ABSTRACT
The personality traits commonly seen in abdominal surgeons remains undefined, and its potential influence on decision-making and patient outcomes underexplored. This systematic review identified studies on abdominal surgeons who had undergone validated personality testing, with assessment of decision-making and post-operative patient outcomes. The study protocol was registered on PROSPERO (University of York, UK (CRD42019151375)). MEDLINE, Embase, PsycInfo and Cochrane Library databases were searched using the keywords: surgeon; surgeon personality; outcomes. All study designs were accepted including adult visceral surgeons published in English. Five articles from 3056 abstracts met our inclusion criteria and one article was identified from hand searches with two reviewers screening studies. Bias was assessed using the Newcastle-Ottawa scale. Six studies included 386 surgeons. Studies assessing personality using the Five Factor Model (four studies, 329 surgeons) demonstrated higher levels of conscientiousness (self-discipline, thoughtfulness), extraversion (sociability, emotional expression) and openness (creative, conventional) in surgeons versus population norms. Surgeon characterisation of agreeableness and emotional stability was less clear, with studies reporting mixed results. Post-operative outcomes were reported by only one study. Further exploration of the influence of surgeon personality and its influence on decision-making is necessary to deliver patient-centred care and targeted non-technical skills training for surgeons.
ABSTRACT
INTRODUCTION: There is limited published literature exploring how the personality traits of surgeons may influence preoperative decision making, particularly in the context of visceral/abdominal surgery. Multiple validated personality scoring systems exist and have been used to describe surgeon personalities previously. The degree to which each trait is expressed by abdominal surgeons is neither currently known, nor the impact of these traits on postoperative outcomes. The protocol has been written in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist. METHODS AND ANALYSIS: The search strategy has been developed by a Health Scientist Librarian in collaboration with the review team. The search was conducted on 1st October 2019.Database subject headings and text words relating to 'abdominal/general surgeons', 'personality', 'postoperative outcomes' and 'decision making' formed the basis of our literature search strategy; the MEDLINE, EMBASE, PsycInfo and Cochrane databases will be searched. Three reviewers will independently screen and appraise articles, with a fourth reviewer utilised if disagreements arise.A systematic narrative synthesis will be performed, with information presented in text and table format. These will summarise the findings and characteristics of any included studies. Using guidance from the Centre for Reviews and Dissemination, the reviewers will describe the potential relationship and findings between studies using the narrative synthesis. Studies will only be reported if they are felt to have low or mid-levels of bias. Studies felt to display high levels of bias will be excluded. ETHICS AND DISSEMINATION: This study does not require ethical approval. The formal systematic review will be submitted for peer reviewed publication and presented at relevant conferences. The methods may inform future reviews in other surgical specialties regarding surgeon personality. PROSPERO REGISTRATION NUMBER: CRD42019151375.
Subject(s)
Clinical Decision-Making , Digestive System Surgical Procedures , Personality , Surgeons , Delivery of Health Care , Humans , Meta-Analysis as Topic , Research Design , Systematic Reviews as TopicABSTRACT
Background and Purpose- Intracerebral hemorrhage (ICH) has a poorer prognosis than acute ischemic stroke (AIS). However, clinician perception of prognosis may influence treatment decisions and adversely affect outcome. On acute CT, the conspicuity of ICH compared with AIS may lead clinicians to overestimate severity and influence prognostic evaluation. We investigated whether clinicians' estimates of volume, severity, and prognosis from acute imaging differed between ICH and AIS. Methods- CT scans from participants with acute ICH or ischemic stroke were reviewed. Volume was calculated using the ABC/2 method and automated volumetric analysis via specialized imaging software. ICH cases were matched with AIS cases for lesion volume, based on acute (<6 hours) CT for ICH, and 24-hour CT for AIS. Blind to clinical information, clinicians estimated lesion volume to the nearest 5 mL, graded lesion severity from 1 (mild) to 5 (very severe), and estimated 30-day prognosis using the modified Rankin Scale. Results- We compared 33 ICH cases with 33 volume-matched AIS cases. Clinicians overestimated ICH volume and underestimated AIS volumes: mean differences (estimated-actual volume) were +8 mL (±30) for ICH and -8 mL (±27) for AIS ( P<0.001). Observers rated ICH to be of greater severity and poorer prognosis compared with AIS cases: 109 of 265 (41%) ICH cases rated severity categories 4 or 5 compared with 36 of 257 (14%) AIS, P<0.001; estimated modified Rankin Scale of 0 to 2 in 125 of 265 (47%) ICH compared with 190 of 257 (74%) AIS, P<0.001. Results were unaffected by presence of intraventricular blood. Estimated severity and prognosis for ICH remained significantly worse compared with AIS after adjustment for estimated volumes. Conclusions- Clinicians overestimated ICH volume and severity compared with AIS of equivalent volume and also assigned significantly worse prognosis independent of volume estimates.
