ArticlePatient education and counseling2022
"Unfortunately, I don't have an answer for you": How resident physicians communicate diagnostic uncertainty to patients during emergency department discharge.
Article in Patient education and counseling, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Understanding diagnostic conversations in clinical practice: A systematic review.Patient education and counseling · 2023Pooled it
- Managing and Communicating Diagnostic Uncertainty in Pediatric Emergency Care: National Insights and Opportunities for Intervention.Pediatric emergency care · 2026Article
- Patient-Physician Agreement on Diagnosis in the ED, Part of Diagnostic Excellence. A Prospective Multicenter Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Designing a SPIKES-based protocol for communicating uncertainty in indeterminate thyroid cytology: a mixed-method analysis within a pilot study.Updates in surgery · 2026Article
- Targeted EHR-based communication of diagnostic uncertainty (TECU) in the emergency department: Protocol for an effectiveness implementation trial.Contemporary clinical trials · 2025Article
- The social experience of uncertainty: a qualitative analysis of emergency department care for suspected pneumonia for the design of decision support.BMC medical informatics and decision making · 2024Article
- Single-encounter elicitation framework for diagnostic excellence patient-reported measures: SEE-Dx-PRM.PEC innovation · 2024Article
- Article
- 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
- Patient Reasoning: Patients' and Care Partners' Perceptions of Diagnostic Accuracy in Emergency Care.Medical decision making : an international journal of the Society for Medical Decision Making · 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
11 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo describe how emergency medicine resident physicians discuss diagnostic uncertainty during a simulated ED discharge discussion.
methodsA secondary content analysis of simulated clinical encounter audiotapes completed by emergency medicine residents across two sites.
resultsWhen discussing lack of diagnosis, residents explained the evaluation revealed no cause for symptoms, noted concerning diagnoses that were excluded, and acknowledged both symptoms and patients' feelings. Residents used explicit and implicit language to discuss diagnostic uncertainty with similar frequency. Almost half of the residents discussed the ED role as focused on emergent illness to give patients context for their uncertain diagnoses. However, 28% of residents in this study did not discuss diagnostic uncertainty in any form. All residents provided reassurance.
conclusionResidents use a range of approaches to discuss diagnostic uncertainty with patients at the time of a simulated ED discharge, with some residents omitting discussion of uncertainty entirely. PRACTICE IMPLICATIONS: These findings represent the current state of communication, which needs improvement. These findings do not immediately transfer to clinical practice recommendations, but rather support a need for both further study and development of formal communication training on this topic.
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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.