Concordance analysis of common hand pathology referrals from primary care to plastic surgery: a retrospective cross-sectional study.
Family physicians' hand-condition referral diagnoses showed substantial agreement with plastic surgeons
Concordance analysis of common hand pathology referrals from primary care to plastic surgery: a retrospective cross-sectional study.
Hand conditions are commonly referred from primary care to plastic surgery; however, no prior studies have assessed diagnostic concordance between family physicians and plastic surgeons.
This study aimed to evaluate the accuracy and agreement of referring diagnoses for common hand pathologies.
We conducted a retrospective cross-sectional study of 141 adult referrals from family physicians to plastic surgery for hand conditions at a tertiary care center over a 1-year period.
family doctors and plastic surgeons agreed on hand diagnoses far more often than by chance
Carpal tunnel syndrome (29.9%) and Dupuytren's disease (13.8%) were the most common referrals.
Concordance was highest for carpal tunnel syndrome and Dupuytren's disease (both κ = 0.88), and lower for trigger finger (κ = 0.69), ganglions (κ = 0.53), and first carpometacarpal joint osteoarthritis (κ = 0.52).
Diagnostic accuracy of family physicians was 70.7%.
Most diagnoses were made clinically by the plastic surgeon at the initial consultation.
Diagnostic concordance between family physicians and plastic surgeons was substantial.
While carpal tunnel syndrome and Dupuytren's disease showed high agreement, lower concordance for other hand conditions highlights opportunities for focused educational tools to improve diagnostic precision in primary care.