TY - JOUR ID - 4272 TI - Factors Associated with Operative Treatment of De Quervain Tendinopathy JO - The Archives of Bone and Joint Surgery JA - ABJS LA - en SN - 2345-4644 AU - Kachooei, Amir Reza AU - P.F.T Nota, Sjoerd AU - Menendez, . Mariano Esteban AU - Dyer, George S.M. AU - Ring, David AD - Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Boston, USA Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran AD - Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey Center, Boston, USA AD - Orthopedic Hand and Upper Extremity Service, Brigham and Women’s Hospital, Boston, USA Y1 - 2015 PY - 2015 VL - 3 IS - 3 SP - 198 EP - 203 KW - Cortisone injection KW - De Quervain tendinopathy KW - Decision aid KW - Operative treatment KW - Variation DO - 10.22038/abjs.2015.4272 N2 - Background:  Geographic and doctor-to-doctor variations in care are a focus of quality and safety efforts in medicine. This study addresses factors associated with variation in the rate of operative treatment of de Quervain tendinopathy.   Methods: We used a database including all patient encounters at 2 large medical centers, to study the experience of 10 hand surgeons and 1 physiatrist working in a hand surgery office in the treatment of 2,513 patients with de Quervain tendinopathy over a 12-year period. Survival analysis using the Kaplan-Meier method was used to compare surgery rates and time to surgery. Cox multivariable regression analysis was applied to identify factors associated with operative treatment. Results:  One hundred ninety nine (7.9%) patients had surgery. The odds of operative treatment were 1.7 times greater after corticosteroid injection and varied more than 10-fold among providers. There was substantial variation in the overall rate of surgery by provider. Corticosteroid injection delayed surgery slightly, but was associated with a higher rate of surgery.  Conclusion:  Providers have substantial influence on treatment of de Quervain tendinopathy. The use of decision aids and other methods that help involve the patient in decision-making merit investigation as interventions to help reduce doctor-to-doctor variation. UR - https://abjs.mums.ac.ir/article_4272.html L1 - https://abjs.mums.ac.ir/article_4272_a81e0983219eb24c84e1999b39ffad18.pdf ER -