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Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review

BACKGROUND: Vignette studies of medical choice and judgement have gained popularity in the medical literature. Originally developed in mathematical psychology they can be used to evaluate physicians' behaviour in the setting of diagnostic testing or treatment decisions. We provide an overview o...

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Autores principales: Bachmann, Lucas M, Mühleisen, Andrea, Bock, Annekatrin, ter Riet, Gerben, Held, Ulrike, Kessels, Alfons GH
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515847/
https://www.ncbi.nlm.nih.gov/pubmed/18664302
http://dx.doi.org/10.1186/1471-2288-8-50
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author Bachmann, Lucas M
Mühleisen, Andrea
Bock, Annekatrin
ter Riet, Gerben
Held, Ulrike
Kessels, Alfons GH
author_facet Bachmann, Lucas M
Mühleisen, Andrea
Bock, Annekatrin
ter Riet, Gerben
Held, Ulrike
Kessels, Alfons GH
author_sort Bachmann, Lucas M
collection PubMed
description BACKGROUND: Vignette studies of medical choice and judgement have gained popularity in the medical literature. Originally developed in mathematical psychology they can be used to evaluate physicians' behaviour in the setting of diagnostic testing or treatment decisions. We provide an overview of the use, objectives and methodology of these studies in the medical field. METHODS: Systematic review. We searched in electronic databases; reference lists of included studies. We included studies that examined medical decisions of physicians, nurses or medical students using cue weightings from answers to structured vignettes. Two reviewers scrutinized abstracts and examined full text copies of potentially eligible studies. The aim of the included studies, the type of clinical decision, the number of participants, some technical aspects, and the type of statistical analysis were extracted in duplicate and discrepancies were resolved by consensus. RESULTS: 30 reports published between 1983 and 2005 fulfilled the inclusion criteria. 22 studies (73%) reported on treatment decisions and 27 (90%) explored the variation of decisions among experts. Nine studies (30%) described differences in decisions between groups of caregivers and ten studies (33%) described the decision behaviour of only one group. Only six studies (20%) compared decision behaviour against an empirical reference of a correct decision. The median number of considered attributes was 6.5 (IQR 4–9), the median number of vignettes was 27 (IQR 16–40). In 17 studies, decision makers had to rate the relative importance of a given vignette; in six studies they had to assign a probability to each vignette. Only ten studies (33%) applied a statistical procedure to account for correlated data. CONCLUSION: Various studies of medical choice and judgement have been performed to depict weightings of the value of clinical information from answers to structured vignettes of care givers. We found that the design and analysis methods used in current applications vary considerably and could be improved in a large number of cases.
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spelling pubmed-25158472008-08-14 Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review Bachmann, Lucas M Mühleisen, Andrea Bock, Annekatrin ter Riet, Gerben Held, Ulrike Kessels, Alfons GH BMC Med Res Methodol Research Article BACKGROUND: Vignette studies of medical choice and judgement have gained popularity in the medical literature. Originally developed in mathematical psychology they can be used to evaluate physicians' behaviour in the setting of diagnostic testing or treatment decisions. We provide an overview of the use, objectives and methodology of these studies in the medical field. METHODS: Systematic review. We searched in electronic databases; reference lists of included studies. We included studies that examined medical decisions of physicians, nurses or medical students using cue weightings from answers to structured vignettes. Two reviewers scrutinized abstracts and examined full text copies of potentially eligible studies. The aim of the included studies, the type of clinical decision, the number of participants, some technical aspects, and the type of statistical analysis were extracted in duplicate and discrepancies were resolved by consensus. RESULTS: 30 reports published between 1983 and 2005 fulfilled the inclusion criteria. 22 studies (73%) reported on treatment decisions and 27 (90%) explored the variation of decisions among experts. Nine studies (30%) described differences in decisions between groups of caregivers and ten studies (33%) described the decision behaviour of only one group. Only six studies (20%) compared decision behaviour against an empirical reference of a correct decision. The median number of considered attributes was 6.5 (IQR 4–9), the median number of vignettes was 27 (IQR 16–40). In 17 studies, decision makers had to rate the relative importance of a given vignette; in six studies they had to assign a probability to each vignette. Only ten studies (33%) applied a statistical procedure to account for correlated data. CONCLUSION: Various studies of medical choice and judgement have been performed to depict weightings of the value of clinical information from answers to structured vignettes of care givers. We found that the design and analysis methods used in current applications vary considerably and could be improved in a large number of cases. BioMed Central 2008-07-30 /pmc/articles/PMC2515847/ /pubmed/18664302 http://dx.doi.org/10.1186/1471-2288-8-50 Text en Copyright © 2008 Bachmann et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bachmann, Lucas M
Mühleisen, Andrea
Bock, Annekatrin
ter Riet, Gerben
Held, Ulrike
Kessels, Alfons GH
Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review
title Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review
title_full Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review
title_fullStr Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review
title_full_unstemmed Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review
title_short Vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review
title_sort vignette studies of medical choice and judgement to study caregivers' medical decision behaviour: systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515847/
https://www.ncbi.nlm.nih.gov/pubmed/18664302
http://dx.doi.org/10.1186/1471-2288-8-50
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