|
This study investigated physicians’ judgment and decision making about screening for and management of prostate cancer in the face of conflicting guidelines and explored their implications for public health policy.
32 primary care physicians from the Capital District of New York State participated in this study. Two sets of 32 hypothetical patient scenarios were used to conduct judgment analysis. A short questionnaire about beliefs, knowledge, and attitude related to prostate cancer was also administered. Physicians were classified into three groups in terms of their beliefs about screening guideline: pro-screening, anti-screening, and conflicting.
This study found that physicians’ interpretation of the recommendations of official medical bodies was associated with their judgments and decisions concerning prostate cancer. The three groups had distinctive characteristics in their judgments and decisions about prostate cancer. While the pro-screening group was very likely to recommend a PSA test and to refer a patient to a urologist, the anti-screening group was unlikely to recommend the test and referral. The physicians in the conflicting group tended to divide into two highly contrasting subgroups in terms of the likelihood of ordering a PSA test and referring a patient to a specialist: either highly likely or highly unlikely. In addition,
many participants appeared to fail to keep vital information and knowledge concerning
prostate cancer up-to-date.
These results had important implications for public health care. First, the current situation may raise fairness and equality issues in health care service. Second, patient preference should be an important consideration in the face of conflicting guidelines and therefore the importance of shared decision making should be emphasized. Finally, by keeping up-to date knowledge concerning prostate, physicians should be able to provide accurate information with patients.
|
