ArticleBMJ open2016
What is a medical decision? A taxonomy based on physician statements in hospital encounters: a qualitative study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Digital Decision Aids to Support Decision-Making in Palliative and End-of-Life Dementia Care: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2025Pooled it
- Decision-Making at End-of-Life for Children With Cancer: A Systematic Review and Meta-Bioethical Analysis.Frontiers in oncology · 2021Pooled it
- Regionalization for health improvement: A systematic review.PloS one · 2020Pooled it
- Clinical decisions presented to patients in hospital encounters: a cross-sectional study using a novel taxonomy.BMJ open · 2018Trial
- Decision volume and temporal workload structure as dissociable correlates of fatigue and mood in intensive care physicians: a real-time observational study.Critical care (London, England) · 2026Observational
- How nurses contribute to medical treatment decision-making with physicians: a scoping review.BMJ open · 2026Article
- Observing, selecting, and building with bridging questions: An exploratory microanalysis of clinical interactional curiosity.Patient education and counseling · 2026Article
- Intensive care physicians' experiences of decision fatigue and characteristics of vulnerable clinical decisions.Scientific reports · 2026Article
- Building a code of conduct for AI-driven clinical consultations.Nature medicine · 2026Article
- Personalized Digital Care Pathways Enable Enhanced Patient Management as Perceived by Health Care Professionals: Mixed-Methods Study.JMIR human factors · 2025Article
- Trust of social media content and risk of making misinformed decisions: Survey of people affected by cancer and their caregivers.PEC innovation · 2024Article
- Sharing a medical decision.Medicine, health care, and philosophy · 2024Article
- Development and preliminary usability testing of an electronic conversation guide incorporating patient values and prognostic information in preparation for older people's decision-making near the end of life.Internet interventions · 2023Article
- Proficiency in the Norwegian language and self-reported health among 12 immigrant groups in Norway: A cross-sectional study.Scandinavian journal of public health · 2023Article
- Shared Decision-making in Different Types of Decisions in Medical Specialist Consultations.Journal of general internal medicine · 2022Article
- Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing.BMC family practice · 2021Article
- "What should I do when I get home?" treatment plan discussion at discharge between specialist physicians and older in-patients: mixed method study.BMC health services research · 2020Article
- Factors Influencing Physicians' Clinical Decision-making at Upazila Health Complexes in Bangladesh.Global journal on quality and safety in healthcare · 2020Article
- Developing a Taxonomy of Communication Techniques and Aids Used By Healthcare Providers During Patient Consultations: Protocol for a Systematic Review.JMIR research protocols · 2020Article
- Development of a measurement system for complex oral information transfer in medical consultations.BMC medical research methodology · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe medical literature lacks a comprehensive taxonomy of decisions made by physicians in medical encounters. Such a taxonomy might be useful in understanding the physician-centred, patient-centred and shared decision-making in clinical settings. We aimed to identify and classify all decisions emerging in conversations between patients and physicians.
designQualitative study of video recorded patient-physician encounters. PARTICIPANTS AND
setting380 patients in consultations with 59 physicians from 17 clinical specialties and three different settings (emergency room, ward round, outpatient clinic) in a Norwegian teaching hospital. A randomised sample of 30 encounters from internal medicine was used to identify and classify decisions, a maximum variation sample of 20 encounters was used for reliability assessments, and the remaining encounters were analysed to test for applicability across specialties.
resultsOn the basis of physician statements in our material, we developed a taxonomy of clinical decisions--the Decision Identification and Classification Taxonomy for Use in Medicine (DICTUM). We categorised decisions into 10 mutually exclusive categories: gathering additional information, evaluating test results, defining problem, drug-related, therapeutic procedure-related, legal and insurance-related, contact-related, advice and precaution, treatment goal, and deferment. Four-coder inter-rater reliability using Krippendorff's α was 0.79.
conclusionsDICTUM represents a precise, detailed and comprehensive taxonomy of medical decisions communicated within patient-physician encounters. Compared to previous normative frameworks, the taxonomy is descriptive, substantially broader and offers new categories to the variety of clinical decisions. The taxonomy could prove helpful in studies on the quality of medical work, use of time and resources, and understanding of why, when and how patients are or are not involved in decisions.
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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.