Do intolerance of uncertainty and resource consumption actually influence the therapeutic strategies chosen by physiotherapists?

Abstract

The medical environment is prone to diagnostic errors, which can have serious consequences for patients' health status. However, healthcare professionals (HCPs) are often overconfident in their choices. In this context, there is a growing interest in the influence of variables that may negatively influence the reasoning of HCPs, namely intolerance of uncertainty (IU) and resource consumption. We challenged 127 physiotherapists to play a simulation game and choose a therapeutic strategy for three cases of low back pain of increasing difficulty (easy, medium, difficult). We measured their IU level and their resource consumption (i.e., requests for test results for each case). Our results showed that 87.4% of participants chose the most appropriate strategy for the easy case, 46.5% for the medium and 29.1% for the difficult. For the easy case, IU and resource consumption had a negative influence on the chosen therapeutic strategy, which was less adapted. Moreover, resource consumption among highly intolerant individuals had a more adverse influence on the chosen strategy. However, we did not find the same results for the medium and difficult cases. We propose hypotheses to explain this difference (i.e., system 1/system 2, consideration of the physiotherapist's speciality, perception of uncertainty). We also outline potential improvements to our tool and suggest future research avenues.