The Association Between Risk Aversion of Surgeons and Their Clinical Decision-Making
Copyright © 2021 Elsevier Inc. All rights reserved..
BACKGROUND: The extent to which a surgeon's risk aversion influences their clinical decisions remains unknown. We assessed whether a surgeon's attitude toward risk ("risk aversion") influences their surgical decisions and whether the relationship can be explained by differences in surgeons' perception of treatment risks and benefits.
MATERIALS AND METHODS: We presented a series of detailed clinical vignettes to a national sample of surgeons (n = 1,769; 13.4% adjusted response rate) and asked them to complete an instrument that measured how risk averse they are within their clinical practice (scale 6-36; higher number indicates greater risk aversion). For each vignette, participants rated their likelihood of recommending an operation and judged the likelihood of complications or full recovery. We examined whether differences in perceived likelihood of complications versus recovery could explain why risk-averse surgeons may be less likely to recommend an operation.
RESULTS: Surgeons varied in their self-reported risk aversion score (median = 25, interquartile range[22,28]). Scores did not differ by level of surgeon experience or gender. Risk-averse surgeons were significantly less likely to recommend an operation for patients with exactly the same condition (65.5% for surgeons in highest quartile of risk aversion versus 62.3% for lowest quartile; P = 0.02). However, after controlling for surgeons' perception of the likelihood of complications versus recovery, there was no longer a significant association between surgeons' risk aversion and the decision to recommend an operation (64.7% versus 64.8%; P = 0.96).
CONCLUSIONS: Surgeons vary widely in their self-reported risk aversion. Risk-averse surgeons were significantly less likely to recommend an operation, a finding that was explained by a higher perceived probability of post-operative complications than their colleagues.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:268 |
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| Enthalten in: |
The Journal of surgical research - 268(2021) vom: 15. Dez., Seite 232-243 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sacks, Greg D [VerfasserIn] |
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| Links: |
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| Themen: |
Decision-making |
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| Anmerkungen: |
Date Completed 06.04.2022 Date Revised 06.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jss.2021.06.056 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM329153935 |
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| 500 | |a Date Revised 06.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: The extent to which a surgeon's risk aversion influences their clinical decisions remains unknown. We assessed whether a surgeon's attitude toward risk ("risk aversion") influences their surgical decisions and whether the relationship can be explained by differences in surgeons' perception of treatment risks and benefits | ||
| 520 | |a MATERIALS AND METHODS: We presented a series of detailed clinical vignettes to a national sample of surgeons (n = 1,769; 13.4% adjusted response rate) and asked them to complete an instrument that measured how risk averse they are within their clinical practice (scale 6-36; higher number indicates greater risk aversion). For each vignette, participants rated their likelihood of recommending an operation and judged the likelihood of complications or full recovery. We examined whether differences in perceived likelihood of complications versus recovery could explain why risk-averse surgeons may be less likely to recommend an operation | ||
| 520 | |a RESULTS: Surgeons varied in their self-reported risk aversion score (median = 25, interquartile range[22,28]). Scores did not differ by level of surgeon experience or gender. Risk-averse surgeons were significantly less likely to recommend an operation for patients with exactly the same condition (65.5% for surgeons in highest quartile of risk aversion versus 62.3% for lowest quartile; P = 0.02). However, after controlling for surgeons' perception of the likelihood of complications versus recovery, there was no longer a significant association between surgeons' risk aversion and the decision to recommend an operation (64.7% versus 64.8%; P = 0.96) | ||
| 520 | |a CONCLUSIONS: Surgeons vary widely in their self-reported risk aversion. Risk-averse surgeons were significantly less likely to recommend an operation, a finding that was explained by a higher perceived probability of post-operative complications than their colleagues | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Decision-making | |
| 650 | 4 | |a Risk attitude | |
| 650 | 4 | |a Risk aversion | |
| 650 | 4 | |a Surgery | |
| 700 | 1 | |a Dawes, Aaron J |e verfasserin |4 aut | |
| 700 | 1 | |a Tsugawa, Yusuke |e verfasserin |4 aut | |
| 700 | 1 | |a Brook, Robert H |e verfasserin |4 aut | |
| 700 | 1 | |a Russell, Marcia M |e verfasserin |4 aut | |
| 700 | 1 | |a Ko, Clifford Y |e verfasserin |4 aut | |
| 700 | 1 | |a Maggard-Gibbons, Melinda |e verfasserin |4 aut | |
| 700 | 1 | |a Ettner, Susan L |e verfasserin |4 aut | |
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