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Second opinion for degenerative spinal conditions: an option or a necessity? A prospective observational study

Overview of attention for article published in BMC Musculoskeletal Disorders, August 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (85th percentile)

Mentioned by

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18 tweeters
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5 Facebook pages

Citations

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10 Dimensions

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29 Mendeley
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Title
Second opinion for degenerative spinal conditions: an option or a necessity? A prospective observational study
Published in
BMC Musculoskeletal Disorders, August 2017
DOI 10.1186/s12891-017-1712-0
Pubmed ID
Authors

Mario Lenza, Rachelle Buchbinder, Margaret P. Staples, Oscar F.P. dos Santos, Reynaldo A. Brandt, Claudio L. Lottenberg, Miguel Cendoroglo, Mario Ferretti

Abstract

Second opinions may improve quality of patient care. The primary objective of this study was to determine the concordance between first and second diagnoses and opinions regarding need for spinal surgery among patients with back or neck pain that have been recommended spinal surgery. We performed a prospective observational study of patients who had been recommended for spinal surgery and received a second opinion between May 2011 and May 2012 at the Hospital Israelita Albert Einstein on the advice of their health insurance company. A physiatrist and orthopaedic surgeon independently performed the second assessment. If both agreed surgery was indicated, or consensus could not be reached, participants attended a spine review panel for a final recommendation. Descriptive analyses compared diagnoses and management plans of the first and second opinions. Of 544 referred patients, 16 (2.9%) did not meet inclusion criteria, 43 (7.9%) refused participation and 485 were included. Diagnoses differed from the first opinion for 290 (59.8%). Diagnoses of cervical and lumbar radiculopathy were concordant in 36/99 (36.4%) and 116/234 (49.6%) respectively. The second opinion was for conservative treatment for 168 (34.6%) participants, 27 (5.6%) were not considered to have a spine condition, and 290 (59.8%) were referred to the review board. 60 participants did not attend the board review and therefore did not receive a final recommendation. Board review was conservative treatment for an additional 67 participants, 20 were not considered to have a spine condition and 143 participants were recommended surgery. Overall, 33.6% received a final opinion of surgery (143/425) although only 66 (15.5%) received the same surgical recommendation, 235 (55.3%) were advised to have conservative treatment, and 47 (11.1%) were not considered to have a spinal diagnosis. We found a large discordance between first and second opinions regarding diagnosis and need for spinal surgery. This suggests that obtaining a second opinion could reduce potentially unnecessary surgery. Current Controlled Trials ISRCTN07143259 . Registered 21 November 2011.

Twitter Demographics

The data shown below were collected from the profiles of 18 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 29 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 5 17%
Researcher 4 14%
Student > Master 4 14%
Student > Doctoral Student 3 10%
Lecturer 2 7%
Other 8 28%
Unknown 3 10%
Readers by discipline Count As %
Medicine and Dentistry 15 52%
Nursing and Health Professions 3 10%
Social Sciences 2 7%
Philosophy 1 3%
Computer Science 1 3%
Other 3 10%
Unknown 4 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 March 2018.
All research outputs
#1,113,172
of 12,673,944 outputs
Outputs from BMC Musculoskeletal Disorders
#257
of 2,522 outputs
Outputs of similar age
#39,205
of 266,195 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#1
of 1 outputs
Altmetric has tracked 12,673,944 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,522 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.8. This one has done well, scoring higher than 89% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 266,195 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them