Evidence map›Paper›PMID 28752911›Full record

ArticleJournal of evaluation in clinical practice2017

The Hawthorne effect in direct observation research with physicians and patients.

Meredith A Goodwin, Kurt C Stange, Stephen J Zyzanski, Benjamin F Crabtree, Elaine A Borawski, Susan A Flocke

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of evaluation in clinical practice, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Observational
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Meredith A GoodwinDepartment of Family Medicine and Community Health, Case Western Reserve University, Cleveland, Ohio, USA.
Kurt C StangeDepartment of Family Medicine and Community Health, Department of Epidemiology and Biostatistics, Department of Sociology, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA.
Stephen J ZyzanskiDepartment of Family Medicine and Community Health, Department of Epidemiology and Biostatistics, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA.
Benjamin F CrabtreeDepartment of Family Medicine, Rutgers University, New Brunswick, New Jersey, USA.
Elaine A BorawskiPrevention Research Center for Healthy Neighborhoods and Department of Epidemiology and Biostatistics, and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA.
Susan A FlockeDepartment of Family Medicine and Community Health, Department of Epidemiology and Biostatistics, Prevention Research Center for Healthy Neighborhoods and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA.

Funding

Prevention Research Center for Healthy NeighborhoodsU48DP005030 · DP · CASE WESTERN RESERVE UNIVERSITY · PI BORAWSKI, ELAINE A. · 2014 to 2018
$6.8M
Using Illness Visits to Provide Health Behavior AdviceR01CA105292 · NCI · CASE WESTERN RESERVE UNIVERSITY · PI FLOCKE, SUSAN A. · 2004 to 2013
$4.2M
Practice Outcomes in Community &Healthcare SystemsR01CA060862 · NCI · CASE WESTERN RESERVE UNIVERSITY · PI STANGE, KURT C · 1994 to 2008
$4.0M
CANCER PREVENTION &CONTROL INNOVATIONS IN PRIMARY CAREK24CA081031 · NCI · CASE WESTERN RESERVE UNIVERSITY · PI STANGE, KURT C · 2000 to 2004
$601k
NCCDPHP CDC HHS U48 DP005030NCI NIH HHS K24 CA081031NCI NIH HHS R01 CA060862NCI NIH HHS R01 CA105292
6 · The paper itself

Abstract

RATIONALE, AIMS, AND

objectivesThis study examines the degree to which a "Hawthorne effect" alters outpatient-visit content.

methodsTrained research nurses directly observed 4454 visits to 138 family physicians. Multiple data sources were used to examine the Hawthorne effect including differences in medical record documentation for observed visits and the prior visit by the same patient, time use during visits on the first versus the second observation day of each physician, and report by the patient, physician, and observer of the effect of observation.

resultsVisits on the first versus the second observation day were longer by an average of 1 minute (P < .001); there were time-use differences for 4 of 20 behaviour categories evaluated. No effect of the observer on the interaction was reported by 74% of patients and 55% of physicians. Most of those that reported an affect indicated it was slight. Patients with non-White race, lower-educational level, and poorer health were more likely to report being affected by the observer.

conclusionsIn a study that was designed to minimize the Hawthorne effect, the presence of an observer had little effect on most patient-physician visits but appeared to at least slightly effect a subgroup of vulnerable patients.

Indexed as

ObservationFamily PracticeFemaleHealth Services ResearchHealth StatusHumansMaleMedical History TakingMedical RecordsOffice VisitsPatient Education as TopicPhysician-Patient RelationsQuality of Health CareSocioeconomic FactorsTime Factorsdirect observationHawthorne effectpractice-based research networkprimary care practice

Identifiers

PMID28752911
PMCPMC5741487

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.