Trial reportBMJ open2018
Clinical decisions presented to patients in hospital encounters: a cross-sectional study using a novel taxonomy.
Trial report in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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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
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers and facilitators to shared decision-making in hospitals from policy to practice: a systematic review.Implementation science : IS · 2021Pooled it
- Intensive care physicians' experiences of decision fatigue and characteristics of vulnerable clinical decisions.Scientific reports · 2026Article
- Article
- First-year residents' experiences of uncertainty in rural and urban emergency departments.BMC medical education · 2026Article
- Article
- Decision fatigue in hospital settings: A scoping review.Journal of hospital medicine · 2025Article
- Patient Care Boards - A tool to promote patient participation during hospital ward rounds.PEC innovation · 2023Article
- Article
- Article
- The use of cognitive task analysis in clinical and health services research - a systematic review.Pilot and feasibility studies · 2022Review
- "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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify and classify all clinical decisions that emerged in a sample of patient-physician encounters and compare different categories of decisions across clinical settings and personal characteristics.
designCross-sectional descriptive evaluation of hospital encounters videotaped in 2007-2008 using a novel taxonomy to identify and classify clinically relevant decisions (both actions and judgements). PARTICIPANTS AND
setting372 patients and 58 physicians from 17 clinical specialties in ward round (WR), emergency room (ER) and outpatient (OP) encounters in a Norwegian university hospital.
resultsThe 372 encounters contained 4976 clinically relevant decisions. The average number of decisions per encounter was 13.4 (min-max 2-40, SD 6.8). The overall distribution of the 10 topical categories in all encounters was: defining problem: 30%, evaluating test result: 17%, drug related: 13%, gathering additional information: 10%, contact related: 10%, advice and precaution: 8%, therapeutic procedure related: 5%, deferment: 4%, legal and insurance related: 2% and treatment goal: 1%. Across three temporal categories, the distribution of decisions was 71% here-and-now, 16% preformed and 13% conditional. On average, there were 15.7 decisions per encounter in internal medicine specialties, 7.1 in ear-nose-throat encounters and 11.0-13.6 in the remaining specialties. WR encounters contained significantly more drug-related decisions than OP encounters (P=0.031) and preformed decisions than ER and OP encounters (P<0.001). ER encounters contained significantly more gathering additional information decisions than OP and WR encounters (P<0.001) and fewer problem defining decisions than WR encounters (P=0.028). There was no significant difference in the average number of decisions related to the physician's and patient's age or gender.
conclusionsPatient-physician encounters contain a larger number of clinically relevant decisions than described in previous studies. Comprehensive descriptions of how decisions, both as judgements and actions, are communicated in medical encounters may serve as a first step in assessing clinical practice with respect to efficiency and quality on a provider or system level.
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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.