Purpose
Patient-reported experience measures (quantifying satisfaction, trust, perceived clinician
empathy, and communication effectiveness) may not be developed with the same rigor
as patient-reported outcome measures (quantifying comfort and capability). We systematically
reviewed the use of measures used to evaluate satisfaction with hand surgery by comparing
recent (2017–2019) and remote (2000–2002) publications to assess the use of satisfaction
measures and areas for potential improvement.
Methods
An initial search yielded 6,159 studies, 278 of which met the eligibility criteria.
We compared the 2 time periods and recorded the method of satisfaction assessment
(dichotomous, categorical, and ordinal) and the results. Because they are measures
of research usage potentially representative of rigor in instrument development, we
evaluated aspects of score distribution, including discernment (the threshold set
at >80% of top scores) and skewness, as well as the differentiation between the satisfaction
with outcome and experience.
Results
Dichotomous ratings of satisfaction were the most common (171 [62%] of 278 studies),
followed by categorical (83 [30%] of 278 studies) and ordinal ( 66 [24%] of 278 studies).
All 3 score types had limited discernment (86% dichotomous, 77% categorical, and 64%
ordinal ratings) and non-Gaussian distributions (negative skew near 1 or greater),
with no differences between the remote and recent time periods. Ninety-seven percent
of studies made no distinction between satisfaction with outcome and experience.
Conclusions
Measurements of satisfaction with hand surgery have remained unchanged over the last
20 years. They are associated with nonnormal distributions, a notable proportion of
top scores, and routine failure to distinguish between experience and outcomes of
care.
Clinical relevance
Patient-reported experience measures developed with the rigor comparable to the development
of patient-reported outcome measures have the potential for either of the following:
(1) specificity, variation, and responsiveness sufficient to guide experience improvement
efforts or (2) verification of notable ceiling effects that may limit their use.
Key words
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Article info
Publication history
Published online: November 26, 2022
Accepted:
October 13,
2022
Received:
February 10,
2022
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2023 by the American Society for Surgery of the Hand. All rights reserved.
