ArticleBMJ (Clinical research ed.)2005
The nature of medical evidence and its inherent uncertainty for the clinical consultation: qualitative study.
Article in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Behavioural modification interventions for medically unexplained symptoms in primary care: systematic reviews and economic evaluation.Health technology assessment (Winchester, England) · 2020Pooled it
- Managing diagnostic uncertainty in primary care: a systematic critical review.BMC family practice · 2017Pooled it
- Thou shalt versus thou shalt not: a meta-synthesis of GPs' attitudes to clinical practice guidelines.The British journal of general practice : the journal of the Royal College of General Practitioners · 2007Pooled it
- Medical communication and technology: a video-based process study of the use of decision aids in primary care consultations.BMC medical informatics and decision making · 2007Trial
- What aspects of clinical uncertainty are addressed by published competencies in evidence-based medicine? A scoping review.BMJ open · 2026Article
- Perceptions of osteoporosis risk assessment during menopause: a qualitative focus group study of patients and healthcare professionals in the UK.BMJ public health · 2026Article
- Developing and validating of the Clinical Uncertainty Measurement Questionnaire (CUMQ) among practicing physicians and clinical residents in Iran.BMC medical education · 2022Article
- Factors Associated with Physician Tolerance of Uncertainty: an Observational Study.Journal of general internal medicine · 2022Observational
- Making complex decisions in uncertain times: experiences of Dutch GPs as gatekeepers regarding hospital referrals during COVID-19-a qualitative study.BMC medical ethics · 2021Article
- A scoping review of practice recommendations for clinicians' communication of uncertainty.Health expectations : an international journal of public participation in health care and health policy · 2021Article
- Article
- COGITA network has constructed a glossary of diagnostic reasoning terms.The European journal of general practice · 2017Article
- The linguistic validation of the gut feelings questionnaire in three European languages.BMC family practice · 2017Article
- Ambiguity and uncertainty tolerance, need for cognition, and their association with stress. A study among Italian practicing physicians.Medical education online · 2017Article
- Conveying Equipoise during Recruitment for Clinical Trials: Qualitative Synthesis of Clinicians' Practices across Six Randomised Controlled Trials.PLoS medicine · 2016Article
- Vitamin D: an examination of physician and patient management of health and uncertainty.Qualitative health research · 2014Article
- Doctors' understanding of individualisation of drug treatments: a qualitative interview study.BMJ open · 2013Article
- Family physicians' diagnostic gut feelings are measurable: construct validation of a questionnaire.BMC family practice · 2013Article
- The negotiation of the sick role: general practitioners' classification of patients with medically unexplained symptoms.Sociology of health & illness · 2012Article
- GPs' decision-making--perceiving the patient as a person or a disease.BMC family practice · 2012Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe how clinicians deal with the uncertainty inherent in medical evidence in clinical consultations.
designQualitative study.
settingClinical consultations related to hormone replacement therapy, bone densitometry, and breast screening in seven general practices and three secondary care clinics in the UK NHS.
participantsWomen aged 45-64.
results45 of the 109 relevant consultations included sufficient discussion for analysis. The consultations could be categorised into three groups: focus on certainty for now and this test, with slippage into general reassurance; a coherent account of the medical evidence for risks and benefits, but blurring of the uncertainty inherent in the evidence and giving an impression of certainty; and acknowledging the inherent uncertainty of the medical evidence and negotiating a provisional decision.
conclusionStrategies health professionals use to cope with the uncertainty inherent in medical evidence in clinical consultations include the use of provisional decisions that allow for changing priorities and circumstances over time, to avoid slippage into general reassurance from a particular test result, and to avoid the creation of a myth of certainty.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.