Dear editor
We read with great interest the paper by Alshammari and colleagues [1] exploring the factors that shape patient’s decisions to undergo orthognathic surgery in the Ha’il region. The topic is highly relevant and of great importance, as such decisions are often influenced by more than just clinical considerations. That said, we would like to offer a few observations that might help guide future work in this area.
First, the study’s sample size (27 participants) is quite small for the breadth of questions it seeks to answer. Given that data collection took place over several years, it would have been valuable to explain how this number was determined or whether it was sufficient to detect meaningful differences. Recruiting from a single hospital also limits the representativeness of the findings and introduces selection bias as patients treated in private or other public facilities may differ in motivation, socioeconomic background, or access to information.
Second, the use of a cross-sectional design, while practical, only provides a snapshot of opinions at one moment in time. Because the choice to undergo orthognathic surgery often evolves through extended consultations and emotional reflection, a longitudinal or qualitative approach might have captured more insights.
Third, the reliance on self-reported interviews raises the possibility of recall bias, especially in sensitive areas such as aesthetic concerns or perceived stigma. Moreover, key constructs such as ‘aesthetic concerns’, ‘social stigma’, and ‘cultural beliefs’ were not measured using validated psychometric tools, making the findings more descriptive than analytical.
Finally, although the authors mention that less than half of participants received full information about risks and benefits, the study does not explore how this communication gap might affect confidence in the surgical decision or postoperative satisfaction. Understanding this link could be crucial in improving patient counselling and aligning with mentioned ‘‘Saudi Vision 2030s [2]’’ emphasis on informed, patient cantered care.
Despite these limitations, the study represents an important starting point for research on patient perspectives in maxillofacial surgery. Broader, multicentre studies using validated psychological measures would help clarify how aesthetic, functional, and emotional factors interact in shaping these complex decisions.
Acknowledgements
The author(s) employed ChatGPT (GPT-5, OpenAI) exclusively for language refinement, including improvements in grammar, clarity, and readability. The tool was not used for data analysis, evidence generation, or the creation of original content. All ideas, interpretations, and arguments presented in this Letter to the Editor are solely derived from the author’s professional expertise, judgment, and experience. All AI-assisted edits were carefully reviewed and approved by the author to ensure accuracy, integrity, and full compliance with Taylor & Francis’s ethical and authorship standards.
Funding Statement
No funding was received for the preparation of this manuscript.
Author contributions statement
Credit: Tuana Haznedar: Writing – original draft, Writing – review & editing; Hui Bing Lim: Writing – original draft, Writing – review & editing. TH and HL are joint first authors and contributed equally.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
No new data were generated or analysed in support of this correspondence. Data sharing is not applicable to this article.
References
- 1.Alshammari AF, Alenezi YE, Alharbi LH, et al. Determinants of decision-making in orthognathic surgery among patients in Ha’il region, Saudi Arabia. Ann Med. 2025;57(1):2477305. doi: 10.1080/07853890.2025.2477305. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Suleiman AK, Ming LC.. Transforming healthcare: saudi Arabia’s vision 2030 healthcare model. J Pharm Policy Pract. 2025;18(1):2449051. doi: 10.1080/20523211.2024.2449051. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
No new data were generated or analysed in support of this correspondence. Data sharing is not applicable to this article.