期刊
JOURNAL OF CLINICAL EPIDEMIOLOGY
卷 60, 期 10, 页码 981-989出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jclinepi.2007.01.012
关键词
diagnostic test; review; low back pain; multiple sclerosis; test ordering
资金
- Medical Research Council [MC_U145079314] Funding Source: Medline
- Medical Research Council [MC_U145079314] Funding Source: researchfish
- MRC [MC_U145079314] Funding Source: UKRI
Objective: To consider the reasons and context for test ordering by doctors when faced with an undiagnosed complaint in primary or secondary care. 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. (C) 2007 Elsevier Inc. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据