{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:12:07Z","timestamp":1785427927437,"version":"3.56.0"},"reference-count":16,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Trust in physicians remains a cornerstone of effective healthcare delivery; however, the rapid expansion of online and non-physician health information sources has introduced new challenges to patient decision-making. In orthopedic practice, delayed evaluation of musculoskeletal symptoms\u2014particularly those concerning for malignancy\u2014may be influenced by misinformation and alternative care pathways.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a cross-sectional, nationally weighted survey of U.S. adults (n=200) to evaluate care-seeking behavior, trust in information sources, and endorsement of cancer-related misconceptions. The survey assessed willingness to delay care for persistent bone or back pain, reliance on physician versus non-physician information sources, and responses to conflicting health information. Stratified analyses were performed based on chronic pain status and prior cancer-related experience.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Although 85% of respondents identified physicians as their most trusted source of health information, 55% reported regular use of online or social media platforms. A substantial proportion of participants reported willingness to delay care for \u22653 weeks or until symptom progression. Individuals with chronic pain demonstrated significantly higher odds of delayed care-seeking (p<0.05) and misinformation endorsement (OR 1.5\u20132.5, p<0.05). Reliance on online information was independently associated with delayed medical evaluation (OR ~2.0, p<0.01). Notably, a subset of respondents reported prioritizing online information over physician recommendations when conflicts arose, representing the highest-risk group for delayed care.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n A pronounced trust\u2013behavior paradox exists in orthopedic care, wherein high trust in physicians does not consistently translate into timely care-seeking. Misinformation and reliance on non-physician information sources contribute to diagnostic delay, particularly among individuals with chronic pain or prior cancer-related experience. Targeted patient education and engagement in digital information spaces are critical to mitigating these risks.<\/jats:p>\n <\/jats:sec>","DOI":"10.52965\/001c.162078","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T16:47:11Z","timestamp":1779468431000},"source":"Crossref","is-referenced-by-count":0,"title":["The Trust\u2013Behavior Paradox in Orthopedic Care: A National Survey of Care-Seeking, Misinformation, and Non-Physician Information Sources"],"prefix":"10.52965","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8609-2486","authenticated-orcid":false,"given":"Maya","family":"Lee","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04ytb9n23","id-type":"ROR","asserted-by":"publisher"}],"name":"Furman University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7717-3864","authenticated-orcid":true,"given":"Latha","family":"Ganti","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"issue":"3","key":"ref1","doi-asserted-by":"publisher","first-page":"166","DOI":"10.5152\/ejbh.2018.3929","article-title":"Use of Alternative Medicine Is Delaying Health-Seeking Behavior by Bangladeshi Breast Cancer Patients","volume":"14","author":"K. Akhtar","year":"2018","journal-title":"Eur J Breast Health"},{"issue":"3","key":"ref2","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1176\/appi.focus.20170014","article-title":"The Role of Integrated Care in Managing Chronic Pain","volume":"15","author":"W. B. Leasure","year":"2017","journal-title":"Focus (Am Psychiatr Publ)"},{"issue":"2","key":"ref3","doi-asserted-by":"publisher","first-page":"317","DOI":"10.3390\/cancers16020317","article-title":"Reducing the Risk of Needle Tract Seeding or Tumor Cell Dissemination during Needle Biopsy Procedures","volume":"16","author":"D. R. Holmes","year":"2024","journal-title":"Cancers (Basel)"},{"issue":"3","key":"ref4","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1007\/s12282-026-01845-4","article-title":"Fear of diagnosis as a barrier to the screening and diagnosis of breast cancer","volume":"33","author":"A. Mantripragada","year":"2026","journal-title":"Breast Cancer"},{"issue":"6","key":"ref5","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1188\/10.ONF.740-748","article-title":"Race and lung cancer surgery--a qualitative analysis of relevant beliefs and management preferences","volume":"37","author":"M. George","year":"2010","journal-title":"Oncol Nurs Forum"},{"issue":"8","key":"ref6","doi-asserted-by":"publisher","first-page":"e25.00152","DOI":"10.5435\/JAAOSGlobal-D-25-00152","article-title":"TikTok and Orthopaedic Education: Engaging the Next Generation of Patients","volume":"9","author":"C. Vicioso","year":"2025","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"issue":"12","key":"ref7","doi-asserted-by":"publisher","first-page":"e49946","DOI":"10.7759\/cureus.49946","article-title":"Misinformation About Orthopaedic Conditions on Social Media: Analysis of TikTok and Instagram","volume":"15","author":"O. Kolade","year":"2023","journal-title":"Cureus"},{"issue":"2","key":"ref8","doi-asserted-by":"publisher","first-page":"e0170988","DOI":"10.1371\/journal.pone.0170988","article-title":"Trust in the health care professional and health outcome: A meta-analysis","volume":"12","author":"J. Birkh\u00e4uer","year":"2017","journal-title":"PLoS One"},{"issue":"3","key":"ref9","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1080\/10810730.2021.1903627","article-title":"Using Social Media for Health: National Data from HINTS 2019","volume":"26","author":"W. S. Chou","year":"2021","journal-title":"J Health Commun"},{"issue":"11","key":"ref10","doi-asserted-by":"publisher","first-page":"1489","DOI":"10.1302\/0301-620X.92B11.24326","article-title":"Earlier diagnosis of bone and soft-tissue tumours","volume":"92","author":"R. J. Rimer","year":"2010","journal-title":"J Bone Joint Surg Br"},{"issue":"11","key":"ref11","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1016\/j.socscimed.2011.09.017","article-title":"\"Cutting\" on cancer: attitudes about cancer spread and surgery among primary care patients in the U.S.A.","volume":"73","author":"A. James","year":"2011","journal-title":"Soc Sci Med"},{"issue":"1","key":"ref12","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","article-title":"Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)","volume":"160","author":"R. D. Treede","year":"2019","journal-title":"Pain"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e43749","DOI":"10.2196\/43749","article-title":"Exposure and Reactions to Cancer Treatment Misinformation and Advice: Survey Study","volume":"9","author":"A. J. Lazard","year":"2023","journal-title":"JMIR Cancer"},{"issue":"2","key":"ref14","doi-asserted-by":"publisher","first-page":"230","DOI":"10.4055\/cios.2014.6.2.230","article-title":"Plain radiologic findings and chronological changes of incipient phase osteosarcoma overlooked by primary physicians","volume":"6","author":"W. S. Song","year":"2014","journal-title":"Clin Orthop Surg"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"jrm00286","DOI":"10.2340\/jrm.v54.241","article-title":"Pain Tolerance in Chronic Pain Patients Seems to be More Associated with Physical Activity than with Depression and Anxiety","volume":"54","author":"O. Skogberg","year":"2022","journal-title":"J Rehabil Med"},{"issue":"4","key":"ref16","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1177\/1534735411403309","article-title":"The Chiropractic Care of Patients With Cancer: A Systematic Review of the Literature: A Systematic Review of the Literature","volume":"11","author":"J. Alcantara","year":"2012","journal-title":"Integrative Cancer Therapies"}],"container-title":["Orthopedic Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/162078-the-trust-behavior-paradox-in-orthopedic-care-a-national-survey-of-care-seeking-misinformation-and-non-physician-information-sources","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T16:47:12Z","timestamp":1779468432000},"score":1,"resource":{"primary":{"URL":"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/162078-the-trust-behavior-paradox-in-orthopedic-care-a-national-survey-of-care-seeking-misinformation-and-non-physician-information-sources"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":16,"URL":"https:\/\/doi.org\/10.52965\/001c.162078","relation":{},"ISSN":["2035-8164"],"issn-type":[{"value":"2035-8164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]}}}