ArticleSocial science & medicine (1982)2008
How are patient characteristics relevant for physicians' clinical decision making in diabetes? An analysis of qualitative results from a cross-national factorial experiment.
Article in Social science & medicine (1982), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed.
- Applying an implementation science lens to understand physician-level variation in patient length of stay in internal medicine.BMC health services research · 2025Article
- Impact of capitation payment on vascular complications among treated diabetic patients in China.Scientific reports · 2025Article
- African American Female Veterans Experiences with Perceived Racism Within the Veteran's Healthcare Administration.Journal of racial and ethnic health disparities · 2025Article
- A Qualitative Exploration of General Practitioners' Treatment Decision-Making for Depressive Symptoms.Medical decision making : an international journal of the Society for Medical Decision Making · 2023Article
- Decision Making from the Experience of Orthognathic Surgery Patients: A Grounded Theory Approach.JDR clinical and translational research · 2022Article
- Factors affecting primary care physician decision-making for patients with complex multimorbidity: a qualitative interview study.BMC primary care · 2022Article
- Key Factors Relevant for Healthcare Decisions of Patients with Type 1 and Type 2 Diabetes in Secondary Care According to Healthcare Professionals.Patient preference and adherence · 2022Article
- Sexual history taking: Doctors' clinical decision-making in primary care in the North West province, South Africa.African journal of primary health care & family medicine · 2021Article
- Factors Influencing Physicians' Clinical Decision-making at Upazila Health Complexes in Bangladesh.Global journal on quality and safety in healthcare · 2020Article
- How organizations shape medical technology allocation: Insulin pumps and pediatric patients with type 1 diabetes.Social science & medicine (1982) · 2020Article
- Psychosocial information use for clinical decisions in diabetes care.Journal of the American Medical Informatics Association : JAMIA · 2019Article
- Geographic context of black-white disparities in Medicare CAHPS patient experience measures.Health services research · 2019Article
- Socioeconomic Status And Acute Stroke Care: Has The Inequality Gap Been Closed?Clinical epidemiology · 2019Article
- Social support, flexible resources, and health care navigation.Social science & medicine (1982) · 2017Article
- Risk of type 2 diabetes: health care provider perceptions of prevention adherence.Applied nursing research : ANR · 2016Article
- Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.PloS one · 2016Article
- Methods of Observing Variations in Physicians' Decisions: The Opportunities of Clinical Vignettes.Journal of general internal medicine · 2015Review
- Physicians' anxiety due to uncertainty and use of race in medical decision making.Medical care · 2014Article
- Factors affecting clinical reasoning of occupational therapists: a qualitative study.Medical journal of the Islamic Republic of Iran · 2014Article
- The influence of non-clinical patient factors on medical oncologists' decisions to recommend breast cancer adjuvant chemotherapy.Breast cancer research and treatment · 2012Article
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Authors and funding
6 authors.
Funding
Abstract
Variations in medical practice have been widely documented and are a linchpin in explanations of health disparities. Evidence shows that clinical decision making varies according to patient, provider and health system characteristics. However, less is known about the processes underlying these aggregate associations and how physicians interpret various patient attributes. Verbal protocol analysis (otherwise known as 'think-aloud') techniques were used to analyze open-ended data from 244 physicians to examine which patient characteristics physicians identify as relevant for their decision making. Data are from a vignette-based factorial experiment measuring the effects of: (a) patient attributes (age, gender, race and socioeconomic status); (b) physician characteristics (gender and years of clinical experience); and (c) features of the healthcare system in two countries (USA, United Kingdom) on clinical decision making for diabetes. We find that physicians used patients' demographic characteristics only as a starting point in their assessments, and proceeded to make detailed assessments about cognitive ability, motivation, social support and other factors they consider predictive of adherence with medical recommendations and therefore relevant to treatment decisions. These non-medical characteristics of patients were mentioned with much greater consistency than traditional biophysiologic markers of risk such as race, gender, and age. Types of explanations identified varied somewhat according to patient characteristics and to the country in which the interview took place. Results show that basic demographic characteristics are inadequate to the task of capturing information physicians draw from doctor-patient encounters, and that in order to fully understand differential clinical decision making there is a need to move beyond documentation of aggregate associations and further explore the mental and social processes at work.
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