ReviewJournal of the Royal Society of Medicine2010
Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice.
Review in Journal of the Royal Society of Medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 155 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
155 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- The Paradoxes of Social Care: Reframing Apparent Conflicts.Annals of family medicine · 2026Pooled it
- Understanding how veterinarians' knowledge, attitudes, and practices influence antibiotic prescription: a systematic review of survey studies.BMC veterinary research · 2025Pooled it
- A conceptual model of factors potentially influencing prescribing decisions for chronic conditions: an overview of systematic reviews.BMC medicine · 2025Pooled it
- Non-medical factors in prehospital resuscitation decision-making: a mixed-methods systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Pooled it
- Pooled it
- Factors influencing general practitioners decisions to refer Paediatric patients to the emergency department: a systematic review and narrative synthesis.BMC family practice · 2020Pooled it
- Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- A systematic review of reasons for and against asking patients about their socioeconomic contexts.International journal for equity in health · 2019Pooled it
- Systematic Review and Meta-analysis of the Effectiveness of Implementation Strategies for Non-communicable Disease Guidelines in Primary Health Care.Journal of general internal medicine · 2018Pooled it
- Educational considerations based on medical student use of polygenic risk information and apparent race in a simulated consultation.Genetics in medicine : official journal of the American College of Medical Genetics · 2022Trial
- Implementing a digital intervention for managing uncontrolled hypertension in Primary Care: a mixed methods process evaluation.Implementation science : IS · 2021Trial
- Influence of psychiatric or social backgrounds on clinical decision making: a randomized, controlled multi-centre study.BMC medical education · 2019Trial
- Reducing unnecessary vitamin testing in general practice: barriers and facilitators according to general practitioners and patients.BMJ open · 2019Trial
- Examining the impact of a multimedia intervention on treatment decision-making among newly diagnosed prostate cancer patients: results from a nationwide RCT.Translational behavioral medicine · 2018Trial
- Trial
- Healthcare cost for non-hospital services and pharmaceuticals among breast cancer survivors: an event study.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Considerations in referring older patients to hospital in acute situations: a qualitative study based on the experiences of healthcare providers.BMC primary care · 2026Article
- Clinician- and facility-level factors associated with chemotherapy dose reductions in stages I-IIIA breast cancer.Journal of the National Cancer Institute · 2026Article
- Personalized Decision-Making in Periodontal Therapy: Systemic and Demographic Factors Influencing Surgical vs. Non-Surgical Re-Treatment.Journal of personalized medicine · 2026Article
- The association of sociodemographic differences with clinical management following a diagnosis of short cervix.Pregnancy (Hoboken, N.J.) · 2026Article
95 more citing papers are in PubMed but not listed here.
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This article reviews an aspect of daily clinical practice which is of critical importance in virtually every clinical consultation, but which is seldom formally considered. Non-clinical influences on clinical decision-making profoundly affect medical decisions. These influences include patient-related factors such as socioeconomic status, quality of life and patient's expectations and wishes, physician-related factors such as personal characteristics and interaction with their professional community, and features of clinical practice such as private versus public practice as well as local management policies. This review brings together the different strands of knowledge concerning non-clinical influences on clinical decision-making. This aspect of decision-making may be the biggest obstacle to the reality of practising evidence-based medicine. It needs to be understood in order to develop clinical strategies that will facilitate the practice of evidence-based medicine.
Indexed as
Identifiers
What 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.