2017
DOI: 10.2217/cer-2016-0077
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Factors influencing patients’ receptiveness to evidence-based recommendations during the clinical encounter

Abstract: Aim:To identify the factors that promote or interfere with evidence-based clinical decisions from the patient perspective. Materials & methods: We developed four hypothetical scenarios with clinical decisions, such as whether to pursue testing for a chronic condition. We conducted eight focus groups to better understand the influences on individuals' decisions in the context of the scenarios. Results: A patient's relationship with a physician emerged as the strongest influence on whether participants would acc… Show more

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Cited by 7 publications
(4 citation statements)
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“…This finding may be important for predicting the impact of efforts to reduce overuse, such as the Choosing Wisely initiative. [26][27][28] Our study has some limitations. Focus groups rely on selfreport and are prone to recall and social desirability biases.…”
Section: Discussionmentioning
confidence: 93%
“…This finding may be important for predicting the impact of efforts to reduce overuse, such as the Choosing Wisely initiative. [26][27][28] Our study has some limitations. Focus groups rely on selfreport and are prone to recall and social desirability biases.…”
Section: Discussionmentioning
confidence: 93%
“…The limited information retention that some patients in this study demonstrated is a possible explanation for our prior nding of knowledge de cits about immunotherapy risks and bene ts among patients starting therapy (14). It has also been well documented that a patient's relationship with their clinician is the strongest in uence on medical decision-making (35), which we found to be especially true among patients facing uncertainty related to ICI toxicity. The problem of the uncertainty that they felt was not solved by their clinicians layering on more information, but rather by the clinicians' reassurance and reframing of ICI risks.…”
Section: Discussionmentioning
confidence: 64%
“…It is recognized that subclinical chronic inflammation and activation of the immune system are involved in the pathogenesis of IR-related metabolic disorders and even seem to be independent risk factors ( 102 ). Pro-inflammatory cytokines (interleukin (IL)-1β, IL-6, and TNF-α), chemokines, and acute-phase proteins such as C-reactive protein (CRP) are elevated in IR ( 103 , 104 ). These pro-inflammatory makers promote IR by interfering with the c-JUN N-terminal kinase (JNK), nuclear factor-kappa B (NF-κB), and the NADPH oxidative pathways ( 105 ), which could activate serine phosphorylation of IRS-1 and further block insulin signaling proteins (such as PI3K-Akt and AMPK) ( 106 ).…”
Section: Possible Mechanisms Of Ir Associated With Retinopathiesmentioning
confidence: 99%