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Patient, physician and presentational influences on clinical decision making for breast cancer: results from a factorial experiment *
Author(s) -
McKinlay John B.,
Burns Risa B.,
Durante Richard,
Feldman Henry A.,
Freund Karen M.,
Harrow Brooke S.,
Irish Julie T.,
Kasten Linda E.,
Moskowitz Mark A.
Publication year - 1997
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.1997.tb00067.x
Subject(s) - medical diagnosis , medicine , breast cancer , medical decision making , socioeconomic status , presentational and representational acting , family medicine , specialty , clinical psychology , psychology , cancer , pathology , population , environmental health , philosophy , aesthetics
This study examines the influence of six patient characteristics (age, race, socioeconomic status, comorbiditics, mobility and presentational style) and two physician characteristics (medical specialty and years of clinical experience) on physicians' clinical decision making behaviour in the evaluation and treatment of an unknown and known breast cancer. Physicians' variability and certainty associated with diagnostic and treatment behaviour were also examined. Separate analyses explored the influence of these non‐medical factors on physicians' cognitive processes. Using a fractional factorial design, 128 practising physicians were shown two videotaped scenarios and asked about possible diagnoses and medical recommendations. Results showed that physicians displayed considerable variability in response to several patient‐based factors. Physician characteristics also emerged as important predictors of clinical behaviour, thus confirming the complexity of the medical decision‐making process.