ArticleBMJ open2013
Cross-sectional survey: risk-averse French GPs use more rapid-antigen diagnostic tests in tonsillitis in children.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 28 citations in OpenAlex.
- The Effect of Expert Feedback on Antibiotic Prescribing in Pediatrics: Experimental Evidence.Medical decision making : an international journal of the Society for Medical Decision Making · 2019Trial
- Impact of Physicians' Personalities and Behavioral Traits on Treatment-Related Decision-making for Elderly Acute Myeloid Leukemia.Journal of general internal medicine · 2021Article
- GPs' management of polypharmacy and therapeutic dilemma in patients with multimorbidity: a cross-sectional survey of GPs in France.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Factors affecting general practitioners' decisions to adopt new prescription drugs - cohort analyses using Australian longitudinal physician survey data.BMC health services research · 2019Article
- Physician uncertainty aversion impacts medical decision making for older patients with acute myeloid leukemia: results of a national survey.Haematologica · 2018Article
- Predicting medical practices using various risk attitude measures.The European journal of health economics : HEPAC : health economics in prevention and care · 2018Article
- Comparing GPs' risk attitudes for their own health and for their patients' : a troubling discrepancy?BMC health services research · 2018Article
- Uncertainty in clinical practice - an interview study with Swedish GPs on patients with sore throat.BMC family practice · 2016Article
- Prescribing style and variation in antibiotic prescriptions for sore throat: cross-sectional study across six countries.BMC family practice · 2015Article
- Exploring the feasibility and synergistic value of the One Health approach in clinical research: protocol for a prospective observational study of diagnostic pathways in human and canine patients with suspected urinary tract infection.Pilot and feasibility studies · 2015Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe tested the following hypotheses: (1) risk-averse general practitioners (GPs) might use more Rapid Antigen Diagnostic Tests (RADTs) in tonsillitis in children, probably to decrease their diagnostic uncertainty regarding the aetiology of the disease (viral vs due to group A Streptococcus); and (2) GPs not using RADT might prescribe more antibiotics when they are risk averse. DESIGN, SETTING AND
participantsWe conducted a cross-sectional survey of a nationwide French representative sample of 1093 GPs in 2012. OUTCOME MEASURES: Multivariate analyses adjusted on the four stratification variables (age, gender, location and volume of activity, ie, the number of annual consultations) were performed to identify the risk domains associated with indicators of good or poor practice.
results69.4% of GPs were aware of national guidelines regarding tonsillitis and declared that they had taken these guidelines into account for their last paediatric tonsillitis case. 59.1% declared they used RADT in their last patient aged between 3 and 16 years presenting with tonsillitis; 29.7% of these tests were positive. Among the GPs who used RADT, 30.7% prescribed an antibiotic; 98.3% did either prescribe an antibiotic because of a positive RADT result, or did not prescribe an antibiotic in view of a negative result. Among the GPs who did not use RADT, 50.7% prescribed an antibiotic. In multivariate analyses, risk-averse GPs declared being more aware of and compliant with guidelines (OR=1.56, p<0.01), and used RADTs more often for their last patient (OR=1.30, p<0.05). Among GPs not using RADT in their last patient, risk-averse GPs prescribed more antibiotics compared with risk-tolerant doctors (OR=1.18, p<0.05).
conclusionsIndividual risk attitudes influenced GPs' practices in tonsillitis, particularly the use of RADTs and antibiotic prescriptions.
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