Non-evidence-based variables affecting physicians' test-ordering tendencies: A systematic review

R. Sood, A. Sood, Amit Ghosh

Research output: Contribution to journalReview article

65 Citations (Scopus)

Abstract

Background: The concept of evidence-based medicine (EBM) was introduced in 1992. Incorporation of EBM into physicians' practices, however, has been slow. Test-ordering tendencies are still based on variables that are not necessarily evidence-based. Methods: The literature was reviewed to identify the non-EBM variables that affect physicians' practices of test ordering. Studies of interest were limited to original research on the determinants of physicians' test-ordering tendencies. The search strategy included queries in MEDLINE (1992-2006), Web of Science (1993-2006), EMBASE (1992-2006), and PsycINFO (1992-2006); checking of reference lists; hand searching relevant journals; and personal communication with experts. Two independent reviewers abstracted information on the design, quality, and limitations of the study. Review articles, letters, and editorials were excluded from analysis. Results: 104 original studies reporting on the variables affecting test ordering were identified. Of these, 53 studies assessing physician variables affecting test ordering were identified. Some of the recognisable physician factors included age, sex, degree of specialisation, geographic location and practice setting, individual belief systems, experience, knowledge, fear of malpractice litigation, physician regret, financial incentives, awareness of costs of tests ordered, and provision of written feedback by peers or employers. Conclusion: Despite considerable advances in our understanding of EBM and its application to patient care, several non-EBM physician variables influence physicians' test-ordering characteristics. Ongoing effort is needed to identify the modifiable non-EBM determinants of physicians' test ordering and to use appropriate tools and techniques to encourage evidence-based behaviours for test ordering.

Original languageEnglish (US)
Pages (from-to)167-177
Number of pages11
JournalNetherlands Journal of Medicine
Volume65
Issue number5
StatePublished - May 2007

Fingerprint

Physicians
Evidence-Based Medicine
Medicine
Geographic Locations
Age Factors
Malpractice
Jurisprudence
MEDLINE
Fear
Motivation
Patient Care
Emotions
Communication
Costs and Cost Analysis
Research

Keywords

  • Decision-making
  • Diagnostic tests
  • Evaluation studies
  • Evidence-based medicine

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Non-evidence-based variables affecting physicians' test-ordering tendencies : A systematic review. / Sood, R.; Sood, A.; Ghosh, Amit.

In: Netherlands Journal of Medicine, Vol. 65, No. 5, 05.2007, p. 167-177.

Research output: Contribution to journalReview article

@article{421c9814d2bf44c3b405acce53153cdd,
title = "Non-evidence-based variables affecting physicians' test-ordering tendencies: A systematic review",
abstract = "Background: The concept of evidence-based medicine (EBM) was introduced in 1992. Incorporation of EBM into physicians' practices, however, has been slow. Test-ordering tendencies are still based on variables that are not necessarily evidence-based. Methods: The literature was reviewed to identify the non-EBM variables that affect physicians' practices of test ordering. Studies of interest were limited to original research on the determinants of physicians' test-ordering tendencies. The search strategy included queries in MEDLINE (1992-2006), Web of Science (1993-2006), EMBASE (1992-2006), and PsycINFO (1992-2006); checking of reference lists; hand searching relevant journals; and personal communication with experts. Two independent reviewers abstracted information on the design, quality, and limitations of the study. Review articles, letters, and editorials were excluded from analysis. Results: 104 original studies reporting on the variables affecting test ordering were identified. Of these, 53 studies assessing physician variables affecting test ordering were identified. Some of the recognisable physician factors included age, sex, degree of specialisation, geographic location and practice setting, individual belief systems, experience, knowledge, fear of malpractice litigation, physician regret, financial incentives, awareness of costs of tests ordered, and provision of written feedback by peers or employers. Conclusion: Despite considerable advances in our understanding of EBM and its application to patient care, several non-EBM physician variables influence physicians' test-ordering characteristics. Ongoing effort is needed to identify the modifiable non-EBM determinants of physicians' test ordering and to use appropriate tools and techniques to encourage evidence-based behaviours for test ordering.",
keywords = "Decision-making, Diagnostic tests, Evaluation studies, Evidence-based medicine",
author = "R. Sood and A. Sood and Amit Ghosh",
year = "2007",
month = "5",
language = "English (US)",
volume = "65",
pages = "167--177",
journal = "Netherlands Journal of Medicine",
issn = "0300-2977",
publisher = "Van Zuiden Communications BV",
number = "5",

}

TY - JOUR

T1 - Non-evidence-based variables affecting physicians' test-ordering tendencies

T2 - A systematic review

AU - Sood, R.

AU - Sood, A.

AU - Ghosh, Amit

PY - 2007/5

Y1 - 2007/5

N2 - Background: The concept of evidence-based medicine (EBM) was introduced in 1992. Incorporation of EBM into physicians' practices, however, has been slow. Test-ordering tendencies are still based on variables that are not necessarily evidence-based. Methods: The literature was reviewed to identify the non-EBM variables that affect physicians' practices of test ordering. Studies of interest were limited to original research on the determinants of physicians' test-ordering tendencies. The search strategy included queries in MEDLINE (1992-2006), Web of Science (1993-2006), EMBASE (1992-2006), and PsycINFO (1992-2006); checking of reference lists; hand searching relevant journals; and personal communication with experts. Two independent reviewers abstracted information on the design, quality, and limitations of the study. Review articles, letters, and editorials were excluded from analysis. Results: 104 original studies reporting on the variables affecting test ordering were identified. Of these, 53 studies assessing physician variables affecting test ordering were identified. Some of the recognisable physician factors included age, sex, degree of specialisation, geographic location and practice setting, individual belief systems, experience, knowledge, fear of malpractice litigation, physician regret, financial incentives, awareness of costs of tests ordered, and provision of written feedback by peers or employers. Conclusion: Despite considerable advances in our understanding of EBM and its application to patient care, several non-EBM physician variables influence physicians' test-ordering characteristics. Ongoing effort is needed to identify the modifiable non-EBM determinants of physicians' test ordering and to use appropriate tools and techniques to encourage evidence-based behaviours for test ordering.

AB - Background: The concept of evidence-based medicine (EBM) was introduced in 1992. Incorporation of EBM into physicians' practices, however, has been slow. Test-ordering tendencies are still based on variables that are not necessarily evidence-based. Methods: The literature was reviewed to identify the non-EBM variables that affect physicians' practices of test ordering. Studies of interest were limited to original research on the determinants of physicians' test-ordering tendencies. The search strategy included queries in MEDLINE (1992-2006), Web of Science (1993-2006), EMBASE (1992-2006), and PsycINFO (1992-2006); checking of reference lists; hand searching relevant journals; and personal communication with experts. Two independent reviewers abstracted information on the design, quality, and limitations of the study. Review articles, letters, and editorials were excluded from analysis. Results: 104 original studies reporting on the variables affecting test ordering were identified. Of these, 53 studies assessing physician variables affecting test ordering were identified. Some of the recognisable physician factors included age, sex, degree of specialisation, geographic location and practice setting, individual belief systems, experience, knowledge, fear of malpractice litigation, physician regret, financial incentives, awareness of costs of tests ordered, and provision of written feedback by peers or employers. Conclusion: Despite considerable advances in our understanding of EBM and its application to patient care, several non-EBM physician variables influence physicians' test-ordering characteristics. Ongoing effort is needed to identify the modifiable non-EBM determinants of physicians' test ordering and to use appropriate tools and techniques to encourage evidence-based behaviours for test ordering.

KW - Decision-making

KW - Diagnostic tests

KW - Evaluation studies

KW - Evidence-based medicine

UR - http://www.scopus.com/inward/record.url?scp=34547411070&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547411070&partnerID=8YFLogxK

M3 - Review article

C2 - 17519512

AN - SCOPUS:34547411070

VL - 65

SP - 167

EP - 177

JO - Netherlands Journal of Medicine

JF - Netherlands Journal of Medicine

SN - 0300-2977

IS - 5

ER -