheumatologists and hand surgeons agree on how to manage RA hand deformities. One-fifth of rheumatologists and 29% of hand surgeons believed that drug therapy can correct hand deformities, which contradicts current evidence. Likewise, 30% and 14%, respectively, recommended surgery for early-stage hand sequelae that do not meet current indications for surgery. Over 80% of surgeons and rheumatologists had no exposure to the other specialty during training and felt their training on the treatment of rheumatoid hand deformities was inadequate. CONCLUSION: Although we found similar interspeciality disagreement in China as is seen in the United States, there appears to be less interaction through training and consultations. Our results also indicate potential deficits in training and unawareness of evidence and indications for rheumatoid hand surgery. These findings help to explain why surgery for rheumatoid hand deformities is rare in China; doctors have fewer opportunities to collaborate across specialties and may not be able to select appropriate candidates for surgery.
Authors: Su Yanjun; Wang Changli; Weng Ling; Jennifer Catherine Ai-Lian Woo; Kwauk Sabrina; Liu Chang; Zhang Lei Journal: Support Care Cancer Date: 2009-11-10 Impact factor: 3.603
Authors: Kevin C Chung; Kate W Nellans; Patricia B Burns; E F Shaw Wilgis; Frank D Burke; David A Fox; H Myra Kim Journal: Clin Rheumatol Date: 2014-09-30 Impact factor: 2.980