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Advances in objective assessment of hand function and outcome
Hand Clin 19 (2003) xiii
Foreword
Advances in objective assessment of hand function and outcome
Peter C. Amadio, MD
Almost 100 years ago, Ernest Amory Codman, a Boston surgeon, conceived of what he called ‘‘the end result idea,’’ which, he wrote, was ‘‘simply the common sense notion that every hospital should follow every patient it treats, long enough to determine whether or not the treatment has been successful, and then to inquire, Ôif not, why not?’, with a view to preventing further failures in the future.’’ (Codman EA. The shoulder. Thomas Todd: Boston; 1934. p. xii.) This idea, now commonly referred to as evidence-based medicine, is the foundation on which the continuous improvement of medicine is based. Yet, if we are to analyze our results, there is a primary need to agree on what things are important to measure and a corollary need for precision and accuracy in the way the measurements are done. These needs are the subject of this volume of Hand Clinics of North America. What to measure? There are, it seems, too many dimensions. Anatomy, physiology, and function are all important, but there is an interplay of these with occupation, social state, self-image, and costs. Whose perspective is to be considered? That of the clinician doing the measurements?
The person being measured? What of society, which bears the costs? How to measure? Must we rely on the impartiality of machines? Where can clinical measurements suffice? And, finally, how accurate and precise are our measurements? How accurate and precise do they need to be? Are they reproducible and reliable from one observer to the next? What standards should we use? For all those for whom these questions are important, this volume contains many useful answers. I am grateful to Fre´de´ric Schuind and his many colleagues for assembling a valuable contribution to our understanding of hand outcomes, and I hope that the readers of Hand Clinics will draw from it as many practical and useful insights as I have.
0749-0712/03/$ - see front matter Ó 2003 Elsevier Inc. All rights reserved. doi:10.1016/S0749-0712(03)00039-8
Peter C. Amadio, MD Professor of Orthopedic Surgery Mayo Clinic 200 First Street SW Rochester, MN 55905, USA
Foreword
Advances in objective assessment of hand function and outcome
Peter C. Amadio, MD
Almost 100 years ago, Ernest Amory Codman, a Boston surgeon, conceived of what he called ‘‘the end result idea,’’ which, he wrote, was ‘‘simply the common sense notion that every hospital should follow every patient it treats, long enough to determine whether or not the treatment has been successful, and then to inquire, Ôif not, why not?’, with a view to preventing further failures in the future.’’ (Codman EA. The shoulder. Thomas Todd: Boston; 1934. p. xii.) This idea, now commonly referred to as evidence-based medicine, is the foundation on which the continuous improvement of medicine is based. Yet, if we are to analyze our results, there is a primary need to agree on what things are important to measure and a corollary need for precision and accuracy in the way the measurements are done. These needs are the subject of this volume of Hand Clinics of North America. What to measure? There are, it seems, too many dimensions. Anatomy, physiology, and function are all important, but there is an interplay of these with occupation, social state, self-image, and costs. Whose perspective is to be considered? That of the clinician doing the measurements?
The person being measured? What of society, which bears the costs? How to measure? Must we rely on the impartiality of machines? Where can clinical measurements suffice? And, finally, how accurate and precise are our measurements? How accurate and precise do they need to be? Are they reproducible and reliable from one observer to the next? What standards should we use? For all those for whom these questions are important, this volume contains many useful answers. I am grateful to Fre´de´ric Schuind and his many colleagues for assembling a valuable contribution to our understanding of hand outcomes, and I hope that the readers of Hand Clinics will draw from it as many practical and useful insights as I have.
0749-0712/03/$ - see front matter Ó 2003 Elsevier Inc. All rights reserved. doi:10.1016/S0749-0712(03)00039-8
Peter C. Amadio, MD Professor of Orthopedic Surgery Mayo Clinic 200 First Street SW Rochester, MN 55905, USA