Factors influencing GPs' decisions on the treatment of hypercholesterolaemic patients

Bäcklund, L; Danielsson, Birgitta; Bring, Johan; Strender, Lars-Erik

doi:10.1080/028134300750018963

Cited by 14 publications

(3 citation statements)

References 10 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical judgement analysis has been applied previously in a number of contexts, supporting our findings of substantial clinical variability when decisions involve complexity [15,22-26]. The method needs developing beyond measuring variations to demonstrate improved consistency and quality of care.…”

Section: Discussionsupporting

confidence: 62%

“…normal and abnormal (low or high)) were also agreed (see Table 1). These variables were used to generate a number of clinical scenarios; a key decision is whether scenarios should present information as found in every day clinical practice or whether to use more artificial, non-correlated, orthogonally-based scenarios [15]. The latter may be better at determining the importance of variables affecting decisions but may lose some clinical relevance.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Using the method of judgement analysis to address variations in diagnostic decision making

2012

View full text Add to dashboard Cite

BackgroundHeart failure is not a clear-cut diagnosis but a complex clinical syndrome with consequent diagnostic uncertainty. Judgment analysis is a method to help clinical teams to understand how they make complex decisions. The method of judgment analysis was used to determine the factors that influence clinicians' diagnostic decisions about heart failure.MethodsThree consultants, three middle grade doctors, and two junior doctors each evaluated 45 patient scenarios. The main outcomes were: clinicians' decisions whether or not to make a diagnosis of suspected heart failure; the relative importance of key factors within and between clinician groups in making these decisions, and the acceptability of the scenarios.ResultsThe method was able to discriminate between important and unimportant factors in clinicians' diagnostic decisions. Junior and consultant physicians tended to use patient information similarly, although junior doctors placed particular weight on the chest X-Ray. Middle-grade doctors tended to use information differently but their diagnostic decisions agreed with consultants more frequently (k = 0.47) than junior doctors and consultants (k = 0.23), or middle grade and junior grade doctors (k = 0.10).ConclusionsJudgment analysis is a potentially valuable method to assess influences upon diagnostic decisions, helping clinicians to manage the quality assurance process through evaluation of care and continuing professional development.

show abstract

Section: Discussionsupporting

confidence: 62%

Section: Methodsmentioning

confidence: 99%

Using the method of judgement analysis to address variations in diagnostic decision making

2012

View full text Add to dashboard Cite

show abstract

“…Study eligibility doubts were resolved by discussion with all authors. One author (NM) extracted data using a form (included in Additional file 3 ) developed using Cochrane guidance [ 11 ] and relevant literature [ 6 , 10 , 12 , 13 ] and which was piloted by all authors. Data pertaining to study characteristics, participants, patient scenario construction, outcome measures, and results were extracted and stored electronically.…”

Section: Methodsmentioning

confidence: 99%

Perceived difficulty and appropriateness of decision making by General Practitioners: a systematic review of scenario studies

McCleary

Ramsay

Francis

et al. 2014

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundHealth-care quality in primary care depends largely on the appropriateness of General Practitioners’ (GPs; Primary Care or Family Physicians) decisions, which may be influenced by how difficult they perceive decisions to be. Patient scenarios (clinical or case vignettes) are widely used to investigate GPs’ decision making. This review aimed to identify the extent to which perceived decision difficulty, decision appropriateness, and their relationship have been assessed in scenario studies of GPs’ decision making; identify possible determinants of difficulty and appropriateness; and investigate the relationship between difficulty and appropriateness.MethodsMEDLINE, EMBASE, PsycINFO, the Cochrane Library and Web of Science were searched for scenario studies of GPs’ decision making. One author completed article screening. Ten percent of titles and abstracts were checked by an independent volunteer, resulting in 91% agreement. Data on decision difficulty and appropriateness were extracted by one author and descriptively synthesised. Chi-squared tests were used to explore associations between decision appropriateness, decision type and decision appropriateness assessment method.ResultsOf 152 included studies, 66 assessed decision appropriateness and five assessed perceived difficulty. While no studies assessed the relationship between perceived difficulty and appropriateness, one study objectively varied the difficulty of the scenarios and assessed the relationship between a measure of objective difficulty and appropriateness. Across 38 studies where calculations were possible, 62% of the decisions were appropriate as defined by the appropriateness standard used. Chi-squared tests identified statistically significant associations between decision appropriateness, decision type and decision appropriateness assessment method. Findings suggested a negative relationship between decision difficulty and appropriateness, while interventions may have the potential to reduce perceived difficulty.ConclusionsScenario-based research into GPs’ decisions rarely considers the relationship between perceived decision difficulty and decision appropriateness. The links between these decisional components require further investigation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-014-0621-2) contains supplementary material, which is available to authorized users.

show abstract

Planning to Avoid Trouble in the Operating Room: Experts’ Formulation of the Preoperative Plan

Zilbert

St-Martin

Regehr

et al. 2015

Journal of Surgical Education

View full text Add to dashboard Cite

Factors influencing GPs' decisions on the treatment of hypercholesterolaemic patients

Abstract: The results indicate that doctors use very different judgement strategies for drug prescription concerning patients with hypercholesterolaemia. A fairly large subgroup of the doctors did not include coronary heart disease in their judgements, in contrast to the present guidelines.

Cited by 14 publications

References 10 publications

Using the method of judgement analysis to address variations in diagnostic decision making

Using the method of judgement analysis to address variations in diagnostic decision making

Perceived difficulty and appropriateness of decision making by General Practitioners: a systematic review of scenario studies

Planning to Avoid Trouble in the Operating Room: Experts’ Formulation of the Preoperative Plan

Contact Info

Product

Resources

About