Defining and Measuring Diagnostic Uncertainty in Medicine: A Systematic Review

[1]  T. Pincus,et al.  Diagnostic uncertainty and recall bias in chronic low back pain , 2014, PAIN®.

[2]  J. Lave,et al.  Diagnostic certainty and hospital resource use. , 1997, Cost & quality quarterly journal : CQ.

[3]  Paul K J Han,et al.  Communicating the Uncertainty of Harms and Benefits of Medical Interventions , 2007, Medical decision making : an international journal of the Society for Medical Decision Making.

[4]  J. Kassirer,et al.  The threshold approach to clinical decision making. , 1980, The New England journal of medicine.

[5]  K. Pitkälä,et al.  Facing uncertainty as a medical student--a qualitative study of their reflective learning diaries and writings on specific themes during the first clinical year. , 2010, Patient education and counseling.

[6]  D M Eddy,et al.  Variations in physician practice: the role of uncertainty. , 1984, Health affairs.

[7]  J P Kassirer,et al.  Dealing with uncertainty, risks, and tradeoffs in clinical decisions. A cognitive science approach. , 1988, Annals of internal medicine.

[8]  H. Brachinger,et al.  Decision analysis , 1997 .

[9]  M. Bühner,et al.  Communicating and Dealing with Uncertainty in General Practice: The Association with Neuroticism , 2014, PloS one.

[10]  M. Mishel.  Adjusting the Fit: Development of Uncertainty Scales for Specific Clinical Populations , 1983, Western journal of nursing research.

[11]  B J McNeil,et al.  Relationship of beliefs and behavior in test ordering. , 1986, The American journal of medicine.

[12]  E. Beresford,et al.  Uncertainty and the shaping of medical decisions. , 1991, The Hastings Center report.

[13]  E. John Orav,et al.  The Association of Physician Attitudes about Uncertainty and Risk Taking with Resource Use in a Medicare HMO , 1998, Medical decision making : an international journal of the Society for Medical Decision Making.

[14]  David Wennberg,et al.  The Implications of Regional Variations in Medicare Spending. Part 1: The Content, Quality, and Accessibility of Care , 2003, Annals of Internal Medicine.

[15]  G. Elwyn,et al.  Dealing with uncertainty in general practice: an essential skill for the general practitioner. , 2011, Quality in primary care.

[16]  J. Wennberg,et al.  Which rate is right? , 1986, The New England journal of medicine.

[17]  A. Babrow,et al.  The many meanings of uncertainty in illness: toward a systematic accounting. , 1998, Health communication.

[18]  Ashley Kennedy.  Managing uncertainty in diagnostic practice. , 2017, Journal of evaluation in clinical practice.

[19]  B. McNeil,et al.  Impact of Underuse, Overuse, and Discretionary Use on Geographic Variation in the Use of Coronary Angiography After Acute Myocardial Infarction , 2001, Medical care.

[20]  Linda Humphrey,et al.  Appropriate Use of Screening and Diagnostic Tests to Foster High-Value, Cost-Conscious Care , 2012, Annals of Internal Medicine.

[21]  Uncertainty and objectivity in clinical decision making: a clinical case in emergency medicine , 2016, Medicine, health care, and philosophy.

[22]  Yingzi Zhang,et al.  Uncertainty in Illness: Theory Review, Application, and Extension. , 2017, Oncology nursing forum.

[23]  Richard M Frankel,et al.  Is it good to express uncertainty to a patient? Correlates and consequences for medical students in a standardized patient visit. , 2009, Patient education and counseling.

[24]  E. Loewy.  The uncertainty of certainty in clinical ethics , 1987, The Journal of medical humanities and bioethics.

[25]  J. J. Fleminger,et al.  Diagnosis ‘Uncertain’: A Follow-up Study , 1977, British Journal of Psychiatry.

[26]  Dean F. Sittig,et al.  Understanding differences in electronic health record (EHR) use: linking individual physicians’ perceptions of uncertainty and EHR use patterns in ambulatory care , 2013, J. Am. Medical Informatics Assoc..

[27]  I. Lossos,et al.  Diagnosis deferred--the clinical spectrum of diagnostic uncertainty. , 1989, Journal of clinical epidemiology.

[28]  Remy Rikers,et al.  Diagnostic errors and reflective practice in medicine. , 2007, Journal of evaluation in clinical practice.

[29]  J. Levenkron,et al.  Does physician uncertainty affect patient satisfaction? , 1988, Journal of General Internal Medicine.

[30]  Jane Ogden,et al.  Doctors expressions of uncertainty and patient confidence. , 2002, Patient education and counseling.

[31]  Paul K. J. Han,et al.  Varieties of Uncertainty in Health Care , 2011 .

[32]  Trudy van der Weijden,et al.  Understanding laboratory testing in diagnostic uncertainty: a qualitative study in general practice. , 2002, The British journal of general practice : the journal of the Royal College of General Practitioners.

[33]  E. Molloy,et al.  The dilemma of diagnostic uncertainty when treating people with chronic low back pain: a qualitative study , 2012, Clinical rehabilitation.

[34]  O. Kostopoulou,et al.  Diagnostic difficulty and error in primary care--a systematic review. , 2008, Family practice.

[35]  J. Linder,et al.  Visit complexity, diagnostic uncertainty, and antibiotic prescribing for acute cough in primary care: a retrospective study , 2013, BMC Family Practice.

[36]  Paul K J Han,et al.  Varieties of uncertainty in health care: a conceptual taxonomy. , 2011, Medical decision making : an international journal of the Society for Medical Decision Making.

[37]  Michael D. Reis,et al.  Types and origins of diagnostic errors in primary care settings. , 2013, JAMA internal medicine.

[38]  P. Embrechts,et al.  Chest pain: an evaluation of the initial diagnosis made by 25 Flemish general practitioners. , 1991, Family practice.

[39]  K. Hall.  Reviewing intuitive decision‐making and uncertainty: the implications for medical education , 2002, Medical education.

[40]  G A Diamond,et al.  Metadiagnosis. An epistemologic model of clinical judgment. , 1983, The American journal of medicine.

[41]  M S Gerrity,et al.  Physicians' Reactions to Uncertainty in Patient Care: A New Measure and New Insights , 1990, Medical care.

[42]  Embracing uncertainty to advance diagnosis in general practice. , 2017, The British journal of general practice : the journal of the Royal College of General Practitioners.

[43]  Steven Hatch.  Uncertainty in medicine , 2017, British Medical Journal.

[44]  C. Cassel,et al.  Choosing wisely: helping physicians and patients make smart decisions about their care. , 2012, JAMA.

[45]  Debra A Swoboda.  Negotiating the diagnostic uncertainty of contested illnesses: physician practices and paradigms , 2008, Health.

[46]  Lance Evans,et al.  Epistemology and uncertainty in primary care: an exploratory study. , 2009, Family medicine.

[47]  N. Wolff.  Professional uncertainty and physician medical decision-making in a multiple treatment framework. , 1989, Social science & medicine.

[48]  T J Ulahannan,et al.  Decision Making in Health and Medicine: Integrating Evidence and Values , 2002 .

[49]  T. Eckman,et al.  Sources of diagnostic uncertainty for chronically psychotic cocaine abusers. , 1998, Psychiatric services.

[50]  K. Pitkala,et al.  Tolerance of uncertainty and fears of making mistakes among fifth-year medical students. , 2012, Family medicine.

[51]  Kai Zheng,et al.  Hedging their Mets: The Use of Uncertainty Terms in Clinical Documents and its Potential Implications when Sharing the Documents with Patients , 2012, AMIA.

[52]  H A Feldman,et al.  Physician variability and uncertainty in the management of breast cancer. Results from a factorial experiment. , 1998, Medical care.

[53]  M. Plebani.  Defensive medicine and diagnostic testing , 2014, Diagnosis.

[54]  B. Barnes,et al.  Professional uncertainty and the problem of supplier-induced demand. , 1982, Social science & medicine.

[55]  E. Baum,et al.  Diagnosing headache in primary care: a qualitative study of GPs' approaches. , 2014, The British journal of general practice : the journal of the Royal College of General Practitioners.

[56]  P. Rust,et al.  The Effect of Physician Personality on Laboratory Test Ordering for Hypertensive Patients , 1988, Medical care.

[57]  N. Calman,et al.  Variability in consultation rates and practitioner level of diagnostic certainty. , 1992, The Journal of family practice.

[58]  R Perera,et al.  Diagnostic strategies used in primary care , 2009, BMJ : British Medical Journal.

[59]  J. Holden,et al.  Diagnostic uncertainty in general practice , 2003, The European journal of general practice.

[60]  Derek W. Meeks,et al.  Physicians' diagnostic accuracy, confidence, and resource requests: a vignette study. , 2013, JAMA internal medicine.

[61]  T. Perneger,et al.  Stress from Uncertainty from Graduation to Retirement—A Population-Based Study of Swiss Physicians , 2007, Journal of General Internal Medicine.

[62]  Bethany Shinkins,et al.  Diagnostic uncertainty: dichotomies are not the answer. , 2013, The British journal of general practice : the journal of the Royal College of General Practitioners.

[63]  Our stubborn quest for diagnostic certainty. , 1989, The New England journal of medicine.

[64]  R. Devellis,et al.  Physicians' Reactions to Uncertainty: Refining the constructs and scales , 1995 .

[65]  F. Hartveit.  Autopsy findings in cases with a clinically uncertain cancer diagnosis , 1979, The Journal of pathology.

[66]  P. Atkinson.  Training for certainty. , 1984, Social science & medicine.

[67]  S. Tachakra.  Level of diagnostic confidence, accuracy, and reasons for mistakes in teleradiology for minor injuries. , 2002, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[68]  J. Muench.  Clinical Uncertainty in Primary Care: The Challenge of Collaborative Engagement. , 2016, Family medicine.

[69]  N. Black,et al.  The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. , 1998, Journal of epidemiology and community health.

[70]  G. Gordon,et al.  Physician expressions of uncertainty during patient encounters. , 2000, Patient education and counseling.

[71]  G. Dinant,et al.  Family physicians’ diagnostic gut feelings are measurable: construct validation of a questionnaire , 2013, BMC Family Practice.

[72]  Charles Rohde,et al.  Primary Care Physician Specialty Referral Decision Making: Patient, Physician, and Health Care System Determinants , 2006, Medical decision making : an international journal of the Society for Medical Decision Making.

[73]  J. Kirk,et al.  Strategies for managing uncertainty and complexity , 1996, Journal of General Internal Medicine.

[74]  D. Meltzer,et al.  Resident uncertainty in clinical decision making and impact on patient care: a qualitative study , 2008, Quality & Safety in Health Care.

[75]  J. Biehn.  Managing uncertainty in family practice. , 1982, Canadian Medical Association journal.

[76]  Diagnostic tests and information theory. , 1992, The Journal of neuropsychiatry and clinical neurosciences.

[77]  B. Löwe,et al.  How do primary care doctors deal with uncertainty in making diagnostic decisions? The development of the 'Dealing with Uncertainty Questionnaire' (DUQ). , 2010, Journal of evaluation in clinical practice.

[78]  J. Zaat,et al.  General Practitioners’ Uncertainty, Risk Preference, and Use of Laboratory Tests , 1992, Medical care.

[79]  D. Levin,et al.  The Overuse of Diagnostic Imaging and the Choosing Wisely Initiative , 2012, Annals of Internal Medicine.

[80]  Frederick B. Hodges,et al.  Training for Uncertainty , 1993 .

[81]  P Croskerry,et al.  Clinical decision making: an emergency medicine perspective. , 1999, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[82]  F. Légaré,et al.  Physicians' reactions to uncertainty in the context of shared decision making. , 2010, Patient education and counseling.

[83]  C B Begg,et al.  The effects of physicians' training and personality on test ordering for ambulatory patients. , 1984, American journal of public health.

[84]  R. Schwartzstein,et al.  Tolerating Uncertainty - The Next Medical Revolution? , 2016, The New England journal of medicine.

[85]  J. Launer,et al.  Clinical uncertainty in primary care , 2013 .

[86]  M. Schmid Mast,et al.  When physician‐expressed uncertainty leads to patient dissatisfaction: a gender study , 2013, Medical education.

[87]  R M Allman,et al.  Physician tolerance for uncertainty. Use of liver-spleen scans to detect metastases. , 1985, JAMA.

[88]  D. M. Mitchell.  Diagnostic Reasoning , 2018, Annals of Internal Medicine.

[89]  Andrew J. E. Seely,et al.  Embracing the Certainty of Uncertainty: Implications for Health Care and Research , 2013, Perspectives in biology and medicine.

[90]  Kent B Lewandrowski,et al.  Clinical uncertainty, diagnostic accuracy, and outcomes in emergency department patients presenting with dyspnea. , 2008, Archives of internal medicine.

[91]  A. Ghosh.  Dealing with medical uncertainty: a physician's perspective. , 2004, Minnesota medicine.

[92]  J. Penrod.  Refinement of the concept of uncertainty. , 2001, Journal of advanced nursing.

[93]  J. Rizzo.  Physician uncertainty and the art of persuasion. , 1993, Social science & medicine.

[94]  Hardeep Singh,et al.  The challenges in defining and measuring diagnostic error , 2015, Diagnosis.

[95]  Sherrill L. Sellers,et al.  Physicians’ Anxiety Due to Uncertainty and Use of Race in Medical Decision Making , 2014, Medical care.

[96]  S. Greenland,et al.  Uncertainty in Clinical Medicine , 2011 .

[97]  Clara Moskowitz,et al.  Snowball in a Blizzard: A Physician's Notes on Uncertainty in Medicine. , 2016 .

[98]  U. Sarkar,et al.  Challenges of making a diagnosis in the outpatient setting: a multi-site survey of primary care physicians , 2012, BMJ quality & safety.

[99]  R. Fox,et al.  The evolution of medical uncertainty. , 1980, The Milbank Memorial Fund quarterly. Health and society.

[100]  David B. Portnoy,et al.  Physicians’ attitudes about communicating and managing scientific uncertainty differ by perceived ambiguity aversion of their patients , 2013, Health expectations : an international journal of public participation in health care and health policy.

[101]  P. Dayer,et al.  [Ordering laboratory tests: their quantity and causes of variations among physicians]. , 1986, Schweizerische medizinische Wochenschrift.

[102]  Guido G. Gatti,et al.  Do physicians know when their diagnoses are correct? , 2005, Journal of General Internal Medicine.

[103]  P. Dayer,et al.  Demandes d'examens de laboratoire. Ampleur et causes des variations entre médecins. , 1986 .

[104]  Z. Jarou.  Early Trends among Seven Recommendations from the Choosing Wisely Campaign , 2016 .

[105]  Robert F. DeVellis,et al.  Uncertainty and Professional Work: Perceptions of Physicians in Clinical Practice , 1992, American Journal of Sociology.

[106]  Ashley N. D. Meyer,et al.  The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations , 2014, BMJ quality & safety.

[107]  B J McNeil,et al.  Shattuck Lecture--Hidden barriers to improvement in the quality of care. , 2001, The New England journal of medicine.

[108]  B. Miller,et al.  Improving Diagnosis in Health Care. , 2016, Military medicine.

[109]  K. Pitkälä,et al.  Medical errors and uncertainty in primary healthcare: A comparative study of coping strategies among young and experienced GPs , 2014, Scandinavian journal of primary health care.

[110]  D. Reuben.  Learning diagnostic restraint. , 1984, The New England journal of medicine.

[111]  Deborah Grady,et al.  Less is more: how less health care can result in better health. , 2010, Archives of internal medicine.

[112]  R. Hopkin,et al.  The Uncertain Diagnosis , 1998, Clinical pediatrics.

[113]  R. Resar,et al.  A trigger tool to identify adverse events in the intensive care unit. , 2006, Joint Commission journal on quality and patient safety.