19 Harley St, London, W1G 9QJ, UK

Left-Digit Bias in Surgical Decision-Making for Lumbar Spinal Stenosis – Lumbar Fusion

Day Case Lumbar Fusion Surgery

The article explores the concept of left-digit bias in surgical decision-making for patients with lumbar spinal stenosis (LSS). The study aimed to determine if the leftmost digit of a patient’s age influenced the decision to perform arthrodesis with instrumentation vs. decompression. Using data from the National Surgical Quality Improvement Program database, the researchers found that patients aged 80/81 were less likely to undergo arthrodesis with instrumentation compared to patients aged 78/79, despite similar comorbidities. This discrepancy was not observed when comparing patients with similar left digits in age. The study suggests that left-digit bias may impact clinical decisions until objective measures of physiologic capacity are established

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced spinal centre in the world

Published article

S: LSS patients aged 80/81 are less likely to undergo AwI than patients aged 78/79, regardless of comorbidities. This was not seen when comparing patients with similar left digits in age. Until objective measures of physiologic capacity are established, left-digit bias may influence clinical decisions.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine J. 2024 Mar 16:S1529-9430(24)00116-5. doi: 10.1016/j.spinee.2024.03.007. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Left-digit bias is a behavioral heuristic or cognitive “shortcut” in which the leftmost digit of a number, such as patient age, disproportionately influences surgical decisions.PURPOSE: To determine if left-digit bias in patient age influences the decision to perform arthrodesis with instrumentation vs. decompression,

Spine J. 2024 Mar 16:S1529-9430(24)00116-5. doi: 10.1016/j.spinee.2024.03.007. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Left-digit bias is a behavioral heuristic or cognitive “shortcut” in which the leftmost digit of a number, such as patient age, disproportionately influences surgical decisions.

PURPOSE: To determine if left-digit bias in patient age influences the decision to perform arthrodesis with instrumentation vs. decompression in lumbar spinal stenosis (LSS).

DESIGN: Retrospective cohort.

PATIENT SAMPLE: Patients with an ICD-10 diagnosis of lumbar stenosis or spondylolisthesis identified in the 2017-2021 National Surgical Quality Improvement Program (NSQIP) database.

OUTCOME MEASURES: The primary outcome was the percent of patients who underwent arthrodesis with instrumentation (AwI). Matched age group comparisons without left-digit differences (i.e., 76/77 vs 78/79, 80/81 vs 82/83, etc.) were performed to isolate the effect of the heuristic. Secondary outcomes including peri-operative events and complications were also compared within AwI and decompression cohorts.

METHODS: Using CPT codes, procedures were classified as either AwI or decompression. Patients were grouped into 6 cohorts based on 2-year age windows (74/75, 76/77, 78/79, 80/81, 82/83, 84/85). The cohorts were propensity matched with neighboring age groups based on the presence of spondylolisthesis, demographics, and comorbidities. The primary comparison was between those aged 78/79 vs 80/81.

RESULTS: After matching, the primary cohort consisted of two groups of 1,550 patients (aged 78/79 and 80/81). Patients aged 80/81 were less likely to undergo AwI than patients aged 78/79 (23.5% vs. 27.2%, p=0.021). AwI procedures occurred at similar rates between age groups with the same left digit. Within the decompression and AwI cohorts, there were no differences in secondary outcomes between patients aged 78/79 and 80/81.

S: LSS patients aged 80/81 are less likely to undergo AwI than patients aged 78/79, regardless of comorbidities. This was not seen when comparing patients with similar left digits in age. Until objective measures of physiologic capacity are established, left-digit bias may influence clinical decisions.

PMID:38499062 | DOI:10.1016/j.spinee.2024.03.007

The London Spine Unit : most advanced spinal centre in the world

Read the original publication:

Left-Digit Bias in Surgical Decision-Making for Lumbar Spinal Stenosis

Related Posts

0/5 (0 Reviews)

Trusindex Reviews

London Spine Unit Harley Street Hospital

A Focus on High Quality Specialised Care

We are a specialist Private Hospital based on Harley Street, London UK The Harley Street Hospital, Day Surgery Hospital

We provide exclusive health services for individuals seeking Advanced medical, non-surgical or minimally invasive treatments. We are covered by All Insurance Companies apart from AXA PPP

Our Medical Director and Lead Spinal Surgeon Mr Mo Akmal MD is a world renowned Spine Specialist Consultant with over 20 years of experience. He and his team have developed revolutionary techniques to perform all types of Spinal Surgery as a Day Case procedure without traditional General Anaesthetic.

We are constantly improving our techniques for treatment and improving facilities for our patients.

Book your Appointment Now 
Check out our Reviews 
Check out our Patient Videos 
Check our Mr Akmal’s Profile

 

What our patients say ...

Spine J. 2024 Mar 16:S1529-9430(24)00116-5. doi: 10.1016/j.spinee.2024.03.007. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Left-digit bias is a behavioral heuristic or cognitive "shortcut" in which the leftmost digit of a number, such as patient age, disproportionately influences surgical decisions.PURPOSE: To determine if left-digit bias in patient age influences the decision to perform arthrodesis with instrumentation vs. decompression

Revolutionary Keyhole surgical technique to vaporise bulging discs

Dr Mo Akmal Medical Director
Dr Mo Akmal MD - Lead Spinal Surgeon

Laser Disc Surgery can be performed under local anaesthetic at The Harley Street Hospital.

Initial Consultation

with Consultant Spine Surgeon
£ 250
  • No Waiting Times
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion
  • Review of Previous Scans and Reports

Follow up Consultation

any appointment after initial consultation
£ 180
  • Top NHS affiliated Consultant
  • Includes Clinical Review and Report
  • Multidisciplinary discussion

High Resolution MRI Scan

any Single Region (3.0 Tesla)
£ 600
  • No waiting times
  • Includes Full Radiologist Report
  • Open or Closed MRI scan types
  • Copy of Scan on CD

Website Offer

Pre-Booked Online
£1130
£ 800
  • Initial Consultation
  • MRI Scan (Single Region)
  • Follow Up consultation
  • Same Day One Stop Visit
  • Full Medical and MRI scan Report
  • Copy of scan on CD
Popular

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810