Disentangling the Relationship between Physician and Organizational Performance: A Signal Detection Approach

Olga Kostopoulou, Martine Nurek and Brendan C. Delaney
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Olga Kostopoulou: Imperial College London, Department of Surgery and Cancer, London, UK
Martine Nurek: Imperial College London, Department of Surgery and Cancer, London, UK
Brendan C. Delaney: Imperial College London, Department of Surgery and Cancer, London, UK

Medical Decision Making, 2020, vol. 40, issue 6, 746-755

Abstract: Background. In previous research, we employed a signal detection approach to measure the performance of general practitioners (GPs) when deciding about urgent referral for suspected lung cancer. We also explored associations between provider and organizational performance. We found that GPs from practices with higher referral positive predictive value (PPV; chance of referrals identifying cancer) were more reluctant to refer than those from practices with lower PPV. Here, we test the generalizability of our findings to a different cancer. Methods. A total of 252 GPs responded to 48 vignettes describing patients with possible colorectal cancer. For each vignette, respondents decided whether urgent referral to a specialist was needed. They then completed the 8-item Stress from Uncertainty scale. We measured GPs’ discrimination ( d′ ) and response bias (criterion; c ) and their associations with organizational performance and GP demographics. We also measured correlations of d′ and c between the 2 studies for the 165 GPs who participated in both. Results. As in the lung study, organizational PPV was associated with response bias: in practices with higher PPV, GPs had higher criterion (b = 0.05 [0.03 to 0.07]; P

Keywords: colorectal cancer; conversion rate; detection rate; gender differences; primary care; QCancer; response bias; stress from uncertainty (search for similar items in EconPapers)
Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:40:y:2020:i:6:p:746-755

DOI: 10.1177/0272989X20936212

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