Decision making biases in the allied health professions: A systematic scoping review

Featherston, Rebecca; Downie, Laura E; Vogel, Adam P.; Galvin, Karyn L.

doi:10.1371/journal.pone.0240716

Cited by 61 publications

(35 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Extensive literature highlights the presence of bias in clinical decision-making in allied health practice and the likelihood of inconsistencies and potential for suboptimal outcomes [ 21 , 26 , 45 ]. Indeed, decision-making remains a complex and multifaceted process [ 45 ] and gaps in our understanding continue to exist since most research pertains to clinical decision-making in medical [ 23 ] and psychology professions [ 26 ] or clinical errors [ 23 , 45 ]. Our findings contribute to existing knowledge of allied health resource allocation decision-making and we identified a key barrier that revolved around acceptance of evidence not aligning with prior expectations.…”

Section: Discussionmentioning

confidence: 99%

“…Internal inconsistency was noted, as was the inconsistency with established frameworks for forming recommendations based on research evidence (such as the GRADE criteria used by the Cochrane Collaboration [ 46 ]). These observations may be symptomatic of confirmation bias, which has been observed in many fields when evidence is presented that does not conform to prior expectations and beliefs [ 47 ] and affective bias, where a person’s emotional state influences decision outcomes [ 26 ]. Similarly, sunk cost bias was evident in that participants were more inclined to weekend service provision as a result of previously invested resources [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…Sunk cost bias represents the impact of irrevocable past decisions on future decision-making [ 25 ]. However few studies explore allied health decision-making beyond psychology and these typically explore clinical rather than resource allocation decision-making [ 26 ]. Indeed, little is known about how allied heath managers make decisions regarding resource allocation [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making

White

Grant

Sarkies

et al. 2021

Health Res Policy Sys

View full text Add to dashboard Cite

Background Health policy and management decisions rarely reflect research evidence. As part of a broader randomized controlled study exploring implementation science strategies we examined how allied health managers respond to two distinct recommendations and the evidence that supports them. Methods A qualitative study nested in a larger randomized controlled trial. Allied health managers across Australia and New Zealand who were responsible for weekend allied health resource allocation decisions towards the provision of inpatient service to acute general medical and surgical wards, and subacute rehabilitation wards were eligible for inclusion. Consenting participants were randomized to (1) control group or (2) implementation group 1, which received an evidence-based policy recommendation document guiding weekend allied health resource allocation decisions, or (3) implementation group 2, which received the same policy recommendation document guiding weekend allied health resource allocation decisions with support from a knowledge broker. As part of the trial, serial focus groups were conducted with a sample of over 80 allied health managers recruited to implementation group 2 only. A total 17 health services participated in serial focus groups according to their allocated randomization wave, over a 12-month study period. The primary outcome was participant perceptions and data were analysed using an inductive thematic approach with constant comparison. Thematic saturation was achieved. Results Five key themes emerged: (1) Local data is more influential than external evidence; (2) How good is the evidence and does it apply to us? (3) It is difficult to change things; (4) Historically that is how we have done things; and (5) What if we get complaints? Conclusions This study explored implementation of strategies to bridge gaps in evidence-informed decision-making. Results provide insight into barriers, which prevent the implementation of evidence-based practice from fully and successfully occurring, such as attitudes towards evidence, limited skills in critical appraisal, and lack of authority to promote change. In addition, strategies are needed to manage the risk of confirmation biases in decision-making processes. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12618000029291). Universal Trial Number (UTN): U1111-1205-2621.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making

White

Grant

Sarkies

et al. 2021

Health Res Policy Sys

View full text Add to dashboard Cite

show abstract

“…The quality of research evidence generally comes from the study design [14]. Formal risk of bias tools also exist to assist clinicians with appraising the quality of an individual study rather than simply relying on the evidence level [17].…”

Section: The Processmentioning

confidence: 99%

Contact Lens Evidence-Based Academic Reports (CLEAR)

Wolffsohn

Morgan

Barnett

et al. 2021

Contact Lens and Anterior Eye

Self Cite

View full text Add to dashboard Cite

“…(9,14,15) Improving clinical decision-making in the pursuit of quality and person-centeredness requires a clear understanding of relevant factors. While effort has gone into understanding this topic for a broader patient population, (16)(17)(18)(19) it is relatively unexplored for a more complex multimorbid population. We sought to clarify this evidence gap by conducting qualitative interviews with primary care physicians.…”

mentioning

confidence: 99%

Factors Affecting Primary Care Physician Decision-Making for Patients with Complex Multimorbidity: A Qualitative Study

Schuttner

Sherlock

Simons

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Patients with multiple chronic conditions (multimorbidity) and additional psychosocial complexity are at higher risk of adverse outcomes. Establishing treatment or care plans for these patients must account for their disease interactions, finite self-management abilities, and even conflicting treatment recommendations from clinical practice guidelines. Despite existing insight into how primary care physicians (PCPs) approach care decisions for their patients in general, less is known about how PCPs make care planning decisions for more complex populations. We therefore sought to describe factors affecting physician decision-making when care planning for complex patients with multimorbidity Methods This was a qualitative study involving semi-structured telephone interviews with PCPs working ≥ 40% time in a team-based, patient-centered medical home setting in the integrated healthcare system of the U.S. Department of Veterans Affairs, the Veterans Health Administration (VHA). Interviews were conducted from April to July, 2020. Content was analyzed with inductive thematic analysis. Results 25 physicians participated in interviews; most were MDs (n = 21) and worked in hospital-affiliated clinics (n = 14) across all regions of the VHA’s national clinic network. Seven major themes emerged for factors affecting decision-making for complex patients with multimorbidity. Physicians described collaborating on care plans with their care team; considering impacts from patient access and resources on care plans; the boundaries provided by organizational structures; tailoring decisions to individual patients; making decisions in keeping with an underlying internal style or habit; working towards an overarching goal for care; and impacts on decisions from their own emotions and relationship with patient. Conclusions PCPs described individual, relationship-based, and environmental factors affecting their care planning for high-risk and complex patients with multimorbidity in the VHA. Findings offer useful strategies employed by physicians to effectively conduct care planning for complex patients, such as delegation of follow-up within care teams, optimizing visit time vs frequency, and deliberate investment in patient relationship building to gain buy-in to care plans.

show abstract

Decision making biases in the allied health professions: A systematic scoping review

Cited by 61 publications

References 50 publications

Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making

Translating evidence into practice: a longitudinal qualitative exploration of allied health decision-making

Contact Lens Evidence-Based Academic Reports (CLEAR)

Factors Affecting Primary Care Physician Decision-Making for Patients with Complex Multimorbidity: A Qualitative Study

Contact Info

Product

Resources

About