Table 2.

Disease-Specific Factors

Variable	Category
	1	2	3	4	5
Nonoperative treatment option effectiveness∗	None available	Available, < 40% as effective as operation	Available, 40% to < 60% as effective as operation	Available, 60% to < 95% as effective as operation	Available, ≥ 95% or equally effective
Nonoperative treatment option resource use/exposure risk	Significantly worse/not applicable	Somewhat worse	Equivalent	Somewhat better	Significantly Better
Impact of 2-wk delay in disease outcomes	Significantly worse	Worse	Moderately worse	Slightly worse	No worse
Impact of 2-wk delay in surgical difficulty/risk	Significantly worse	Worse	Moderately worse	Slightly worse	No worse
Impact of 6-wk delay in disease outcomes	Significantly worse	Worse	Moderately worse	Slightly worse	No worse
Impact of 6-wk delay in surgical difficulty/risk	Significantly worse	Worse	Moderately worse	Slightly worse	No worse

Disease score 6 to 30. Higher score equates with less harm to patient if nonoperative treatment is pursued and/or operation delayed. Limited resources might be better deployed for diseases where nonoperative treatment is less effective or not available, or delayed surgical treatment leads to worse disease outcomes and/or increases surgical risk. Consideration of disease factors at 2 different time points integrates natural history of disease, significance of patient symptoms, and time sensitivity of operation into the decision-making process.

^∗Patients scoring 1 point under “nonoperative treatment option effectiveness” will also score 1 point under “nonoperative treatment option resource use/exposure risk” because the question would be “not applicable.”