Patient Experiences as Knowledge for the Evidence Base
Bibliographic record
Abstract
BACKGROUND AND OBJECTIVES: It is reported that patients continue to have misgivings about regional anesthesia (RA) despite strong evidence to support its use for hip and knee replacement surgery. To date, no one has had an opportunity to study the experiences of patients who have undergone both types of anesthesia for these procedures. METHODS: Using descriptive qualitative methods, 12 patients who had hip or knee replacements under both RA and GA at two different time points (excluding revisions) were interviewed using purposeful sampling until saturation had been reached. Following transcription of each tape, a small study team met over the course of several months to read and discuss each transcript. A coding template was developed, and emerging themes noted. RESULTS: For the majority of patients, RA was either well tolerated or preferred. Having a previous negative experience with general anesthesia was common and was strongly associated with a patient's satisfaction with RA. Patients also described being highly influenced by the preference of their surgeon. CONCLUSIONS: These findings have important implications. First, many patients were surprisingly neutral about the procedure and seemed more fearful of anesthesia in general rather than of either technique specifically. This finding, combined with patient's influence by clinician preference, underscores the importance of physician support for RA. Some participants identified one of their misgivings about RA as being fear of being awake, which is consistent with the medical literature. Our findings also support the idea that from a patient's perspective, appropriate sedation while undergoing RA may be important.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.039 | 0.110 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.004 | 0.010 |
| Scholarly communication | 0.011 | 0.006 |
| Open science | 0.002 | 0.007 |
| Research integrity | 0.004 | 0.008 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".