Evidence map›Paper›PMID 35347422›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2022

Surgeons' risk perception in ASD surgery: The value of objective risk assessment on decision making and patient counselling.

Ferran Pellisé, Alba Vila-Casademunt, Susana Núñez-Pereira, Sleiman Haddad, Justin S Smith, Michael P Kelly, Ahmet Alanay, Christopher Shaffrey, Javier Pizones, Çaglar Yilgor and 12 more

Abstract read
PubMed Publisher
In one paragraph

Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 14 institutions in 5 countries.

Ferran PelliséSpine Surgery Unit, Vall d'Hebron University Hospital, Barcelona, Spain. 24361fpu@comb.cat.ORCID 0000-0002-0644-7757
Alba Vila-CasademuntSpine Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain.
Susana Núñez-PereiraSpine Surgery Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
Sleiman HaddadSpine Surgery Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
Justin S SmithDepartment of Neurosurgery, University of Virginia Medical Center, Charlottesville, VA, USA.
Michael P KellyDepartment of Orthopaedic Surgery, Washington University, St Louis, MO, USA.
Ahmet AlanayDepartment of Orthopedics and Traumatology, Acibadem University, Istanbul, Turkey.
Christopher ShaffreyDuke University Medical Center, Durham, NC, USA.
Javier PizonesSpine Surgery Unit, La Paz University Hospital, Madrid, Spain.
Çaglar YilgorDepartment of Orthopedics and Traumatology, Acibadem University, Istanbul, Turkey.
Ibrahim ObeidSpine Surgery Unit, Bordeaux University Hospital, Bordeaux, France.
Douglas BurtonDepartment of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, KS, USA.
Frank KleinstückSpine Center Division, Schulthess Klinik, Zurich, Switzerland.
Tamas FeketeSpine Center Division, Schulthess Klinik, Zurich, Switzerland.
Shay BessDenver International Spine Center, Presbyterian St. Luke's/Rocky Mountain Hospital for Children, Denver, CO, USA.
Munish GuptaDepartment of Orthopaedic Surgery, Washington University, St Louis, MO, USA.
Markus LoiblSpine Center Division, Schulthess Klinik, Zurich, Switzerland.
Eric O KlinebergDepartment of Orthopedic Surgery, University of California Davis, Sacramento, CA, USA.
Francisco J Sánchez Pérez-GruesoSpine Surgery Unit, La Paz University Hospital, Madrid, Spain.
Miquel Serra-BurrielEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Christopher P AmesDepartment of Neurosurgery, University of California San Francisco, San Francisco, CA, USA.
European Spine Study Group, International Spine Study Group
Schulthess-Klinik · CHAcıbadem University · TRHospital Universitario La Paz · ESVall d'Hebron Hospital Universitari · ESWashington University in St. Louis · USDuke Medical Center · USHebron University · PSRocky Mountain Hospital for Children · USUniversity of California, Davis · USUniversity of California, San Francisco · USUniversity of Kansas Medical Center · USUniversity of Virginia Medical Center · USUniversity of Zurich · CHVall d'Hebron Institut de Recerca · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgeons often rely on their intuition, experience and published data for surgical decision making and informed consent. Literature provides average values that do not allow for individualized assessments. Accurate validated machine learning (ML) risk calculators for adult spinal deformity (ASD) patients, based on 10 year multicentric prospective data, are currently available. The objective of this study is to assess surgeon ASD risk perception and compare it to validated risk calculator estimates.

methodsNine ASD complete (demographics, HRQL, radiology, surgical plan) preoperative cases were distributed online to 100 surgeons from 22 countries. Surgeons were asked to determine the risk of major complications and reoperations at 72 h, 90 d and 2 years postop, using a 0-100% risk scale. The same preoperative parameters circulated to surgeons were used to obtain ML risk calculator estimates. Concordance between surgeons' responses was analyzed using intraclass correlation coefficients (ICC) (poor < 0.5/excellent > 0.85). Distance between surgeons' and risk calculator predictions was assessed using the mean index of agreement (MIA) (poor < 0.5/excellent > 0.85).

resultsThirty-nine surgeons (74.4% with > 10 years' experience), from 12 countries answered the survey. Surgeons' risk perception concordance was very low and heterogeneous. ICC ranged from 0.104 (reintervention risk at 72 h) to 0.316 (reintervention risk at 2 years). Distance between calculator and surgeon prediction was very large. MIA ranged from 0.122 to 0.416. Surgeons tended to overestimate the risk of major complications and reintervention in the first 72 h and underestimated the same risks at 2 years postop.

conclusionsThis study shows that expert surgeon ASD risk perception is heterogeneous and highly discordant. Available validated ML ASD risk calculators can enable surgeons to provide more accurate and objective prognosis to adjust patient expectations, in real time, at the point of care.

Indexed as

SurgeonsAdultCounselingDecision MakingHumansPerceptionProspective StudiesRisk AssessmentAdult spinal deformityComputerized decision support toolsMachine learningRisk perceptionSurgery

Identifiers

PMID35347422
OpenAlexW4220783562

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.