Objective: The need for standardised measures of patient perspective has stimulated an extensive and rigorous process which has led to the development of validated patient-oriented instruments. These tools, mainly self-administered questionnaires, concentrate on how illness affects the individual and they permit us to quantify these new parameters with measures that are not influenced by the physician's opinion. To obtain the "independent" (from physician) collection of data, Outcomes movement clearly stated that self-administered questionnaires has to be filled in by the patients in the waiting room before any contact with the physician. To evaluate the influence of the physician point of view through the diagnosis in the patient- oriented evaluation, we provided to a group of patients with suspected Carpal Tunnel Syndrome (CTS) with a self-administered questionnaire before and after the electrodiagnosis. Methods: We studied 32 consecutive patients (24 females, 8 males, mean age 50.1 years, range 17-76). referred to our neurophysiological laboratory for suspected CTS. For each patient we studied only the most symptomatic hand. We used the Italian validated version of the Carpal Tunnel Questionnaire. The questionnaire furnished after the electrodiagnosis had the same questions but in different order. At the end of the neurophysiological tests we furnished the results of the electrodiagnostic evaluation according to the neurophysiological classification of CTS. The neurophysiologist clearly stated that the diagnosis and the quantification of severity of CTS was based only on the results of the electrodiagnostic test. No other explanation and opinion were furnished to the patients. We compared the results of the questionnaires filled in by the patients before (PRE) and after (POST) the communication of the electrodiagnostic result by using a non parametric paired statistical test. Results and conclusion: Comparison of the Pre- and Post-diagnosis Carpal Tunnel Questionnaire results showed significant difference of the reported symptoms and hand function impairment. The importance of filling in before the physician contact is emphasised from this results
The Influence of Instrumental Diagnosis on the Patient-Oriented Assessment
ZANOLI, Gustavo Alberto;
1999
Abstract
Objective: The need for standardised measures of patient perspective has stimulated an extensive and rigorous process which has led to the development of validated patient-oriented instruments. These tools, mainly self-administered questionnaires, concentrate on how illness affects the individual and they permit us to quantify these new parameters with measures that are not influenced by the physician's opinion. To obtain the "independent" (from physician) collection of data, Outcomes movement clearly stated that self-administered questionnaires has to be filled in by the patients in the waiting room before any contact with the physician. To evaluate the influence of the physician point of view through the diagnosis in the patient- oriented evaluation, we provided to a group of patients with suspected Carpal Tunnel Syndrome (CTS) with a self-administered questionnaire before and after the electrodiagnosis. Methods: We studied 32 consecutive patients (24 females, 8 males, mean age 50.1 years, range 17-76). referred to our neurophysiological laboratory for suspected CTS. For each patient we studied only the most symptomatic hand. We used the Italian validated version of the Carpal Tunnel Questionnaire. The questionnaire furnished after the electrodiagnosis had the same questions but in different order. At the end of the neurophysiological tests we furnished the results of the electrodiagnostic evaluation according to the neurophysiological classification of CTS. The neurophysiologist clearly stated that the diagnosis and the quantification of severity of CTS was based only on the results of the electrodiagnostic test. No other explanation and opinion were furnished to the patients. We compared the results of the questionnaires filled in by the patients before (PRE) and after (POST) the communication of the electrodiagnostic result by using a non parametric paired statistical test. Results and conclusion: Comparison of the Pre- and Post-diagnosis Carpal Tunnel Questionnaire results showed significant difference of the reported symptoms and hand function impairment. The importance of filling in before the physician contact is emphasised from this resultsI documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
