Varieties of Uncertainty in Health Care: A Conceptual Taxonomy

Han, Paul K. J.; Klein, William M. P.; Arora, Neeraj

doi:10.1177/0272989x11393976

Cited by 364 publications

(580 citation statements)

References 55 publications

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“…Illness uncertainty -the inability to explain the cause of an illness, define an illness, or make predictions about future health 10,11 -can undermine health-related decision making and psychological adjustment. 12,13 Such barriers posed by illness uncertainty may increase patient motivation to learn more information from sequencing results.…”

Section: Introductionmentioning

confidence: 99%

Patient hopes for diagnostic genomic sequencing: roles of uncertainty and social status

et al. 2015

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For patients with unexplained or undiagnosed conditions, genomic sequencing offers the hope of resolving unanswered questions. With the growth of clinical genomic sequencing, understanding factors that shape patients' hope for information could have important implications for developing patient education guidelines. Based on the goal-directed theory of hope, we investigated illness uncertainty as a form of motivation and subjective social status as a form of perceived resources to predict the amount and kinds of information that adult patients (N = 191) and parents of pediatric patients (N = 79) hoped to receive from diagnostic sequencing results. Participants were part of a larger longitudinal study on clinical genomic sequencing, but the current study focuses on their hopes for diagnostic sequencing results. Hopes for information were assessed through close-ended and open-ended responses. Findings from mixed methods analyses indicated that although patients and parents hoped to learn multiple kinds of information from diagnostic sequencing results, their hopes appeared to be influenced by their illness uncertainty and perceptions of their social and economic resources. These findings suggest that patients' illness uncertainty and perceived resources could be useful avenues for discussing patient hopes and educating patients about strengths and limitations of genomic sequencing.

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Section: Introductionmentioning

confidence: 99%

Patient hopes for diagnostic genomic sequencing: roles of uncertainty and social status

et al. 2015

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“…The uncertainty of what newly medicalized terminology may mean can be described as a lack of clarity, a sub-domain of quality of information, whereas an uncertainty of diagnosis would fall within the domain of probability-the perceived likelihood of a particular outcome or the presence of a range of possibilities (Babrow et al, 1998). The source of uncertainty can influence the impact of uncertainty on decision, as demonstrated by the divergent effects of uncertainty on ratings of self-reported careseeking urgency observed in this study and Hall et al (2010), and it is important to recognize the differences in the source of the uncertainty, in order to appropriately manage it (Han et al, 2011).…”

Section: Discussionmentioning

confidence: 92%

The Impact of Medical Terminology in Self-Triage Decision-Making

D'Angelo

Humphreys

et al. 2017

Front. Commun.

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Objective: The present study examined whether medical terminology impacts self-triage decisions (deciding if and when to seek medical treatment) compared to lay terminology.Methods: Undergraduate psychology student participants read 32 hypothetical health scenarios and reported how urgently they would seek care ["In this situation, when would you seek medical attention?" presented along with a seven-point scale, with anchors at either extreme: "Never (At the next scheduled appointment, if at all)" and "As soon as possible (Within the hour)," reflecting the options coded as 1 and 7, respectively]. Data were collected in person via a paper-based questionnaire. Scenarios included a description of symptoms, which were labeled as consistent with a particular medical disorder using either a lay disease label (e.g. "Heart Attack") or medical terminology (e.g. "Myocardial Infarction"). The 32 health scenarios represented medical disorders that purposefully reflected a spectrum of severity, commonality, and how recently the medical terminology had entered common use. results: For disorders for which medical terminology has been more recently established, participants reported that they would seek care more urgently when the disorder was presented using a medical label [mean (SE) = 4.08 (0.23)] than when they were described using the lay disease labels [3.32 (0.23), t(35) = 5.36, p < 0.001, e.g., "seborrheic dermatitis" versus "chronic dandruff"]. However, this differential response to medical or lay disease labels was not observed for disorders for which medical terminology has been more well established [medical labels = 5.16 (0.18); lay labels = 4.89 (0.18), t(35) = −1.67, p = 0.104, e.g., "heart attack" and "myocardial infarction"].conclusion: These results indicate that self-triage decision-making can be readily influenced by the terminology used to identify a disorder; however, this phenomenon appears to be particularly relevant for disorders in which public opinion may still be in flux.

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“…Geosciences 2018, 8,24 14 of 20 resources influence official agencies and political slants may override all inclusion principles [105], with the public health professional often negotiator for all parties. The specifics of the interlinking of the knowledge from the scientific investigation with all the different concerns and interactions can be achieved through a small multi-agency team which can identify and evaluate the different aspects of the technical risk assessment, the context and the stakeholder interests ( Figure 5).…”

Section: Putting It All Together: Preventing Adverse Health Outcomesmentioning

confidence: 99%

Environment and Human Health: The Challenge of Uncertainty in Risk Assessment

Stewart

Hursthouse

2018

Geosciences

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High quality and accurate environmental investigations and analysis are essential to any assessment of contamination and to the decision-making process thereafter. Remediation decisions may be focused by health outcomes, whether already present or a predicted risk. The variability inherent in environmental media and analysis can be quantified statistically; uncertainty in models can be reduced by additional research; deep uncertainty exists when environmental or biomedical processes are not understood, or agreed upon, or remain uncharacterized. Deep uncertainty is common where health and environment interact. Determinants of health operate from the individual's genes to the international level; often several levels act synergistically. We show this in detail for lead (Pb). Pathways, exposure, dose and response also vary, modifying certainty. Multi-disciplinary approaches, built on high-quality environmental investigations, enable the management of complex and uncertain situations. High quality, accurate environmental investigations into pollution issues remain the cornerstone of understanding attributable health outcomes and developing appropriate responses and remediation. However, they are not sufficient on their own, needing careful integration with the wider contexts and stakeholder agendas, without which any response to the environmental assessment may very well founder. Such approaches may benefit more people than any other strategy.

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Varieties of Uncertainty in Health Care: A Conceptual Taxonomy

Cited by 364 publications

References 55 publications

Patient hopes for diagnostic genomic sequencing: roles of uncertainty and social status

Patient hopes for diagnostic genomic sequencing: roles of uncertainty and social status

The Impact of Medical Terminology in Self-Triage Decision-Making

Environment and Human Health: The Challenge of Uncertainty in Risk Assessment

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