Surgeon Prediction of Patient Postoperative One-Year Single-Assessment Numeric Evaluation Score Following Rotator Cuff Repair Surgery

Preoperative patient expectation was found to be a significant predictor of post-operative outcomes and satisfaction in elective orthopedic surgery, including Rotator cuff repair (RCR). Given their knowledge and clinical expertise, surgeons are thought to be better at predicting patient outcomes than patients themselves. Thus, surgeon prediction of surgical outcomes could be used to set realistic patient expectations ahead of surgery to optimize outcomes. The purpose of the study was to determine the surgeon's and patient's accuracy in predicting patient's outcome one year following RCR. Data was collected in a healthcare registry as standard of care for all patients undergoing RCR from January 1 to December 31, 2022 at a single surgical center. The primary outcome was the SANE (Single-Assessment Numeric Evaluation) score where patients rate their shoulder function out of 100%, preoperatively and at one-year postoperatively. The surgeon was asked to predict the 1-year SANE score immediately following completion of the surgery. A repeated-measures ANOVA compared surgeon-predicted, patient-predicted, and actual mean 1-year post-operative SANE scores. The differences between actual and surgeon-predicted SANE scores, and actual and patient-predicted SANE scores were calculated. An “accurate prediction” was defined a priori as a difference being within +/−5% of the patient's achieved SANE. Sixty-nine patients were included in this study with a mean age of 60.9 (SD=6.9) years and of which 77% (N=53) were male. Mean surgeon-predicted 1-year postoperative SANE score was 77.6% (range 60–95%, SD= 6.8%), mean patient-predicted SANE was 88.7% (range 50–100%, SD=11.1%), and mean achieved SANE was 80.6% (range 8–100%, SD=19%) (p mean surgeon-predicted (p no statistical difference between mean surgeon-predicted and mean actual postoperative SANE. When assessing the distribution of the patient and surgeon predictions of outcomes, 24 patients and 14 surgeons predicted a SANE score that was higher than the patient's achieved SANE score. On the other hand, 31 surgeons and nine patients predicted a SANE score that was lower than the patient's achieved SANE score. The findings of this study demonstrate discrepancy between surgeon prediction and patient expectation of the one-year outcome following RCR. Surgeons on average were better than patients at predicting outcomes of RCR surgery. Additionally, surgeons tended to underestimate outcome while patients tended to overestimate outcome. This raises the importance of preoperative patient counselling to set more realistic expectations that could potentially improve their outcomes after RCR. This could be achieved using the surgeon's prediction of outcome as a benchmark.