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Comparison between patient-reported and physician-estimated pain and disability in hand and wrist disorders.

Authors
  • Berduszek, Redmar J1
  • Reinders-Messelink, Heleen A1, 2
  • Dijkstra, Pieter U1, 3
  • van der Sluis, Corry K1
  • 1 Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. , (Netherlands)
  • 2 Rehabilitation Center Revalidatie Friesland, Beetsterzwaag, The Netherlands. , (Netherlands)
  • 3 Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. , (Netherlands)
Type
Published Article
Journal
Musculoskeletal care
Publication Date
Jun 01, 2022
Volume
20
Issue
2
Pages
354–362
Identifiers
DOI: 10.1002/msc.1598
PMID: 34704346
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Pain and disability are important components of the assessment of hand problems, but it is unknown how physician estimates compare to patient self-reports. To analyse differences between patient-reported and physician-estimated pain and disability in patients with hand or wrist disorders and to analyse factors influencing these differences. Observational study of patients with hand or wrist disorders seen during multidisciplinary outpatient consultations. Patients, rehabilitation medicine (RM) consultants, RM trainees and plastic surgeons completed visual analogue scales (VASs) to rate the level of self-reported (patients) or estimated (physicians) pain and disability. Multilevel analyses were performed to evaluate differences in VAS-pain and VAS-disability scores between patients and physicians and to evaluate the influences of diagnosis, physician experience and medical specialty. Complete data were obtained for 250 patients. Levels of pain and disability estimated by physicians were lower compared to patient self-reports. Ratings differed among medical specialties. Pain was underestimated to a greater extent by plastic surgeons compared to RM consultants. Disability was underestimated to a greater extent by RM consultants compared to plastic surgeons. Estimates of pain and disability did not differ between consultants and trainees in RM. Type of diagnosis did not influence the degree of underestimation of pain and disability. Physicians underestimate pain and disability compared to self-reports in patients with hand or wrist disorders. Ratings differ among medical specialties: plastic surgeons underestimate pain more, while RM consultants underestimate disability more. Physician experience and diagnosis do not influence the degree of underestimation of pain and disability. © 2021 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.

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