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At least 847 records · Page 47Linked to original sources
PubMed1995

Intraocular pressure rise after phacoemulsification with posterior chamber lens implantation: effect of prophylactic medication, wound closure, and surgeon's experience.

AIMS: A prospective clinical trial was carried out to evaluate the effect of prophylactic medication, the technique of wound closure, and the surgeon's experience on the intraocular pressure rise after cataract extraction. METHODS: In 100 eyes, the intraocular pressure was measured before as well as 2-4, 5-7, and 22-24 hours after phacoemulsification and posterior chamber lens implantation. Each of 25 patients received either 1% topical apraclonidine, 0.5% topical levobunolol, 500 mg oral acetazolamide, or placebo. Forty four eyes were operated with sclerocorneal sutureless tunnel and 56 eyes with corneoscleral incision and suture. Sixty three operations were performed by experienced surgeons (more than 300 intraocular operations) and 37 by inexperienced surgeons (less than 200 intraocular operations). RESULTS: The pressure increase from baseline to the maximum 5-7 hours after surgery did not differ significantly (p = 0.8499) for apraclonidine (9.5 mm Hg), levobunolol (7.2 mm Hg), acetazolamide (7.8 mm Hg), and placebo (8.6 mm Hg). The increase was significantly (p = 0.0095) lower in eyes with corneoscleral tunnel (5.5 mm Hg) than in eyes with corneoscleral suture (10.5 mm Hg) and significantly (p = 0.0156) lower for experienced (6.6 mm Hg) than for inexperienced surgeons (11.2 mm Hg). CONCLUSIONS: The intraocular pressure rise after phacoemulsification and posterior chamber lens implantation depends strongly on the technique of wound closure and the surgeon's experience. Compared with these two factors, the effect of prophylactic medication can be neglected.

Acetazolamide↗
PubMed1980

Veterinary surgeons as vectors of Salmonella dublin.

Salmonella dublin is an important bovine pathogen, causing dysentery, abortion, and death from septicaemia. S dublin dermatitis, a little-recognised occupational hazard for veterinary surgeons, does not cause serious disability or inconvenience. During a survey of brucellosis in south-west Wales four cases of S dublin dermatitis were seen in veterinary surgeons. One surgeon was reinfected three years later. On all five occasions the veterinary surgeons had not worn or had discarded polyethylene gloves. An apparently healthy cow may serve as a latent carrier of S dublin. Thus when disease starts in a closed, protected herd reactivation of infection within the herd is usually blamed and its introduction by extraneous agents considered to be unlikely. Veterinary surgeons should be regarded as potential vectors of S dublin.

Animals↗
PubMed1990

Operating practices of and precautions taken by orthopaedic surgeons to avoid infection with HIV and hepatitis B virus during surgery.

OBJECTIVE: To assess the precautions being taken by orthopaedic surgeons to avoid becoming infected with HIV or hepatitis B virus by their patients during surgery. DESIGN: Pilot study of 50 surgeons selected at random followed by a postal questionnaire completed anonymously. SUBJECTS: All 1220 fellows and associates of the British Orthopaedic Association working in the United Kingdom. RESULTS: 800 (67%) Questionnaires were returned. 511 Surgeons has sustained a needlestick injury or had got body fluid in their eye within the past month despite 430 regularly wearing eye protection during major surgery. Seven had definitely and four possibly been infected with hepatitis B virus by a patient while operating, and 582 had been immunised against hepatitis B. Only 75 surgeons were satisfied with the present guidelines on testing patients for HIV antibodies. CONCLUSIONS: Although most surgeons who replied took some precautions when operating, most still exposed themselves to considerable risk from patients not known to be infected with HIV or hepatitis B virus.

AIDS Serodiagnosis↗
PubMed2004

Should surgeons take a break after an intraoperative death? Attitude survey and outcome evaluation.

OBJECTIVES: To investigate attitudes of cardiac surgeons and anaesthetists towards working immediately after an intraoperative death and to establish whether an intraoperative death affects the outcome of subsequent surgery. DESIGN: Questionnaire on attitudes to working after an intraoperative death and matched cohort study. SETTING: UK adult cardiac surgery centres and regional cardiothoracic surgical centre. PARTICIPANTS: 371 consultant cardiac surgeons and anaesthetists in the United Kingdom were asked to complete a questionnaire, and seven surgeons from one centre who continued to operate after intraoperative death. MAIN OUTCOME MEASURES: Outcome for 233 patients operated on by a surgeon who had experienced an intraoperative death within the preceding 48 hours compared with outcome of 932 matched controls. Hospital mortality and length of stay as a surrogate for hospital morbidity. RESULTS: The questionnaire response rate was 76%. Around a quarter of surgeons and anaesthetists thought they should stop work after an intraoperative death and most wanted guidelines on this subject. Overall, there was no increased mortality in patients operated on in the 48 hours after an intraoperative death. However, mortality was higher if the preceding intraoperative death was in an emergency or high risk case. Survivors operated on within 48 hours after an intraoperative death had longer stay in intensive care (odds ratio 1.64, 95% confidence interval 1.08 to 2.52, P = 0.02) and longer stay in hospital (relative change 1.15, 1.03 to 1.24, P = 0.02). CONCLUSION: Mortality is not increased in operations performed in the immediate aftermath of an intraoperative death, but survivors have longer stays in intensive care and on the hospital ward.

Anesthesiology↗
PubMed1996

Surgeons' decision making in patients with chronic wrist pain: role of bilateral three-compartment wrist arthrography--prospective study.

PURPOSE: To determine if wrist arthrography changes surgeons' diagnoses and treatment plans for patients with chronic wrist pain. MATERIALS AND METHODS: Bilateral, three-compartment wrist arthrography was performed in 64 patients. Prospective questionnaires evaluated surgeons' diagnoses and management plans at three stages: before arthrography, after arthrography of the symptomatic wrist, and after arthrography of the asymptomatic wrist. RESULTS: Surgeons tended to plan more conservative management after receiving the results of arthrography. The number of patients for whom the reported treatment plan included surgery dropped from 28 of 64 patients (44%) to 19 of 64 patients (30%) after review of the arthrography results (P = .05). The number of patients for whom the treatment plan included treatment of any kind dropped from 55 of 64 patients (86%) to 49 of 64 patients (77%) after review of the arthrography results (P = .09). An overall change in treatment plan occurred in 29 of 64 patients (45%). CONCLUSION: Wrist arthrography influences surgeons' decision making. After reviewing the results of arthrography, surgeons tended to change treatment plans toward more conservative, less invasive treatment.

Adult↗
PubMed1995

Palliative resection of pancreatic adenocarcinoma. A survey of British surgeons.

A survey was carried out by postal questionnaire of the attitudes of British surgeons to pancreatic resection as palliation for ductal adenocarcinoma of the pancreas. Replies from 24 surgeons related to experience in over 700 resections. The incidence of estimated residual local disease after resection was median 12.5 percent, range 0-35 percent. Half (12) of the surgeons felt that pancreatic resection with residual macroscopic disease was justified. Only 3 (12.5 percent) surgeons accepted that palliative resection in the presence of liver metastases was sometimes justifiable. Further evidence is required of improved quality of life after resection before the majority of surgeons will accept palliative resection in the management of pancreatic ductal adenocarcinoma.

Attitude of Health Personnel↗
PubMed2001

Current practices in left-sided colonic emergencies: a survey of US gastrointestinal surgeons.

BACKGROUND: The paradigms in the surgical management of obstruction and perforation of the left colon - once considered absolute contraindications to primary resection and anastomosis - are changing. The aim of this survey was to poll American Gastrointestinal surgeons on their current approach to left colonic emergencies. METHODS: A questionnaire was sent to 500 US-based surgeons, randomly selected members from the membership list of the Society for Surgery of the Alimentary Tract. It surveyed the surgeons on how they would approach 'good-risk' and 'poor-risk' patients with left colonic obstruction or perforation. RESULTS: 215 (43%) surgeons responded to the questionnaire; 180 fully completed questionnaires (36%) were analyzed. Sigmoid obstruction: 96 responders (53%) selected a one-stage procedure in 'good-risk' patients; 78 preferred sigmoid resection with (n = 46) or without (n = 32) 'on-table' colonic lavage and 18 opted for a subtotal colectomy and ileo-rectal anastomosis. Most (94%) responders preferred a staged procedure in 'high-risk' patients: a Hartmann resection (n = 120) or a transverse colostomy (n = 46). Sigmoid diverticular perforation: only one third of the responders recommended a one-stage procedure in 'good-risk' patients: 58 would perform a sigmoidectomy with (n = 19) or without (n = 39) 'on-table' colonic lavage; only two opted for subtotal colectomy with ileo-rectal anastomosis. In 'high-risk' patients most surgeons opted for a Hartmann's (88%) procedure or a diverting colostomy (7%). CONCLUSIONS: This survey suggests that a half and one-third of the responders would perform a one-stage resection and anastomosis in 'good-risk' patients with left colonic obstruction and perforation, respectively. In 'poor-risk' patients most responders would still opt for a staged procedure.

Anastomosis, Surgical↗
PubMedDate not supplied

Voice rehabilitation practices among head and neck surgeons.

Voice rehabilitation practices among head and neck surgeons were surveyed to determine the proportional contribution of various methods of speech support and the impact of recent developments in this field. Of the 400 head and neck surgeons contacted, 212 (53%) responded and 196 provided data. Noninvasive methods of speech support continue to predominate in this country. Esophageal speech is used by all surgeons in some of their patients. The introduction of tracheoesophageal puncture techniques for prosthetic placement has added a new dimension to speech rehabilitation and is used almost 30% of the time by those who use it (88% of surgeons surveyed). The proportional use of the most common methods of speech support is almost identical between head and neck surgeons of a general surgical background and otolaryngologists. The incidence of total failures to achieve voice rehabilitation is less than 10%.

General Surgery↗
PubMed2006

Do surgeons wish to become doctors?

OBJECTIVES: To gauge opinion among otolaryngologists about their wish to retain the title Mr, Miss, Ms or Mrs or to adopt the title of doctor. DESIGN: An e-mail questionnaire sent to all members of ENT-UK (The British Association of Otolaryngologists-Head and Neck Surgeons), who had registered an e-mail address with the ENT-UK secretariat. SETTING: The specialty group of otolaryngologists in the UK. PARTICIPANTS: 723 recipients of e-mails, who were members or fellows of a surgical Royal College and, by convention in the UK, entitled to adopt the title Mr, Miss, Ms or Mrs. RESULTS: 304 recipients of the e-mail questionnaire responded. 39% were not aware of any proposals to change the convention, addressing surgeons as 'doctor' in the future. Overall, 61.8% were in favour of retaining the current convention and retaining the title Mr or a female equivalent. Applying the null hypothesis that most surgeons would not like to change a title, the chi(2) test produced a highly significant P value of 0.0002. Of female respondents, however, only 43% supported retention of the current convention. Using Fisher's exact test to compare female and male respondents, the two-sided P value was highly significant at 0.006, with female respondents favouring the title of doctor. CONCLUSIONS: A large proportion of ENT surgeons in the UK responded to the questionnaire. They were unaware of proposals to change the current convention of address for surgeons. A significant number of those responding were in favour of retaining the current convention. The small proportion of female respondents indicated a preference for being addressed as 'doctor'.

Attitude of Health Personnel↗
PubMed2003

Surgeon training and complications in total ankle arthroplasty.

BACKGROUND: This study assessed the problems with initial use of ankle arthroplasty by surgeons who were trained by observing the surgeon/inventor (group I), who have completed a structured, hands-on surgical training course (group II), or who were trained during a 1-year foot and ankle fellowship (group III). MATERIALS AND METHODS: The perioperative records of the first 10 cases of nine surgeons were reviewed. We evaluated the 6-month-postoperative standing mortise and lateral radiographs for evidence of syndesmosis union and accuracy of tibial component implantation. Three surgeons were each in group I, group II, and group III. Average patient age at time of surgery was similar. Ankle arthritis was classified as rheumatoid arthritis (RA) or osteoarthritis (OA) as follows: group I (7 RA, 23 OA), group II (7 RA, 23 OA), and group III (3 RA, 27 OA). RESULTS: In group I, there were nine intraoperative complications, four postoperative wound dehiscences, and three postoperative deep infections. Radiographic evaluation of the 26 cases with adequate postoperative roentgenograms revealed that 10/26 (38%) had a delayed union of the syndesmosis. In group II, there were six intraoperative complications and two postoperative wound problems: an early anterior wound problem and a delayed lateral wound breakdown. Radiographic evaluation of the 26 cases with adequate postoperative roentgenograms revealed that 13/26 (50%) had a delayed union of the syndesmosis. In group III, there were four intraoperative complications and four postoperative wound problems--all healed with local supportive care with one requiring lateral hardware removal. Radiographic evaluation of the 26 cases with adequate postoperative roentgenograms revealed that 5/30 (17%) had a delayed union of the syndesmosis. The initial series from these three groups are statistically indistinguishable with respect to rates of complications, revisions, or malalignment. CONCLUSION: No identified training method had a statistically demonstrable positive impact on preparing surgeons for performing total ankle replacement. Some of these findings are likely generic for total ankle replacements and not restricted to any class or design of implant. Surgeon initial use of total ankle replacement needs to be done with caution and serious consideration.

Adult↗
PubMedDate not supplied

Initial experience with endovascular aortic aneurysm repair without cardiologists or radiologists--do vascular surgeons really need them?

Endovascular abdominal aortic aneurysm repair (EVAR) has been predominantly accomplished by teams of multidisciplinary interventionalists, frequently under the primary direction of cardiologists and radiologists. The purpose of this paper was to examine the feasibility and safety of an initial experience of EVARs performed by vascular surgeons at a single institution without other interventionalists. The authors reviewed the first 50 EVARs performed solely by vascular surgeons at our hospital, which we believed represented a fair and sizable enough learning curve for this new procedure. The operations were performed in an endovascular operating room and the surgeons had prior endovascular experience. The EVAR protocol included preoperative abdominal computed tomography (CT) scans and aortograms, same-day admissions, epidural anesthesia, transfer to the ward the day of surgery, and discharge the first postoperative day. CT scans were performed on postoperative day 1 and then annually, unless duplex ultrasound (DU) suggested an endoleak. DU was performed 1 week postoperatively, every 3 months for the first year, and then every 6 months thereafter. Of the first 23 patients, 3 required immediate conversion to open repair because of device malfunction (all in a Phase III FDA trial) and 1 underwent conversion 3 weeks after initial graft placement during treatment of a failing endograft limb as diagnosed by duplex ultrasonography. None of the next 27 cases required conversion. In 2 (4%) patients, graft limb occlusions occurred postoperatively and were treated with femorofemoral crossover grafts. There were 5 (10%) endoleaks: 2 were treated endovascularly, 1 closed spontaneously, and 2 were followed. Several advanced adjunctive endovascular procedures were performed concomitantly during EVAR including internal iliac artery coil embolization using aortic crossover catheters in 16% (8/50) of patients, proximal or distal extension cuff placement in 16% (8/50), and graft limb stenting in 50% (25/50). The average length of stay for patients who underwent uncomplicated aortic stent grafts was 1.9 days (range, 1-4 days) compared to 2.3 days for all patients (range 1-13 days). In no case were other interventionalists necessary for intraoperative assistance. These results of EVAR performed solely by vascular surgeons are comparable to reports by multidisciplinary teams and support the premise that vascular surgeons with endovascular skills have the knowledge and capability to begin performing EVAR independently of other specialists.

Aortic Aneurysm, Abdominal↗
PubMed2026

Rhinoplasty Difficulty Scale: Development and Psychometric Analysis of a Surgeon's Assessment of Rhinoplasty Technique and Nasal Deformity Correction.

BACKGROUND: Rhinoplasty surgeons lack a universal scale of the relative difficulty of rhinoplasty techniques and rhinoplasty deformities. OBJECTIVE: To compare the expert opinion of the difficulty of rhinoplasty techniques and rhinoplasty deformities among international rhinoplasty surgeons, as measured by a scale of difficulty. METHODS: A cross-sectional survey of rhinoplasty surgeons collected training levels, experience, case volume, and perceived expertise. Rhinoplasty techniques/deformities (n = 64) were rated from 1-10, representing the least to most technically demanding. Rasch analysis was used to examine the fit of the observed data to Rasch model requirements, assess rating scale functioning, and provide estimates of internal consistency. RESULTS: Respondents (n = 63) were in practice (<5 years, 14%; 5-10, 20%; 10-20, 20%; 20-30, 26%; >30, 20%), and rhinoplasty volume ranged from <25 (14%) to >100 cases/year (32%). Self-reported expertise was comfortably novice (32%), intermediate (10%), advanced (28%), and expert (30%). Otolaryngology (42%), facial plastic surgery (30%), and plastic surgery (28%) were represented. Rasch estimates of internal consistency reliability were excellent (0.96 for surgeons and 0.99 for items); the item difficulties were more heterogeneous (mean: 0, SD: 1.23) than the distribution of surgeons (mean: -0.09, SD: 0.58). Survey items were ordered by difficulty, ranging from least difficult (inferior turbinate reduction = 1.01) to most difficult (contracted nose repair post-infection = 8.24). CONCLUSION: The newly developed Rhinoplasty Difficulty Scale provides ratings of common rhinoplasty techniques and deformities with a high correlation among experts using this rating scale.

Humans↗
PubMedDate not supplied

Online exclusive: patient and surgeon decision making regarding surgery for advanced cancer.

PURPOSE/OBJECTIVES: To describe a program of research related to outcomes of palliative surgery and focus on one phase of this research involving decision making by patients and surgeons considering surgery for advanced disease. DESIGN: Descriptive. SAMPLE: 10 patients undergoing surgery and 3 oncology surgeons. METHODS: Qualitative interviews were conducted with patients and their surgeons pre- and postoperatively. Transcripts were content analyzed to identify major themes in patient and surgeon interviews based on study questions. MAIN RESEARCH VARIABLES: Decision making, palliative surgery, quality of life. FINDINGS: The study findings highlight the issues of greatest concern to patients and surgeons considering palliative surgery. This phase was an important component of the overall program of palliative surgery research. CONCLUSIONS: Comprehensive care for patients with advanced cancer seeks to achieve a balance of providing aggressive care, ensuring optimum symptom management, and maintaining a focus on comfort. Further study of palliative surgery as an aspect of interdisciplinary care is warranted. IMPLICATIONS FOR NURSING: Patients undergoing surgery for advanced disease require expert nursing care to address quality-of-life concerns. Further research is needed in this area.

Adult↗
PubMed2003

Likelihood of change: a study assessing surgeon use of multisource feedback data.

BACKGROUND: Multisource feedback, using questionnaire-based data from patients, coworkers, and medical colleagues, is designed to provide broad-based information about clinical performance to facilitate change. PURPOSE: To determine and explain the likelihood that surgeons would implement change following receipt of performance data. METHODS: Surgeons were surveyed to determine the likelihood they would make changes based on specific feedback about their clinical practices. RESULTS: One hundred fifty-three surgeons (76.5%) responded to the follow-up survey. There was little correlation between performance ratings provided by self or medical colleagues and the likelihood of change. A linear regression analysis indicated that 19.2% of the variance in likelihood to change could be explained by age, time spent reviewing feedback, the gap between self- and other ratings, and surgical specialty. CONCLUSION: Surgeons made few changes in practice in response to feedback data. Attention needs to be paid to methods that might increase surgeon use of performance data

Alberta↗
PubMed2004

A survey of orthopedic surgeons' attitudes and knowledge regarding regional anesthesia.

UNLABELLED: We conducted a survey to explore the surgical attitudes and preferences regarding regional anesthesia among Canadian orthopedic surgeons. Surveys were returned by 468 (61%) of 768 surgeons. Forty-eight percent of respondents directed their patients' choice of anesthetic. Forty percent of surgeons directed their patients to choose regional anesthesia. The principal reasons for favoring regional anesthesia were less postoperative pain (32%), decreased nausea and vomiting (12%), and safety (14%). Reasons for not favoring regional anesthesia were delays in the induction of anesthesia (43%) and an unpredictable success rate (12%). This survey suggests that orthopedic surgeons are supportive of regional anesthesia. Barriers to increased popularity include perceived delays and unreliability. IMPLICATIONS: Orthopedic surgeons understand the benefits of and are supportive of the use of regional anesthesia in their practices. Barriers to increased popularity include perceived operating room delays and lack of reliability.

Adult↗
PubMed2003

Surgery of the head and 70-day brain surgeons.

In 1917, the Sugeon General of the United States Army, William Gorgas, learned that almost 15% of the casualties on the Western Front sustained intracranial injuries. Soon after the United States declared war in April 1917, the Council of National Defense established a General Medical Board and attached a brain surgery subsection to its Committee of Ophthalmology. Postcards were sent to experts around the country, asking for the names of individuals who had specialty training or practice in brain surgery. In August, Gorgas assumed control of this subsection and created a Division of Surgery of the Head in the American Army Medical Department, with additional sections for plastic surgery, ophthalmology, and otolaryngology. He needed almost 300 brain surgeons; he received 50 names. As Harvey Cushing, Gilbert Horrax, and others went to France, neurosurgeons at home trained student officers. Schools were established in Philadelphia (Charles Frazier), Chicago (Dean Lewis), New York City (Charles Elsberg), St. Louis (Ernest Sachs), and Camp Greenleaf in Georgia (Claude Coleman), with 10-week intensive courses for selected candidates. Basic science and x-ray classes and operative clinics addressed most aspects of neurosurgical care. An army manual outlined clinical diagnoses and surgical techniques. Lewis H. Weed established a laboratory at Johns Hopkins Hospital, staffed by volunteers such as K.D. Blackfan and W.E. Dandy, to investigate infections of the central nervous system. By the time of the armistice, Gorgas had his complement of brain surgeons. The newly trained brain surgeons and their mentors gradually made their way to the Western Front during the summer of 1918. Plans for a neurosurgical school in France were quickly discarded as the American Army Medical Department changed the specialized assignments to front-line general surgical care. Some of the 190 brain surgeons in the American Expeditionary Forces, notably Gilbert Horrax, Charles E. Dowman, and Charles Neuhoff, treated head injuries exclusively, whereas others, such as Eustace Semmes and Howard Naffziger, treated all battle casualties depending on the tactical circumstances. The rational but naive recommendations for coordinated care made by Cushing, as senior consultant in neurosurgery, were hindered by the confusion of the St. Mihiel and Meuse-Argonne offensives and the chaos of war. Only three 70-day brain surgeons participated in the postwar development of the specialty. However, 9 of 10 original members of the Neurosurgical Club, which was established 18 months after the armistice, taught in American Army Medical Department courses or served on the Western Front. The schools and their teachers emphasized a growing recognition of neurosurgical expertise in the early 20th century.

Brain Injuries↗
PubMed2004

Variation in activity rates of consultant surgeons and the influence of reward structures in the English NHS.

OBJECTIVES: To explore variation in the National Health Service (NHS) activity rates of consultant surgeons, and examine whether activity is dependent upon the type of contract held and/or bonus payments, after accounting for age and other consultant and hospital characteristics. METHODS: NHS Hospital Episode Statistics (HES) for England were used in combination with workforce data in five surgical specialties in 1998/99 and 1999/2000. Descriptive statistics were used to explore variation in activity rates. A multi-level model was used to analyse the relationship between NHS contract and bonus payments, and activity. RESULTS: There is considerable variation in activity rates of English NHS consultant surgeons, with and without adjustment for casemix. Interquartile variation shows that the top 25% of consultants have activity rates 60 to 85% higher than the bottom 25%. A multi-level model indicates that consultant surgeons with a 'maximum part-time' contract have significantly higher activity rates than those with a full time contract (129 more finished consultant episodes (FCEs) per year, 95% CI 97-160). Consultant surgeons who hold discretionary salary points undertake significantly more activity than those without (95 FCEs, 95% CI 62-128). Those with a distinction award (a type of bonus payment) have a tendency towards higher activity rates, but this does not reach statistical significance (48 FCEs, 95% CI -4 to 103). CONCLUSIONS: 'Maximum part-time contract' status is associated with higher absolute activity rates among NHS surgeons. Rich data sources like HES merit careful exploration and increased use as an essential first step in measuring and managing variations in specialists' performance.

Analysis of Variance↗
PubMed2005

Determinants of patient and surgeon perspectives on maximum acceptable waiting times for hip and knee arthroplasty.

OBJECTIVES: Lengthy waiting times for hip and knee arthroplasty have raised concerns about equitable and timely access to care. The Western Canada Waiting List project has developed priority criteria scores linked to maximum acceptable waiting times (MAWT) for different levels of priority. Our study purpose was to assess the determinants of patient- and surgeon-rated MAWT, and to test whether the anticipated waiting time has an independent influence after adjusting for age, sex and patient urgency. A second aim was to compare MAWT, waiting time and anticipated waiting time for different levels of urgency assessed using the priority criteria score. METHODS: Orthopaedic surgeons assessed 233 consecutive patients waiting for arthroplasty in terms of their urgency (assessed using the priority criteria score and a visual analogue scale), MAWT and anticipated waiting time. Patient data included urgency (assessed by a visual analogue scale), MAWT and the Western Ontario McMaster Osteoarthritis index. We used hierarchical linear regression to test the models. RESULTS: After adjusting for age and sex, urgency (assessed by priority criteria score and visual analogue scale) and anticipated waiting time accounted for 40% of the variance in surgeon MAWT. The patient model accounted for 30% of the variance in patient MAWT. Older patients preferred signficantly shorter MAWTs (P <0.05). Anticipated waiting time added significantly to both the surgeon and patient MAWT models (R(2) change 0.11 and 0.07, respectively). Actual waiting time was weakly correlated with urgency assessed using the priority criteria score (r = -0.25, P <0.0001). CONCLUSIONS: Patients' and surgeons' views are critical to a fair process of establishing MAWT for elective procedures. Anticipated waiting time may influence the perspectives on MAWT and must be considered in their interpretation.

Aged↗