R. Kaur1, E. Chang1, P. Chung1, S. Hahn1, D. Chang1, A. Alfonso1, G. Sugiyama1 1SUNY Downstate,BROOKLYN, NY – NEW YORK, USA
Introduction: Healthcare professionals (HCPs) have a duty to provide service for patients based on the best possible evidence available. However there is often little data available when novel approaches are first introduced. We conducted a survey of HCPs preferences for minimally invasive cholecystectomies with robotic cholecystectomy being the most recently introduced in available mainstream options for the procedure.
Methods: Non-surgical HCPs (attending and resident physicians, nurse practitioners, physician assistants and registered nurses) at our academic medical center were surveyed on their preferences for the following: multiport laparoscopic cholecystectomy (MLC), single incision laparoscopic cholecystectomy (SILC), single incision robotic cholecystectomy (SIRC), or no preference. HCPs were then provided educational material providing images of post-operative wounds, and expected outcomes based on currently available data. Only known parameters of patient outcomes in regards to SIRC were reported in the survey due to lack of currently available outcomes data.
Results: 100 HCPs completed the survey study. Prior to image and data presentation, reported preferences were SILC (48%), SIRC (21%), no preference (20%), and MLC (11%). After image and data presentation, preferences were SIRC (45%), SILC (33%), MLC 12%, and no preference (10%). The Stuart-Maxwell test showed a significant change (p < 0.0001) in preference for surgical approach between the paired groups.
Conclusion:The plasticity displayed in HCPs’ preferences for surgical approach before and after data presentation shows the effects of information on HCPs’ choices. These results were surprising. Despite being provided incomplete outcomes data for SIRC, many HCPs chose SIRC over the more familiar options of MLC and SILC. These results suggest that HCPs are comfortable making decisions based on incomplete data. Further studies to explore the magnitude of the effects of marketing in the absence of concrete outcomes data as applied to robotic surgery is necessary.