How the UK public views the use of diagnostic decision aids by physicians: a vignette-based experiment

OBJECTIVE: Physicians’ low adoption of diagnostic decision aids (DDAs) may be partially due to concerns about patient/public perceptions. We investigated how the UK public views DDA use and factors affecting perceptions. MATERIALS AND METHODS: In this online experiment, 730 UK adults were asked to imagine attending a medical appointment where the doctor used a computerized DDA. The DDA recommended a test to rule out serious disease. We varied the test’s invasiveness, the doctor’s adherence to DDA advice, and the severity of the patient’s disease. Before disease severity was revealed, respondents indicated how worried they felt. Both before [t1] and after [t2] severity was revealed, we measured satisfaction with the consultation, likelihood of recommending the doctor, and suggested frequency of DDA use. RESULTS: At both timepoints, satisfaction and likelihood of recommending the doctor increased when the doctor adhered to DDA advice (P ≤ .01), and when the DDA suggested an invasive versus noninvasive test (P ≤ .05). The effect of adherence to DDA advice was stronger when participants were worried (P ≤ .05), and the disease turned out to be serious (P ≤ .01). Most respondents felt that DDAs should be used by doctors “sparingly” (34%([t1])/29%([t2])), “frequently,” (43%([t1])/43%([t2])) or “always” (17%([t1])/21%([t2])). DISCUSSION: People are more satisfied when doctors adhere to DDA advice, especially when worried, and when it helps to spot serious disease. Having to undergo an invasive test does not appear to dampen satisfaction. CONCLUSION: Positive attitudes regarding DDA use and satisfaction with doctors adhering to DDA advice could encourage greater use of DDAs in consultations.