Hand Surgeons Performing More Open Carpal Tunnel Releases Do Not Show Better Patient Outcomes

Stefanie Evers, Miguel C. Jansen, Harm P. Slijper, Nicoline de Haas, Xander Smit, Jarry T. Porsius, Steven E.R. Hovius, Peter C Amadio, Ruud W. Selles

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

METHODS: Patients who underwent carpal tunnel release between 2011 and 2015 at outpatient hand surgery clinics in The Netherlands were included. Surgeon annual volume was defined as the average number of carpal tunnel releases performed per year per participating surgeon over the study period. Primary outcome measures were the Symptom Severity Scale and Functional Status Scale of the Boston Carpal Tunnel Questionnaire 6 months postoperatively. Multilevel random intercept linear regression analyses were performed to assess whether there was an association between surgeon annual volume and outcome measures, with adjustment for patient characteristics, concomitant procedures, and intake score on the Boston Carpal Tunnel Questionnaire.

RESULTS: A total of 1345 patients were included, operated on by 17 surgeons. Median annual surgeon volume was 75 (interquartile range, 50 to 149). Only 0.5 to 0.6 percent of the total variance in patient outcome on the Boston Carpal Tunnel Questionnaire could be explained by random differences between surgeons. The authors did not find an association between annual surgeon volume and outcome measures 6 months postoperatively (Symptom Severity Scale: β = 0.000; 95 percent CI, -0.001 to 0.001; and Functional Status Scale: β = 0.000; 95 percent CI, -0.001 to 0.001).

CONCLUSION: In the authors' sample of highly specialized hand surgeons operating in high-volume centers, they found no differences in outcome between high- and low-volume surgeons.

BACKGROUND: Although previous studies have shown that more experienced surgeons have better patient outcomes following a variety of procedures, in hand surgery and carpal tunnel release in particular, this relation remains unproven. The authors assessed whether there is an association between surgeon volume and patient outcomes following open carpal tunnel release.

Original languageEnglish (US)
Pages (from-to)1439-1446
Number of pages8
JournalPlastic and Reconstructive Surgery
Volume141
Issue number6
DOIs
StatePublished - Jun 1 2018

Fingerprint

Wrist
Hand
Outcome Assessment (Health Care)
Surgeons
Ambulatory Surgical Procedures
Netherlands
Linear Models
Regression Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Evers, S., Jansen, M. C., Slijper, H. P., de Haas, N., Smit, X., Porsius, J. T., ... Selles, R. W. (2018). Hand Surgeons Performing More Open Carpal Tunnel Releases Do Not Show Better Patient Outcomes. Plastic and Reconstructive Surgery, 141(6), 1439-1446. https://doi.org/10.1097/PRS.0000000000004369

Hand Surgeons Performing More Open Carpal Tunnel Releases Do Not Show Better Patient Outcomes. / Evers, Stefanie; Jansen, Miguel C.; Slijper, Harm P.; de Haas, Nicoline; Smit, Xander; Porsius, Jarry T.; Hovius, Steven E.R.; Amadio, Peter C; Selles, Ruud W.

In: Plastic and Reconstructive Surgery, Vol. 141, No. 6, 01.06.2018, p. 1439-1446.

Research output: Contribution to journalArticle

Evers, S, Jansen, MC, Slijper, HP, de Haas, N, Smit, X, Porsius, JT, Hovius, SER, Amadio, PC & Selles, RW 2018, 'Hand Surgeons Performing More Open Carpal Tunnel Releases Do Not Show Better Patient Outcomes', Plastic and Reconstructive Surgery, vol. 141, no. 6, pp. 1439-1446. https://doi.org/10.1097/PRS.0000000000004369
Evers, Stefanie ; Jansen, Miguel C. ; Slijper, Harm P. ; de Haas, Nicoline ; Smit, Xander ; Porsius, Jarry T. ; Hovius, Steven E.R. ; Amadio, Peter C ; Selles, Ruud W. / Hand Surgeons Performing More Open Carpal Tunnel Releases Do Not Show Better Patient Outcomes. In: Plastic and Reconstructive Surgery. 2018 ; Vol. 141, No. 6. pp. 1439-1446.
@article{12f399b2c7284782a43be44a5fcaf705,
title = "Hand Surgeons Performing More Open Carpal Tunnel Releases Do Not Show Better Patient Outcomes",
abstract = "METHODS: Patients who underwent carpal tunnel release between 2011 and 2015 at outpatient hand surgery clinics in The Netherlands were included. Surgeon annual volume was defined as the average number of carpal tunnel releases performed per year per participating surgeon over the study period. Primary outcome measures were the Symptom Severity Scale and Functional Status Scale of the Boston Carpal Tunnel Questionnaire 6 months postoperatively. Multilevel random intercept linear regression analyses were performed to assess whether there was an association between surgeon annual volume and outcome measures, with adjustment for patient characteristics, concomitant procedures, and intake score on the Boston Carpal Tunnel Questionnaire.RESULTS: A total of 1345 patients were included, operated on by 17 surgeons. Median annual surgeon volume was 75 (interquartile range, 50 to 149). Only 0.5 to 0.6 percent of the total variance in patient outcome on the Boston Carpal Tunnel Questionnaire could be explained by random differences between surgeons. The authors did not find an association between annual surgeon volume and outcome measures 6 months postoperatively (Symptom Severity Scale: β = 0.000; 95 percent CI, -0.001 to 0.001; and Functional Status Scale: β = 0.000; 95 percent CI, -0.001 to 0.001).CONCLUSION: In the authors' sample of highly specialized hand surgeons operating in high-volume centers, they found no differences in outcome between high- and low-volume surgeons.BACKGROUND: Although previous studies have shown that more experienced surgeons have better patient outcomes following a variety of procedures, in hand surgery and carpal tunnel release in particular, this relation remains unproven. The authors assessed whether there is an association between surgeon volume and patient outcomes following open carpal tunnel release.",
author = "Stefanie Evers and Jansen, {Miguel C.} and Slijper, {Harm P.} and {de Haas}, Nicoline and Xander Smit and Porsius, {Jarry T.} and Hovius, {Steven E.R.} and Amadio, {Peter C} and Selles, {Ruud W.}",
year = "2018",
month = "6",
day = "1",
doi = "10.1097/PRS.0000000000004369",
language = "English (US)",
volume = "141",
pages = "1439--1446",
journal = "Plastic and Reconstructive Surgery",
issn = "0032-1052",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Hand Surgeons Performing More Open Carpal Tunnel Releases Do Not Show Better Patient Outcomes

AU - Evers, Stefanie

AU - Jansen, Miguel C.

AU - Slijper, Harm P.

AU - de Haas, Nicoline

AU - Smit, Xander

AU - Porsius, Jarry T.

AU - Hovius, Steven E.R.

AU - Amadio, Peter C

AU - Selles, Ruud W.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - METHODS: Patients who underwent carpal tunnel release between 2011 and 2015 at outpatient hand surgery clinics in The Netherlands were included. Surgeon annual volume was defined as the average number of carpal tunnel releases performed per year per participating surgeon over the study period. Primary outcome measures were the Symptom Severity Scale and Functional Status Scale of the Boston Carpal Tunnel Questionnaire 6 months postoperatively. Multilevel random intercept linear regression analyses were performed to assess whether there was an association between surgeon annual volume and outcome measures, with adjustment for patient characteristics, concomitant procedures, and intake score on the Boston Carpal Tunnel Questionnaire.RESULTS: A total of 1345 patients were included, operated on by 17 surgeons. Median annual surgeon volume was 75 (interquartile range, 50 to 149). Only 0.5 to 0.6 percent of the total variance in patient outcome on the Boston Carpal Tunnel Questionnaire could be explained by random differences between surgeons. The authors did not find an association between annual surgeon volume and outcome measures 6 months postoperatively (Symptom Severity Scale: β = 0.000; 95 percent CI, -0.001 to 0.001; and Functional Status Scale: β = 0.000; 95 percent CI, -0.001 to 0.001).CONCLUSION: In the authors' sample of highly specialized hand surgeons operating in high-volume centers, they found no differences in outcome between high- and low-volume surgeons.BACKGROUND: Although previous studies have shown that more experienced surgeons have better patient outcomes following a variety of procedures, in hand surgery and carpal tunnel release in particular, this relation remains unproven. The authors assessed whether there is an association between surgeon volume and patient outcomes following open carpal tunnel release.

AB - METHODS: Patients who underwent carpal tunnel release between 2011 and 2015 at outpatient hand surgery clinics in The Netherlands were included. Surgeon annual volume was defined as the average number of carpal tunnel releases performed per year per participating surgeon over the study period. Primary outcome measures were the Symptom Severity Scale and Functional Status Scale of the Boston Carpal Tunnel Questionnaire 6 months postoperatively. Multilevel random intercept linear regression analyses were performed to assess whether there was an association between surgeon annual volume and outcome measures, with adjustment for patient characteristics, concomitant procedures, and intake score on the Boston Carpal Tunnel Questionnaire.RESULTS: A total of 1345 patients were included, operated on by 17 surgeons. Median annual surgeon volume was 75 (interquartile range, 50 to 149). Only 0.5 to 0.6 percent of the total variance in patient outcome on the Boston Carpal Tunnel Questionnaire could be explained by random differences between surgeons. The authors did not find an association between annual surgeon volume and outcome measures 6 months postoperatively (Symptom Severity Scale: β = 0.000; 95 percent CI, -0.001 to 0.001; and Functional Status Scale: β = 0.000; 95 percent CI, -0.001 to 0.001).CONCLUSION: In the authors' sample of highly specialized hand surgeons operating in high-volume centers, they found no differences in outcome between high- and low-volume surgeons.BACKGROUND: Although previous studies have shown that more experienced surgeons have better patient outcomes following a variety of procedures, in hand surgery and carpal tunnel release in particular, this relation remains unproven. The authors assessed whether there is an association between surgeon volume and patient outcomes following open carpal tunnel release.

UR - http://www.scopus.com/inward/record.url?scp=85055632923&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85055632923&partnerID=8YFLogxK

U2 - 10.1097/PRS.0000000000004369

DO - 10.1097/PRS.0000000000004369

M3 - Article

VL - 141

SP - 1439

EP - 1446

JO - Plastic and Reconstructive Surgery

JF - Plastic and Reconstructive Surgery

SN - 0032-1052

IS - 6

ER -