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Patient expectations and patient-reported outcomes in surgery: A systematic review
Open accessAbstract
Background Recent events in health care reform have brought national attention to integrating patient experiences and expectations into quality metrics. Few studies have comprehensively evaluated the effect of patient expectations on patient-reported outcomes (PROs) after surgery. The purpose of this study is to systematically review the available literature describing the relationship between patient expectations and postoperative PROs.Methods We performed a search of the literature published before November 1, 2012. Articles were included in the review if (1) primary data were presented, (2) patient expectations regarding a surgical procedure were measured, (3) PROs were measured, and (4) the relationship between patient expectations and PROs was specifically examined. PROs were categorized into 5 subgroups: Satisfaction, quality of life (QOL), disability, mood disorder, and pain. We examined each study to determine the relationship between patient expectations and PROs as well as study quality.Results From the initial literature search yielding 1,708 studies, 60 articles were included. Fulfillment of expectations was associated with improved PROs among 24 studies. Positive expectations were correlated with improved PROs for 28 studies (47%), and poorer PROs for 9 studies (15%). Eighteen studies reported that fulfillment of expectations was correlated with improved patient satisfaction, and 10 studies identified that positive expectations were correlated with improved postoperative. Finally, patients with positive preoperative expectations reported less pain (8 studies) and disability (15 studies) compared with patients with negative preoperative expectations.Conclusion Patient expectations are inconsistently correlated with PROs after surgery, and there is no accepted method to capture perioperative expectations. Future efforts to rigorously measure expectations and explore their influence on postoperative outcomes can inform clinicians and policymakers seeking to integrate PROs into measures of surgical quality.
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Metadata
- Authors
- Waljee, J., McGlinn, E. P., Sears, E. D., & Chung, K. C.
- Affiliations
- Michigan Medicine (US)
- Corresponding author
- Chung, Kevin C.
- Venue
- Surgery
- Publisher
- Elsevier BV
- Published
- 2014-05
- Volume
- 155
- Issue
- 5
- Pages
- 799-808
- ISSN
- 0039-6060 (ISSN-L)
- PMC
- PMC4170731
- OpenAlex
- W2062806164
- Cited by
- 245
- References
- 105
- Citations by year
- 2026: 19 · 2025: 30 · 2024: 26 · 2023: 19 · 2022: 21 · 2021: 32 · 2020: 24 · 2019: 15 · 2018: 17 · 2017: 10 · 2016: 18 · 2015: 10 · 2014: 4
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Surgery (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (2R01 AR047328-06)
- National Institute on Aging (R01 AR062066, K24 AR053120)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- patient expectations, patient-reported outcomes, postoperative outcomes, surgical quality metrics, patient satisfaction, quality of life, disability, mood disorders, postoperative pain, preoperative expectations
- MeSH terms
- Humans, Postoperative Pain, Pain, Postoperative, Quality of Life, Surveys and Questionnaires, Surgical Procedures, Operative, Prevalence, Treatment Outcome, Patient Satisfaction, Outcome Assessment, Health Care, Mood Disorders, Self Report, Patient Outcome Assessment
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