SynthesisFamily practice2021
Diagnostic uncertainty in primary care: what is known about its communication, and what are the associated ethical issues?
Synthesis in Family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 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
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Understanding diagnostic conversations in clinical practice: A systematic review.Patient education and counseling · 2023Pooled it
- Communication of Diagnostic Uncertainty in Primary Care and Its Impact on Patient Experience: an Integrative Systematic Review.Journal of general internal medicine · 2023Pooled it
- Pooled it
- To what extent should doctors communicate diagnostic uncertainty with their patients? An empirical ethics vignette study.Journal of medical ethics · 2025Trial
- Beyond a Diagnosis: A Qualitative Study Exploring Patient and Caregiver Expectations About Emergency Department Visits Amid Uncertainty.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Managing diagnostic uncertainty in primary care: a mixed-methods study of family physicians' experiences in Türkiye.BMC primary care · 2026Article
- Better, not just fewer: Rethinking antibiotic prescribing.PLoS medicine · 2026Article
- Clinical Reasoning Uncertainty in Veterinary Medical Encounters with a Clinical Example.Veterinary sciences · 2025Review
- Clinicians' tolerance for uncertainty and communication about uncertainty with older adults -a standardized patient assessment study.BMC geriatrics · 2025Observational
- Article
- Why Forensic Pathologists Maintain Uncertainty in Reporting Causes of Death: How Communicative Uncertainty Devices Shape Reasoning.Sociology of health & illness · 2025Article
- In Defence of Causing Patients to Worry: Ethical Issues in the Communication of Diagnostic Uncertainty.Bioethics · 2025Article
- 'Shades of grey': a focus group study on diagnostic uncertainty among general practitioners using point-of-care ultrasound.Scandinavian journal of primary health care · 2025Article
- Anticipating Uncertainty: A New Frontier in Family Medicine Training.Family medicine · 2025Article
- Article
- How is diagnostic uncertainty communicated and managed in real world primary care settings?BMC primary care · 2024Article
- Identifying Facilitators and Inhibitors of Shared Understanding: An Ethnography of Diagnosis Communication in Acute Medical Settings.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- How and why do doctors communicate diagnostic uncertainty: An experimental vignette study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Understanding the patient's experience of coeliac disease diagnosis: a qualitative interview study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Uncertainty in serious illness: A national interdisciplinary consensus exercise to identify clinical research priorities.PloS one · 2024Article
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
Abstract
backgroundDiagnostic uncertainty (DU) in primary care is ubiquitous, yet no review has specifically examined its communication, or the associated ethical issues.
objectivesTo identify what is known about the communication of DU in primary care and the associated ethical issues.
methodsSystematic review, critical interpretive synthesis and ethical analysis of primary research published worldwide. Medline, Embase, Web of Science and SCOPUS were searched for papers from 1988 to 2020 relating to primary care AND diagnostic uncertainty AND [ethics OR behaviours OR communication]. Critical interpretive synthesis and ethical analysis were applied to data extracted.
resultsSixteen papers met inclusion criteria. Although DU is inherent in primary care, its communication is often limited. Evidence on the effects of communicating DU to patients is mixed; research on patient perspectives of DU is lacking. The empirical literature is significantly limited by inconsistencies in how DU is defined and measured. No primary ethical analysis was identified; secondary analysis of the included papers identified ethical issues relating to maintaining patient autonomy in the face of clinical uncertainty, a gap in considering the direct effects of (not) communicating DU on patients, and considerations regarding over-investigation and justice.
conclusionsThis review highlights significant gaps in the literature: there is a need for explicit ethical and patient-centred empirical analyses on the effects of communicating DU, and research directly examining patient preferences for this communication. Consensus on how DU should be defined, and greater research into tools for its measurement, would help to strengthen the empirical evidence base.
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.