Literature DB >> 3692862

Do cardiologists have higher thresholds for recommending coronary arteriography than family physicians?

M J Young1, L S Fried, J Eisenberg, J Hershey, S Williams.   

Abstract

The purpose of this study was to use a new model of decision making to understand variability in physicians' utilization of diagnostic tests. We studied physicians' recommendations for coronary arteriography in hypothetical patients with chest pain by analyzing responses of 235 cardiologists and family physicians. Thresholds for testing were derived by obtaining estimates of the probability of disease and recommendations for coronary arteriography before and after an exercise test. We found that cardiologists compared with family practitioners had a significantly higher decision threshold and recommended coronary arteriography in fewer patients. These findings suggest that analyzing physicians' decision-making thresholds may be used to characterize differences in the practice behavior of groups of physicians.

Entities:  

Mesh：

Year:  1987        PMID： 3692862      PMCID： PMC1065466     

Source DB:  PubMed          Journal:  Health Serv Res        ISSN： 0017-9124            Impact factor:   3.402


  31 in total

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Authors:  M J Goran; J W Williamson; J S Gonnella
Journal:  J Med Educ       Date:  1973-02

2.  Comparing aggregate estimates of derived thresholds for clinical decisions.

Authors:  M J Young; J M Eisenberg; S V Williams; J C Hershey
Journal:  Health Serv Res       Date:  1986-02       Impact factor: 3.402

Review 3.  Angina pectoris. Natural history and strategies for evaluation and management.

Authors:  K J Silverman; W Grossman
Journal:  N Engl J Med       Date:  1984-06-28       Impact factor: 91.245

Review 4.  The decline in ischemic heart disease mortality rates. An analysis of the comparative effects of medical interventions and changes in lifestyle.

Authors:  L Goldman; E F Cook
Journal:  Ann Intern Med       Date:  1984-12       Impact factor: 25.391

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Authors:  J M Wahl; A H Hakki; A S Iskandrian
Journal:  Arch Intern Med       Date:  1985-02

6.  Clinical diagnostic process: an analysis.

Authors:  D J Leaper; P W Gill; J R Staniland; J C Horrocks; F T de Dombal
Journal:  Br Med J       Date:  1973-09-15

7.  Usefulness of synovial fluid analysis in the evaluation of joint effusions. Use of threshold analysis and likelihood ratios to assess a diagnostic test.

Authors:  J M Eisenberg; H R Schumacher; P K Davidson; L Kaufmann
Journal:  Arch Intern Med       Date:  1984-04

8.  Physician tolerance for uncertainty. Use of liver-spleen scans to detect metastases.

Authors:  R M Allman; E P Steinberg; J C Keruly; P E Dans
Journal:  JAMA       Date:  1985-07-12       Impact factor: 56.272

9.  The selective impact of a cardiology data bank on physicians' therapeutic recommendations.

Authors:  T C Li; H Sherman; E F Cook; G H Mudge; N Mitchell; M Flatley; R Rosati; L Goldman
Journal:  Med Decis Making       Date:  1984       Impact factor: 2.583

10.  Physician choices in the treatment of angina pectoris.

Authors:  M H Charap; R I Levin; J Weinglass
Journal:  Am J Med       Date:  1985-10       Impact factor: 4.965
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  6 in total

Review 1.  Knowledge, patterns of care, and outcomes of care for generalists and specialists.

Authors:  L R Harrold; T S Field; J H Gurwitz
Journal:  J Gen Intern Med       Date:  1999-08       Impact factor: 5.128

2.  Diagnostic test restraint and the specialty consultation.

Authors:  R L Braham; A Ron; H S Ruchlin; J P Hollenberg; P Pompei; M E Charlson
Journal:  J Gen Intern Med       Date:  1990 Mar-Apr       Impact factor: 5.128

3.  Doctors and medical science.

Authors:  Moyez Jiwa
Journal:  Australas Med J       Date:  2012-09-09

4.  Who has screening mammography? Results from the 1994-1995 National Population Health Survey.

Authors:  F Tudiver; E Fuller-Thomson
Journal:  Can Fam Physician       Date:  1999-08       Impact factor: 3.275

5.  Why don't family physicians follow clinical practice guidelines for cancer screening? Family Physician Study Group, Sociobehavioral Cancer Research Network, National Cancer Institute of Canada.

Authors:  F Tudiver; C Herbert; V Goel
Journal:  CMAJ       Date:  1998-10-06       Impact factor: 8.262

6.  How long does it take patients to find a new primary care physician when theirs retires: a population-based, longitudinal study.

Authors:  Lindsay Hedden; Megan A Ahuja; M Ruth Lavergne; Kimberlyn M McGrail; Michael R Law; Lucy Cheng; Morris L Barer
Journal:  Hum Resour Health       Date:  2021-07-23
  6 in total

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