SynthesisBMJ open2022
How defensive medicine is defined in European medical literature: a systematic review.
Synthesis in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06500832 (An Analysis of Clinicians' Knowledge and Attitudes Regarding Defensive Dentistry Practices), which is not on this map. Cited by 29 papers, 1 of them a synthesis 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.
An Analysis of Clinicians' Knowledge and Attitudes Regarding Defensive Dentistry Practices: A Survey-based Research
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Enhancing Patient-Dedicated Time in Clinical Encounters: A Systematic Review and Meta-analysis of Intervention Strategies.Journal of general internal medicine · 2026Pooled it
- Danish GP trainees' experiences of navigating patient expectations for non-indicated procedures or tests: a qualitative interview study.Scandinavian journal of primary health care · 2026Article
- Respect for Patients' Rights in Hospital Practice: Associations with Physicians' Legal Knowledge, Defensive Medicine, and Patient-Centered Care.Healthcare (Basel, Switzerland) · 2026Article
- Title Medico-Legal Preparedness in Dental Education: Training Gaps, Defensive Practice and Curriculum Implications Among Romanian Dental Students and Dentists.Dentistry journal · 2026Article
- Defensive medicine practices and workplace violence among physicians in tertiary healthcare settings in Zagazig, Egypt: a cross-sectional study.BMC public health · 2026Article
- Perceptions of Medical Malpractice Liability and Informed Consent Among Hospital Healthcare Workers: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Medical Malpractice Stress Syndrome, Malpractice-Related Anxiety, and Defensive Medicine Practices Among Emergency Medicine Physicians in Türkiye: A National Cross-Sectional Survey.Journal of clinical medicine · 2026Article
- Defensive medicine practices and attitudes toward malpractice among physicians in Jordan: a cross-sectional study.BMC health services research · 2026Article
- Hospital Culture: Defensive Medicine as Perceived by Medical Students: A Qualitative Study.Deutsches Arzteblatt international · 2026Article
- Review
- Large language model-based uncertainty-adjusted label extraction for artificial intelligence model development in upper extremity radiography.European radiology · 2026Article
- Regulation and criminal law enforcement in healthcare: an uneasy alliance or partners in crime?BMC health services research · 2026Article
- Defensive medicine in dermatological practice - Dermatopathology as a mirror of structural challenges.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2026Review
- Examining the role of psychiatrists in involuntary admissions under the Mental Health Act in New Zealand.Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists · 2025Article
- Impact of patient aggression and violence against physicians on the team and organisational levels in China: a qualitative study.BMJ open · 2025Article
- Defensive Medicine in an Emergency Department: The Overuse of High-Sensitivity Cardiac Troponin I Testing.Life (Basel, Switzerland) · 2024Article
- Unnecessary diagnostic imaging requested by medical students during a first day of residency simulation: an explorative study.BMC medical education · 2024Article
- Review
- The Chinese version of Defensive Medicine Scale (DMS): reliability and validity test among physicians.BMC psychology · 2024Article
- Locum doctor working and quality and safety: a qualitative study in English primary and secondary care.BMJ quality & safety · 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
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDefensive medicine has originally been defined as motivated by fear of malpractice litigation. However, the term is frequently used in Europe where most countries have a no-fault malpractice system. The objectives of this systematic review were to explore the definition of the term 'defensive medicine' in European original medical literature and to identify the motives stated therein.
designSystematic review. DATA SOURCES: PubMed, Embase and Cochrane, 3 February 2020, with an updated search on 6 March 2021.
methodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we reviewed all European original peer-reviewed studies fully or partially investigating 'defensive medicine'.
resultsWe identified a total of 50 studies. First, we divided these into two categories: the first category consisting of studies defining defensive medicine by using a narrow definition and the second category comprising studies in which defensive medicine was defined using a broad definition. In 23 of the studies(46%), defensive medicine was defined narrowly as: health professionals' deviation from sound medical practice motivated by a wish to reduce exposure to malpractice litigation. In 27 studies (54%), a broad definition was applied adding … or other self-protective motives. These self-protective motives, different from fear of malpractice litigation, were grouped into four categories: fear of patient dissatisfaction, fear of overlooking a severe diagnosis, fear of negative publicity and unconscious defensive medicine. Studies applying the narrow and broad definitions of defensive medicine did not differ regarding publication year, country, medical specialty, research quality or number of citations.
conclusionsIn European research, the narrow definition of defensive medicine as exclusively motivated by fear of litigation is often broadened to include other self-protective motives. In order to compare results pertaining to defensive medicine across countries, future studies are recommended to specify whether they are using the narrow or broad definition of defensive medicine. PROSPERO REGISTRATION NUMBER: CRD42020167215.
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.