Medical decision making in symptoms of type 2 diabetes mellitus in general practice

作者:de Cruppe W*; von dem Knesebeck O; Gerstenberger E; Link C; Marceau L; Siegrist J; Geraedts M; McKinlay J
来源:Deutsche Medizinische Wochenschrift, 2011, 136(8): 359-364.
DOI:10.1055/s-0031-1272536

摘要

Background: Patient and physician attributes influence medical decisions as non-medical factors. The current study examines the influence of patient age and gender and physicians' gender and years of clinical experience on medical decision making in patients with undiagnosed diabetes type 2.
Method: A factorial experiment was conducted to estimate the influence of patient and physician attributes. An identical physician patient encounter with a patient presenting with diabetes symptoms was videotaped with varying patient attributes. Professional actors played the, patients". A sample of 64 randomly chosen and stratified (gender and years of experience) primary care physicians was interviewed about the presented videos.
Results: Results show few significant differences in diagnostic decisions: Younger patients were asked more frequently about psychosocial problems while with older patients a cancer diagnosis was more often taken into consideration. Female physicians made an earlier second appointment date compared to male physicians. Physicians with more years of professional experience considered more often diabetes as the diagnosis than physicians with less experience.
Conclusion: Medical decision making in patients with diabetes type 2 is only marginally influenced by patients' and physicians' characteristics under study.

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