Evidence map›Paper›PMID 40456007›Full record

Observational studyThe European journal of general practice2025

Identifying opportunities for shared decision-making through patients' and physicians' perceptions on the diagnostic process: A qualitative analysis of malpractice claims in general practice.

Sofie Jacobse, Hanneke Rijkels-Otters, Manon Eikens-Jansen, Trudy van der Weijden, Glyn Elwyn, Walter van den Broek, Patrick Bindels, Laura Zwaan

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The European journal of general practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. The power of peers.The European journal of general practice · 2026
    Article
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  3. Review
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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

8 authors.

Sofie JacobseDepartment of General Practice, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
Hanneke Rijkels-OttersDepartment of General Practice, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
Manon Eikens-JansenVvAA Group, Utrecht, the Netherlands.
Trudy van der WeijdenDepartment of Family Medicine, Care and Public Health Research Institute CAPHRI, Maastricht University, Maastricht, the Netherlands.
Glyn ElwynThe Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, PA, USA.
Walter van den BroekInstitute of Medical Education Research Rotterdam (iMERR), Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
Patrick BindelsDepartment of General Practice, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
Laura ZwaanInstitute of Medical Education Research Rotterdam (iMERR), Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundShared decision-making (SDM) is considered the preferred communication model, yet its applicability in the diagnostic process is understudied.

objectiveTo identify clinical situations in the diagnostic process that could benefit from SDM.

methodsAn observational study of closed malpractice claims against general practitioners (2012-2020) related to problems of diagnosis, obtained from a liability insurance company in the Netherlands. We established SDM-selection criteria, specified for the diagnostic process (i.e. diagnostic uncertainty, multiple options and clinical equipoise). Phase 1: We selected and categorised eligible cases, using summarised information from a claim database. Phase 2: We analysed 90 fully documented claims and extracted information from GPs and patients related to the diagnostic process. Using this data, we conducted an inductive thematic analysis.

resultsPhase 1: 261 out of 1477 claims (18%) met the SDM-selection criteria. The main reason for complaints was (omitted) test-ordering (155 claims, 59.4%). The most frequent final diagnoses were: fracture (49%), malignancy (10%), infection (9%), tendon rupture (8%) and cardiovascular disease (4%). Phase 2: Six types of diagnostic considerations emerged from the data: diagnostic uncertainty, using time as a diagnostic tool, management consequences, information about test indication or procedure, indications for re-evaluation and individual patient context. Contradictory statements from GPs and patients demonstrated a lack of shared understanding.

conclusionThe diagnostic process could benefit from SDM in several areas, including discussing diagnostic options, test conditions (e.g. timing and procedure) and follow-up. SDM training programs should be tailored to encourage clinicians to apply SDM in diagnostic decisions.

Indexed as

Decision Making, SharedGeneral PracticeGeneral PractitionersMalpracticeAdultAgedAttitude of Health PersonnelFemaleHumansMaleMiddle AgedNetherlandsPhysician-Patient RelationsQualitative Researchdiagnostic testingGeneral practicemalpractice claimsshared decision making

Identifiers

PMID40456007
PMCPMC12131537

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Registered trials

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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.