Wednesday, November 23, 2016

Taking a deep dive into the patient experience for brachial plexus injuries

Earlier this year, we published a paper in the Journal of Hand Surgery that systematically evaluated and thematically analyzed the content of 2 discussion boards for brachial plexus injury (BPI). I wanted to write a little bit here about the origin of the study, as well as some of the follow-up that will result from the study.

One of my earlier research interests during residency was trying to understand the quality and readability of information on the internet for hand surgery conditions. As a doctor, I know that my patients are often looking up information about their conditions on the internet - either trying to get a diagnose or get more information about the treatment (I do the same when I am a patient!) 

I know that it can be frustrating to look for good quality information on the internet, even for common conditions. I imagine that it can be really challenging for patients newly diagnosed with brachial plexus injuries (and their families) to find reliable information. Many patients encounter discussion boards (such as the American and the UK's Traumatic BPI group) that have a remarkable amount of information. Anticipating that many patients and families would spend time on these websites consuming information and sharing their experience with others, we thought it would be helpful to systematically examine these websites. Basically, we wanted to see what our patients would be interested in learning and what type of information is being shared on these sites. 

Marie Morris (at the time, a Wash U medical student and now one of our orthopedic surgery residents) pulled posts from and the Traumatic BPI discussion boards from the 2015 calendar year. Using established methods for thematic analysis and qualitative research, Marie and I then looked through each post to determine common themes. Here are the themes we came up with: 

This was an incredibly educational experience for me - as a BPI surgeon, reading through all of these posts and culling them together gave me a deeper understanding of what my patients are experiencing and what they are reading. This knowledge has helped me empathize with patients and try to explain the injury and treatments in a relatable and understandable manner. 

So what now? One of the secondary goals of this project was to develop a list of subjects/topics that I can write about for this blog. In the coming weeks and months, I hope to go through these themes in blog posts. The content that we found on these discussion boards was largely high quality and understandable (kudos to UBPN and Traumatic BPI!), so I hope that providing some content from the BPI surgeon perspective will be helpful to patients and families worldwide.

Christopher J. Dy, MD MPH
My Bio at Washington University Orthopedics 

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