Evidence map›Paper›PMID 39060782›Full record

ArticleJournal of general internal medicine2024

Association Between Clinician Confidence and Making Guideline-Recommended Decisions in the Management of Abnormal Cervical Cancer Screening Results.

Tin H Dang, Meghan L Rieu-Werden, Sarah C Kobrin, Jasmin A Tiro, Claudia Werner, Jacquelyn M Lykken, Jessica Chubak, Steven J Atlas, Robin T Higashi, Simon C Lee and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Process Mapping to Compare and Improve Management of Abnormal Cervical Cancer Screening Results in Two US Healthcare Systems within the PROSPR Consortium.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
    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

14 authors.

Tin H DangDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Meghan L Rieu-WerdenDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Sarah C KobrinDivision of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
Jasmin A TiroDepartment of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, IL, USA.
Claudia WernerDepartment of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jacquelyn M LykkenPeter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jessica ChubakKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Steven J AtlasDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Robin T HigashiPeter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Simon C LeeDepartment of Population Health, Medical Center, University of Kansas, Kansas City, KS, USA.
Jennifer S HaasDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Celette Sugg SkinnerPeter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Michelle I SilverDepartment of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Sarah FeldmanDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. sfeldman@bwh.harvard.edu.ORCID 0000-0002-5582-9401

Funding

PROSPR METRICS CISNET Collaboration Investigating Impact of Structural Racism/Discrimination on Cervical Screening Moonshot SupplementUM1CA221940 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI CHUBAK, JESSICA, HAAS, JENNIFER S · 2018 to 2023
$15.9M
American Cancer Society CRP-22-080-01-CTPSNCI NIH HHS UM1 CA221940NCI NIH HHS UM1CA221940
6 · The paper itself

Abstract

backgroundGuidelines for managing abnormal cervical cancer screening results are complex and adherence is challenging for clinicians. Previous studies have identified gaps in knowledge as a possible cause; few have explored the confidence clinicians have in their management decisions. Confidence in decision-making may influence management practices, particularly when guidelines are complex and evolving.

objectiveAssess whether confidence in decision-making is associated with making guideline-concordant recommendations for abnormal cervical cancer screening results.

designA clinician survey used vignettes to ask clinicians to make a management recommendation for different abnormal results and rate their level of confidence in their response.

participantsPhysicians and advanced practice providers (APPs) at three diverse health systems in Washington, Texas, and Massachusetts. MAIN MEASURES: Correct response to each vignette based on either the 2012 or 2019 American Colposcopy and Cervical Pathology (ASCCP) management guidelines. KEY

resultsIn total, 501 clinicians completed the survey between October and December 2020 (response rate 53.7%). Overall, most clinicians made guideline-recommended management decisions for two vignettes (73.2 and 73.7%), but fewer were confident in their selection (48.3% and 46.6%, respectively). Clinicians who reported high levels of confidence were more often correct than those who reported lower levels of confidence (85.8% vs. 62.2% and 87.5% vs. 60.7%, both p<0.001). After adjusting for clinician and practice characteristics, confidence remained significantly associated with selecting the correct answer.

conclusionsClinician confidence in management decisions for abnormal cervical cancer screening results was significantly associated with knowing guideline-concordant recommendations. Given the complexity of cervical cancer management guidelines, solutions to improve clinician confidence in decision-making are needed.

Indexed as

Early Detection of CancerPractice Guidelines as TopicUterine Cervical NeoplasmsAdultClinical CompetenceClinical Decision-MakingFemaleGuideline AdherenceHumansMaleMiddle AgedPractice Patterns, Physicians'Surveys and Questionnairescancer preventioncancer screeningcervical cancer

Identifiers

PMID39060782
PMCPMC11618551

What OpenQuestion holds

Textmetadata
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.