Variation in test ordering behaviour of GPs: professional or context-related factors?

Verstappen, WH

doi:10.1093/fampra/cmh408

Cited by 51 publications

(45 citation statements)

References 27 publications

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“…Individual doctors respond differently to patients' requests for unnecessary tests [5,13,17]. Involvement in research, specifically in guideline development, was found to reduce the number of tests requested [10]. Another factor found to reduce test ordering was giving doctors feedback on how their test ordering rates compared to colleagues [8,10,16].…”

Section: Doctor-related Factorsmentioning

confidence: 99%

“…Involvement in research, specifically in guideline development, was found to reduce the number of tests requested [10]. Another factor found to reduce test ordering was giving doctors feedback on how their test ordering rates compared to colleagues [8,10,16]. Cognitive biases influence the diagnostic process as a whole, and thus inevitably impact on test ordering [23,24].…”

Section: Doctor-related Factorsmentioning

confidence: 99%

“…For example, a recent consultation with a patient with a rare condition may predispose a doctor to suspect that diagnosis and request tests he or she may not otherwise have ordered. Additional factors found to influence test ordering were doctor specialty [4,9] and doctor working patterns [10,22].…”

Section: Doctor-related Factorsmentioning

confidence: 99%

“…Payment by salaries is associated with lower test ordering than a fee for service approach where doctors are reimbursed for each test performed [6,26,30,34]. Type of primary care practice has been shown to influence test ordering in a number of studies, with doctors in solo or small practices tending to request more tests than those in group practices [9,10,22,26]. The introduction of a structured test ordering form has been found to reduce test ordering [7,10,22,26].…”

Section: Policy and Organization-related Factorsmentioning

confidence: 99%

“…Type of primary care practice has been shown to influence test ordering in a number of studies, with doctors in solo or small practices tending to request more tests than those in group practices [9,10,22,26]. The introduction of a structured test ordering form has been found to reduce test ordering [7,10,22,26]. More broadly, policy makers issue guidelines regarding when tests should be used (http://www.nice.org.uk).…”

Section: Policy and Organization-related Factorsmentioning

confidence: 99%

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A review identifies and classifies reasons for ordering diagnostic tests

Whiting¹,

Toerien²,

Salis³

et al. 2007

Journal of Clinical Epidemiology

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Article:Whiting, P., Toerien, M. orcid.org/0000-0003-3159-0931, de Salis, I. et al. (4 more ReuseUnless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. REVIEW ARTICLESA review identifies and classifies reasons for ordering diagnostic tests Study Design and Setting: We reviewed any study of any design that discussed factors that may affect a doctor's decision to order a test. Articles were located through searches of electronic databases, authors' files on diagnostic methodology, and reference lists of relevant studies. We extracted data on: study design, type of analysis, setting, topic area, and any factors reported to influence test ordering.Results: We included 37 studies. We carried out a thematic analysis to synthesize data. Five key groupings arose from this process: diagnostic factors, therapeutic and prognostic factors, patient-related factors, doctor-related factors, and policy and organization-related factors. To illustrate how the various factors identified may influence test ordering we considered the symptom low back pain and the diagnosis multiple sclerosis as examples.Conclusions: A wide variety of factors influence a doctor's decision to order a test. These are integral to understanding diagnosis in clinical practice. Traditional diagnostic accuracy studies should be supplemented with research into the broader context in which doctors perform their work. Ó

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Section: Doctor-related Factorsmentioning

confidence: 99%

Section: Doctor-related Factorsmentioning

confidence: 99%

Section: Doctor-related Factorsmentioning

confidence: 99%

Section: Policy and Organization-related Factorsmentioning

confidence: 99%

Section: Policy and Organization-related Factorsmentioning

confidence: 99%

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A review identifies and classifies reasons for ordering diagnostic tests

Whiting¹,

Toerien²,

Salis³

et al. 2007

Journal of Clinical Epidemiology

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Clinical Behavior Change

Weijden¹,

Wensing²

2007

Encyclopedia of Statistics in Quality and Reliability

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Many patients do not receive optimal care. Clinical behavior change is directed at improvements in patient care. A systematic approach to clinical behavior change is promoted. Research on clinical behavior change is the scientific study of methods to promote the systematic uptake of clinical research findings into routine practice. Both quantitative and qualitative approaches in data collection can contribute to the development and evaluation of interventions targeted at clinical behavior change. This chapter focuses on the collection and analysis of quantitative data to answer questions such as “What is current practice?” and “What is the effect of an implementation strategy?” There are several specific statistical issues in this research area, such as the validity of measurements of clinical behavior, interdoctor variation, and clustering effects affecting power calculation and level of analysis. These issues are discussed in this chapter, and illustrated with examples from a study describing the changing test‐ordering behavior of general practitioners.

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