Diagnostic Certainty as a Source of Medical Practice Variation in Coronary Heart Disease: Results from a Cross-National Experiment of Clinical Decision Making

Karen E. Lutfey, Carol L. Link, Lisa D. Marceau, Richard W. Grant, Ann Adams, Sara Arber, Johannes Siegrist, Markus Bönte, Olaf von dem Knesebeck and John B. McKinlay
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Karen E. Lutfey: New England Research Institutes, Watertown, Massachusetts, klutfey@neriscience.com
Carol L. Link: New England Research Institutes, Watertown, Massachusetts
Lisa D. Marceau: New England Research Institutes, Watertown, Massachusetts
Richard W. Grant: Massachusetts General Hospital and Harvard Medical School, Boston
Ann Adams: University of Warwick, Coventry, UK
Sara Arber: University of Surrey, Guildford, UK
Johannes Siegrist: Dusseldorf University, Dusseldorf, Germany (JS); and University of Hamburg, Hamburg, Germany
Markus Bönte: New England Research Institutes, Watertown, Massachusetts
Olaf von dem Knesebeck: New England Research Institutes, Watertown, Massachusetts
John B. McKinlay: New England Research Institutes, Watertown, Massachusetts

Medical Decision Making, 2009, vol. 29, issue 5, 606-618

Abstract: The authors examined physician diagnostic certainty as one reason for cross-national medical practice variation. Data are from a factorial experiment conducted in the United States, the United Kingdom, and Germany, estimating 384 generalist physicians’ diagnostic and treatment decisions for videotaped vignettes of actor patients depicting a presentation consistent with coronary heart disease (CHD). Despite identical vignette presentations, the authors observed significant differences across health care systems, with US physicians being the most certain and German physicians the least certain (P

Keywords: clinical decision making; medical practice variation; health disparities. (search for similar items in EconPapers)
Date: 2009
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:29:y:2009:i:5:p:606-618

DOI: 10.1177/0272989X09331811

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