ArticleJournal of general internal medicine2007
Sources of variation in physician adherence with clinical guidelines: results from a factorial experiment.
Article in Journal of general internal medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.
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Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it, 116 citations in OpenAlex.
- Implicit bias in healthcare professionals: a systematic review.BMC medical ethics · 2017Pooled it
- Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status.American journal of obstetrics and gynecology · 2010Trial
- Physician clinical information technology and health care disparities.Medical care research and review : MCRR · 2009Trial
- [Diagnosis and therapy of depression in the elderly--influence of patient and physician characteristics].Psychotherapie, Psychosomatik, medizinische PsychologieTrial
- Effects of Use of Primary Care Checklists and of Extent of Clinical Experience on Performance in Interpreting Paediatric ECGs Linked to Risk of Sudden Cardiac Death.Healthcare (Basel, Switzerland) · 2026Article
- Guideline adherence for the management of cardiovascular disease in primary care: a scoping review.Family practice · 2026Article
- PRICE: a personalized recursive intelligent cost effectiveness analysis framework for rare disease diagnosis.BMC medical informatics and decision making · 2025Article
- Bridging the gap between evidence and practice: a national level initiative to implement Standard Treatment Guidelines (STGs) in clinical practice.BMC health services research · 2025Article
- The Influence of Anesthesiologist Gender and Experience on Risk Understanding and Anxiety Changes After Online Preoperative Patient Education: A Sub-Analysis of the iPREDICT Randomized Controlled Trial.Journal of clinical medicine · 2025Article
- Diabetes diagnosis based on glucose control levels and time until diagnosis: a regression discontinuity approach to assess the effect on direct healthcare costs.Health economics review · 2025Article
- A survey of emergency medicine physicians' knowledge, attitude, and practice towards esophagogastric variceal bleeding.International journal of emergency medicine · 2025Article
- Thyroid hormones for euthyroid patients with simple goiter growing over time: a survey of European thyroid specialists.Endocrine · 2025Article
- Variations, effectiveness and its associated factors of a nationwide web-based hypertension management training project in China: insights from a government-led campaign for 1.2 million lay health workers.Journal of geriatric cardiology : JGC · 2024Article
- Do Women Physicians Accept and Follow Heart Failure Guidelines More Than Men?Current heart failure reports · 2023Review
- Effectiveness of instructional videos for enhancing healthcare provider competencies for hypertension management - a pre-post study in primary healthcare settings, Tanzania.BMC health services research · 2022Article
- Variability in Coronary Artery Disease Testing for Patients With New-Onset Heart Failure.Journal of the American College of Cardiology · 2022Article
- Article
- Clinical practice guideline adherence in oncology: A qualitative study of insights from clinicians in Australia.PloS one · 2022Article
- Urgent-care antibiotic prescribing: An exploratory analysis to evaluate health inequities.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- Deprived social status is associated with decreased use of oral chemotherapy in patients with metastatic colorectal cancer: A retrospective cohort study on administrative databases in a French University Hospital.Pharmacology research & perspectives · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundHealth services research has documented the magnitude of health care variations. Few studies focus on provider level sources of variation in clinical decision making-for example, which primary care providers are likely to follow clinical guidelines, with which types of patient.
objectivesTo estimate: (1) the extent of primary care provider adherence to practice guidelines and the unconfounded influence of (2) patient attributes and (3) physician characteristics on adherence with clinical practice guidelines.
designIn a factorial experiment, primary care providers were shown clinically authentic video vignettes with actors portrayed different "patients" with identical signs of coronary heart disease (CHD). Different types of providers were asked how they would manage the different "patients" with identical CHD symptoms. Measures were taken to protect external validity.
resultsAdherence to some guidelines is high (over 50% of physicians would follow a third of the recommended actions), yet there is low adherence to many of them (less than 20% would follow another third). Female patients are less likely than males to receive 4 of 5 types of physical examination (p < .03); older patients are less likely to be advised to stop smoking (p < .03). Race and SES of patients had no effect on provider adherence to guidelines. A physicians' level of experience (age) appears to be important with certain patients.
conclusionsPhysician adherence with guidelines varies with different types of "patient" and with the length of clinical experience. With this evidence it is possible to appropriately target interventions to reduce health care variations by improving physician adherence with clinical guidelines.
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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.