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First let me quote a simple definition of outcomes research from the "father of the outcomes movement," John Wennberg, who asked, "what treatments most benefit which groups of patients?"1 Outcomes research attempts to do just that.
In orthopedics we traditionally have reported the results of surgical treatment using criteria of success that are determined somewhat arbitrarily by the surgeon writing the paper, with little universal consensus on how the results should be expressed. These studies have limited value in helping either doctors or patients (let alone the insurers) determine if such treatment fits the individual patient's needs.
For example, is it helpful to tell a patient with osteoarthritis of the knee whose chief complaint is inability to garden that "85% of patients undergoing my operation achieve a score of 90"? How much better would it be to match individual parameters such as pain relief and gains in specific functional areas to the individual patient's desires? In addition to guiding our patients into appropriate decisions, we would be able to demonstrate to those who pay the bill (ultimately the voters) the beneficia! effects of our efforts. In most areas of orthopedics it will be difficult, if not impossible, to demonstrate financial benefit from our interventions, which are so often directed toward pain relief and subjective improvement in the quality of life -...