A Novel, Dynamic Statistical Model for Predicting Patient Satisfaction with Fundoplication Based on Pre-Operative Symptom Patterns

Background Fundoplication provides excellent control of gastro-oesophageal reflux disease (GORD), but there remain a number of unsatisfied patients who have proven difficult to identify pre-operatively. We hypothesised that pre-operative symptom patterns can predict of the risk of post-operative dis...

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Bibliographic Details
Published in:World journal of surgery 2017-11, Vol.41 (11), p.2778-2787
Main Authors: Woodham, B. L., Meng, R., Roberts, R. H.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Achalasia
Area Under Curve
Cardiac Surgery
Disease control
Esophagus
Female
Fundoplication - statistics & numerical data
Gastroesophageal reflux
Gastroesophageal Reflux - surgery
General Surgery
Humans
Lower Oesophageal Sphincter Pressure
Male
Mathematical models
Medical personnel
Medicine
Medicine & Public Health
Models, Statistical
Original Scientific Report
Partial Fundoplication
Patient satisfaction
Patient Satisfaction - statistics & numerical data
Postoperative Period
Practice Guidelines as Topic
Preoperative Period
Receiver Operating Characteristic Analysis
Risk Factors
ROC Curve
Surgery
Surveys and Questionnaires
Symptom Assessment
Thoracic Surgery
Treatment Outcome
Vascular Surgery
Youden Index
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Summary:Background Fundoplication provides excellent control of gastro-oesophageal reflux disease (GORD), but there remain a number of unsatisfied patients who have proven difficult to identify pre-operatively. We hypothesised that pre-operative symptom patterns can predict of the risk of post-operative dissatisfaction. Methods Pre-operative symptoms and post-operative satisfaction were measured using standardised questionnaires along with routine investigations. These data were used to calculate our novel pre-operative risk of dissatisfaction (PROD) score. Potential pre-operative prognostic markers were tested against the post-operative satisfaction data, including the objective investigations and the PROD score. The prognostic utility of the PROD score and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guideline was tested using receiver operating characteristic analysis to determine the area under the curve (AUC). Results An association was found between our PROD score and each of the satisfaction measures ( n  = 225, p  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-017-4057-9