Evidence map›Paper›PMID 36348323›Full record

ArticleBMC health services research2022

Second opinion opportunity declined: patient typology and experiences regarding the decision-making process preceding elective surgeries in Germany.

Susann May, Dunja Bruch, Felix Muehlensiepen, Barbara Prediger, Dawid Pieper, Cecile Ronckers, Sebastian von Peter, Edmund Neugebauer

Abstract read
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In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

8 authors.

Susann MayBrandenburg Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Seebad 82/83, 15562, Rüdersdorf, Germany. susann.may@mhb-fontane.de.ORCID https://orcid.org/0000-0003-3847-4861
Dunja BruchBrandenburg Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Seebad 82/83, 15562, Rüdersdorf, Germany.ORCID https://orcid.org/0000-0002-9511-8487
Felix MuehlensiepenBrandenburg Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Seebad 82/83, 15562, Rüdersdorf, Germany.ORCID https://orcid.org/0000-0001-8571-7286
Barbara PredigerInstitute for Research in Operative Medicine, Witten/ Herdecke University, Witten, Germany.ORCID https://orcid.org/0000-0002-2012-7549
Dawid PieperBrandenburg Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Seebad 82/83, 15562, Rüdersdorf, Germany.ORCID https://orcid.org/0000-0002-0715-5182
Cecile RonckersDepartment of Health Services Research, School of Medicine, and Health Sciences, Carl von Ossietzky Universität Oldenburg, 26129, Oldenburg, Germany.ORCID https://orcid.org/0000-0003-3524-4657
Sebastian von PeterBrandenburg Medical School (Theodor Fontane), 16816, Neuruppin, Germany.
Edmund NeugebauerBrandenburg Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Seebad 82/83, 15562, Rüdersdorf, Germany.ORCID https://orcid.org/0000-0002-6192-8692

Funding

Innovation Fund, Germany 01VSF18014
6 · The paper itself

Abstract

backgroundTo address the problem of overuse of elective surgery and to support patients in their decision-making process, a Second Opinion Directive was introduced in Germany, which enables patients with statutory health insurance to obtain a second opinion for certain surgical indications. The study aims to identify, based on the experiences of patients who have undergone elective surgery, the role of seeking a second opinion in reaching their decision.

methodsSixty-two patients who had undergone an elective surgery (hysterectomy, tonsillectomy, shoulder arthroscopy) were recruited using purposive sampling and interviewed during October to December 2020. The transcribed interviews were analysed using a framework analysis to create a typology from the patient's perspective.

resultsThe time spent by patients in making the decision to undergo surgery varies between individuals, and is influenced by factors such as the type of physician-patient relationship, individual patient aspects, prior experiences in the health care system, as well as information needs. Within the framework of the analysis, we were able to identify three patterns of patient types based on the three different time-points or phases when decisions were typically made, with one type being divided into two subtypes: Type 1a: Quick decision making, Type 1b: Overwhelmed quick decision making, Type 2: Time to consider, Type 3: Struggling with the decision.

conclusionsPatients who followed a recommendation for elective surgery appreciate having the possibility to seek a second opinion. However, various factors influenced their opting for a second opinion during the decision-making process. Patients have differing information needs, such that a one-size-fits-all second opinion service may not fit adequately for all patients.

Indexed as

Decision MakingElective Surgical ProceduresFemaleGermanyHumansPhysician-Patient RelationsReferral and ConsultationDecision-makingElective surgeryPatient orientationSecond opinionShared decision making

Identifiers

PMID36348323
PMCPMC9643974

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Registered trials

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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.