Relation of Physicians' Predicted Probabilities of Pneumonia to Their Utilities for Ordering Chest X-rays to Detect Pneumonia

Paul S. Heckerling, Thomas G. Tape and Robert S. Wigton

Medical Decision Making, 1992, vol. 12, issue 1, 32-38

Abstract: To investigate the relation between physicians' predicted probabilities of pneumonia and their utilities for ordering chest x-rays to detect pneumonia, the authors studied 52 physicians who ordered chest x-rays of 886 patients presenting to an emergency department with fever or respiratory complaints Physicians estimated the probability of pneumonia prior to obtaining the results of the chest x-ray. Utilities were assessed by asking physicians to consider a hypothetical patient presenting with acute respiratory symptoms, with unknown chest x-ray status, and to rank on a scale from +50 ("best thing I could do") to - 50 ("worst thing I could do") their rating scale utilities for not diagnosing pneumonia and not ordering a chest x-ray when the patient had pneumonia (i.e, missing a pneumonia), and for diagnosing pneumonia and ordering a chest x-ray when the patient did not have pneumonia (i.e, ordering an unnecessary x-ray) The utility for ordering an unnecessary x-ray was negatively correlated with average predicted probability (r = -0 1495, p = 0 29), whereas the utility for missing a pneumonia was positively correlated with average predicted probability (r = 0 2254, p = 0.11), although the correlations were not statistically significant. Relative chagrin, defined as the difference in these utilities, was significantly inversely correlated with average predicted probability (r = -0 2992, p

Date: 1992
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:12:y:1992:i:1:p:32-38

DOI: 10.1177/0272989X9201200106

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