As of 2015, second opinions are legally implemented in Germany. However, empirical results from German second opinion programs are lacking. The aim of this study was to examine several aspects within a population of a German second opinion program. Study population consisted of patients who sought a second opinion in the period from August 2011 to December 2016. Multivariate logistic regression and ANOVA were used to examine differences in patient characteristics, differentiated by agreement of initial therapy recommendation and second opinion. Follow-up points for patient satisfaction and HRQoL were defined at 1, 3 and 6 months after obtaining the second opinion. Total number of patients who sought a second opinion was 1414. Most common indications concerned the knee (37.3%), spine (27.3%), hip (11.5%) and shoulder (10.1%). The independent specialists did not confirm the initial therapy recommendations in two out of three cases. The type of indication influenced the agreement between initial therapy recommendation and the second opinion significantly (p = 0.035). The second opinion and the offered service was highly valued by the patients (89%). The second opinion offers patients the possibility to confirm a medical indication independently and support patients in their decision making process. Reasons for the large discrepancy between initial therapy recommendation and second opinion should be addressed in future research.

中文翻译：

---

德国以患者为中心的第二意见计划的结果表明，初始治疗推荐与第二意见之间存在很大差异

截至2015年，第二意见已在德国合法实施。但是，缺乏德国第二意见计划的经验结果。这项研究的目的是研究德国第二意见计划人群中的几个方面。研究人群包括在2011年8月至2016年12月期间寻求第二意见的患者。多因素logistic回归和ANOVA用于检查患者特征的差异，并根据初始治疗建议和第二意见的差异加以区分。获得第二种意见后的1、3和6个月定义了患者满意度和HRQoL的随访点。寻求第二意见的患者总数为1414。最常见的适应症是膝盖（37.3％），脊柱（27.3％），臀部（11.5％）和肩膀（10.1％）。独立专家在三分之二的病例中均未确认最初的治疗建议。适应症的类型显着影响了初始治疗推荐与第二种意见之间的一致性（p = 0.035）。第二意见和所提供的服务受到患者的高度评价（89％）。第二种意见为患者提供了独立确认医学适应症并支持患者决策过程的可能性。最初的治疗建议和第二种意见之间存在巨大差异的原因应在以后的研究中解决。第二意见和所提供的服务受到患者的高度评价（89％）。第二种意见为患者提供了独立确认医学适应症并支持患者决策过程的可能性。最初的治疗建议和第二种意见之间存在巨大差异的原因应在以后的研究中解决。第二意见和所提供的服务受到患者的高度评价（89％）。第二种意见为患者提供了独立确认医学适应症并支持患者决策过程的可能性。最初的治疗建议和第二种意见之间存在巨大差异的原因应在以后的研究中解决。