ArticleCanadian family physician Medecin de famille canadien2005
Contextual factors in clinical decision making: national survey of Canadian family physicians.
Article in Canadian family physician Medecin de famille canadien, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process.BMC medical education · 2017Pooled it
- Perceived difficulty and appropriateness of decision making by General Practitioners: a systematic review of scenario studies.BMC health services research · 2014Pooled it
- Context factors in clinical decision-making: a scoping review.BMC medical informatics and decision making · 2025Article
- Efficiency over thoroughness in laboratory testing decision making in primary care: findings from a realist review.BJGP open · 2021Article
- Effect of clinical spectrum, inoculum size and physician characteristics on sensitivity of a rapid antigen detection test for group A streptococcal pharyngitis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2013Article
- Integration of evidence based medicine into the clinical years of a medical curriculum.Journal of family & community medicine · 2012Article
- Differential prognostic effect of revascularization according to a simple comorbidity index in high-risk non-ST-segment elevation acute coronary syndrome.Clinical cardiology · 2012Article
- The Frontera Collaboration: a preliminary report of health sciences librarians promoting evidence-based practice in U.S.-Mexico border communities.Medical reference services quarterly · 2012Article
- Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice.Journal of the Royal Society of Medicine · 2010Review
- Norwegian physicians' knowledge of and opinions about evidence-based medicine: cross-sectional study.PloS one · 2009Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveMany factors are at play in the process of clinical decision making, but to date, the interaction of these factors has not been well understood. Such information could have important implications for teaching and promoting evidence-based medicine (EBM) in primary care. This study was designed to explore the relationship between physician-related variables and management of patient-related contextual factors in clinical decision making. A secondary objective was to examine the extent to which this relationship varies by type of clinical decision.
designCross-sectional randomized postal survey of 1134 Canadian primary care physicians stratified by age, sex, and practice location. Nonrespondents were sent reminders at 4 weeks and again at 8 weeks; at 12 weeks, all remaining nonrespondents were mailed replacement copies of the questionnaire.
settingFamily practices in Canada.
participantsOf the final sample of 431 family physicians, 52% were men, 63% practised in urban locations, and 71% were in group practice.
main outcome measuresSelf-reported likelihood of considering various contextual factors during the course of clinical decision making.
resultsDespite the three follow-up mailings, the final response rate was 42%; however, nonrespondents did not differ significantly from respondents on three important demographic factors: age, sex, and practice location. Using multinomial logistic regression analysis, the data showed that female family physicians and practitioners less strongly identified with EBM were more likely to consider contextual factors in clinical decision making. The effect was more obvious for ordering tests than for decisions about treatment.
conclusionThe evolving model of EBM should consider important physician-related variables in clinical decision making. Our data indicate that physicians' sex and identification with the tenets of EBM influence management of contextual factors. These results have important implications because they indicate that clinicians strongly identified with the EBM model of clinical practice are less sensitive to context, which might be an obstacle to efforts to integrate patient values and clinical circumstances into patient-centred care. We believe these findings support continued development of the model of "context-sensitive medicine" previously proposed as an alternative to EBM.
Indexed as
Identifiers
16926949PMC1479511W1898403372What OpenQuestion holds
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.