Factors affecting medical decision-making in patients with osteoarthritis of the hip: allocation of surgical priority

Abstract

Doctors made reasonable estimates of patients' pain and function by direct history taking and examination. There was no systematic underestimation of patients' pain, in contrast to previous studies. Doctors' estimate plus radiological changes account for most of the priority differences. Patients' and surgeons' expectation of improvement, relatively unrelated to severity of pain and dysfunction, in the absence of agreed minimal clinical criteria, may drive surgical demand. There was a wide range in measures of pain and function. Introduction of formal measurement of pain and function, and setting formal clinical criteria, could assist medical decision-making.