Dataset Information

Do patients' faces influence General Practitioners' cancer suspicions? A test of automatic processing of sociodemographic information.

ABSTRACT: Delayed cancer diagnosis leads to poorer patient outcomes. During short consultations, General Practitioners (GPs) make quick decisions about likelihood of cancer. Patients' facial cues are processed rapidly and may influence diagnosis.To investigate whether patients' facial characteristics influence immediate perception of cancer risk by GPs.Web-based binary forced choice experiment with GPs from Northeast Scotland.GPs were presented with a series of pairs of face prototypes and asked to quickly select the patient more likely to have cancer. Faces were modified with respect to age, gender, and ethnicity. Choices were analysed using Chi-squared goodness-of-fit statistics with Bonferroni corrections.Eighty-two GPs participated. GPs were significantly more likely to suspect cancer in older patients. Gender influenced GP cancer suspicion, but this was modified by age: the male face was chosen as more likely to have cancer than the female face for young (72% of GPs;95% CI 61.0-87.0) and middle-aged faces (65.9%; 95% CI 54.7-75.5); but 63.4% (95% CI 52.2-73.3) decided the older female was more likely to have cancer than the older male (p = 0.015). GPs were significantly more likely to suspect cancer in the young Caucasian male (65.9% (95% CI 54.7, 75.5)) compared to the young Asian male (p = 0.004).GPs' first impressions about cancer risk are influenced by patient age, gender, and ethnicity. Tackling GP cognitive biases could be a promising way of reducing cancer diagnostic delays, particularly for younger patients.

SUBMITTER: Adam R

PROVIDER: S-EPMC5699847 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Do patients' faces influence General Practitioners' cancer suspicions? A test of automatic processing of sociodemographic information.

Adam Rosalind R Garau Roberta R Raja Edwin Amalraj EA Jones Benedict B Johnston Marie M Murchie Peter P

PloS one 20171122 11

<h4>Background</h4>Delayed cancer diagnosis leads to poorer patient outcomes. During short consultations, General Practitioners (GPs) make quick decisions about likelihood of cancer. Patients' facial cues are processed rapidly and may influence diagnosis.<h4>Aim</h4>To investigate whether patients' facial characteristics influence immediate perception of cancer risk by GPs.<h4>Design and setting</h4>Web-based binary forced choice experiment with GPs from Northeast Scotland.<h4>Method</h4>GPs wer ...[more]

PMID: 29166652

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Project description:BackgroundGeneral Practitioners (GPs) employ strategies to identify and retrieve medical evidence for clinical decision making which take workload and time constraints into account. Optimal Foraging Theory (OFT) initially developed to study animal foraging for food is used to explore the information searching behaviour of General Practitioners. This study is the first to apply foraging theory within this context.Study objectives were: 1. To identify the sequence and steps deployed in identifiying and retrieving evidence for clinical decision making. 2. To utilise Optimal Foraging Theory to assess the effectiveness and efficiency of General Practitioner information searching.MethodsGPs from the Wellington region of New Zealand were asked to document in a pre-formatted logbook the steps and outcomes of an information search linked to their clinical decision making, and fill in a questionnaire about their personal, practice and information-searching backgrounds.ResultsA total of 115/155 eligible GPs returned a background questionnaire, and 71 completed their information search logbook. GPs spent an average of 17.7 minutes addressing their search for clinical information. Their preferred information sources were discussions with colleagues (38% of sources) and books (22%). These were the two most profitable information foraging sources (15.9 min and 9.5 min search time per answer, compared to 34.3 minutes in databases). GPs nearly always accessed another source when unsuccessful (95% after 1st source), and frequently when successful (43% after 2nd source). Use of multiple sources accounted for 41% of searches, and increased search success from 70% to 89%.ConclusionsBy consulting in foraging terms the most 'profitable' sources of information (colleagues, books), rapidly switching sources when unsuccessful, and frequently double checking, GPs achieve an efficient trade-off between maximizing search success and information reliability, and minimizing searching time. As predicted by foraging theory, GPs trade time-consuming evidence-based (electronic) information sources for sources with a higher information reward per unit time searched. Evidence-based practice must accommodate these 'real world' foraging pressures, and Internet resources should evolve to deliver information as effectively as traditional methods of information gathering.

Project description:BackgroundRedundant use of diagnostic tests in primary care has shown to be a contributor to rising Dutch healthcare costs. A price display in the test ordering system of the electronic health records (EHRs) could potentially be a low-cost and easy to implement intervention to a decrease in test ordering rate in the primary care setting by creating more cost-awareness among general practitioners (GPs). The aim of this study was to assess the effect of a price display for diagnostic laboratory tests in the EHR on laboratory test ordering behavior of GPs in the Westelijke Mijnstreek region in the Netherlands.MethodsA pre-post intervention study among 154 GPs working in 57 general practices was conducted from September 2019, until March 2020, in the Netherlands. The intervention consisted of displaying the costs of 22 laboratory tests at the time of ordering. The primary outcome was the mean test ordering rate per 1.000 patients per month, per general practice.ResultsTest ordering rates were on average rising prior to the intervention. The total mean monthly test order volume showed a non-statistically significant interruption in this rising trend after the intervention, with the mean monthly test ordering rate levelling out from 322.4 to 322.2 (P = 0.86). A subgroup analysis for solely individually priced tests showed a statistically significant decrease in mean monthly test ordering rate after implementation of the price display for the sum of all tests from 67.2 to 63.3 (P = 0.01), as well as for some of these tests individually (i.e. thrombocytes, ALAT, TSH, folic acid). Leucocytes, ESR, vitamin B12, anti-CCP and NT-proBNP also showed a decrease, albeit not statistically significant (P > 0.05).ConclusionsOur study suggests that a price display intervention is a simple tool that can alter physicians order behavior and constrain the expanding use of laboratory tests. Future research might consider alternative study designs and a longer follow-up period. Furthermore, in future studies, the combination with a multitude of interventions, like educational programs and feedback strategies, should be studied, while potentially adverse events caused by reduced testing should also be taken into consideration.

Dataset Information

Do patients' faces influence General Practitioners' cancer suspicions? A test of automatic processing of sociodemographic information.

Publications

Do patients' faces influence General Practitioners' cancer suspicions? A test of automatic processing of sociodemographic information.

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