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dc.contributor.authorMorgan, Daniel J
dc.contributor.authorPineles, Lisa
dc.contributor.authorOwczarzak, Jill
dc.contributor.authorMagder, Larry
dc.contributor.authorScherer, Laura
dc.contributor.authorBrown, Jessica P
dc.contributor.authorPfeiffer, Chris
dc.contributor.authorTerndrup, Chris
dc.contributor.authorLeykum, Luci
dc.contributor.authorFeldstein, David
dc.contributor.authorFoy, Andrew
dc.contributor.authorStevens, Deborah
dc.contributor.authorKoch, Christina
dc.contributor.authorMasnick, Max
dc.contributor.authorWeisenberg, Scott
dc.contributor.authorKorenstein, Deborah
dc.date.accessioned2021-07-27T12:51:02Z
dc.date.available2021-07-27T12:51:02Z
dc.date.issued2021-07-21
dc.identifier.urihttp://hdl.handle.net/10713/16234
dc.description.abstractImportance: Knowing the expected effect of treatment on an individual patient is essential for patient care. Objective: To explore clinicians' conceptualizations of the chance that treatments will decrease the risk of disease outcomes. Design, setting, and participants: This survey study of attending and resident physicians, nurse practitioners, and physician assistants was conducted in outpatient clinical settings in 8 US states from June 2018 to November 2019. The survey was an in-person, paper, 26-item survey in which clinicians were asked to estimate the probability of adverse disease outcomes and expected effects of therapies for diseases common in primary care. Main outcomes and measures: Estimated chance that treatments would benefit an individual patient. Results: Of 723 clinicians, 585 (81%) responded, and 542 completed all the questions necessary for analysis, with a median (interquartile range [IQR]) age of 32 (29-44) years, 287 (53%) women, and 294 (54%) White participants. Clinicians consistently overestimated the chance that treatments would benefit an individual patient. The median (IQR) estimated chance that warfarin would prevent a stroke in the next year was 50% (5%-80%) compared with scientific evidence, which indicates an absolute risk reduction (ARR) of 0.2% to 1.0% based on a relative risk reduction (RRR) of 39% to 50%. The median (IQR) estimated chance that antihypertensive therapy would prevent a cardiovascular event within 5 years was 30% (10%-70%) vs evidence of an ARR of 0% to 3% based on an RRR of 0% to 28%. The median (IQR) estimated chance that bisphosphonate therapy would prevent a hip fracture in the next 5 years was 40% (10%-60%) vs evidence of ARR of 0.1% to 0.4% based on an RRR of 20% to 40%. The median (IQR) estimated chance that moderate-intensity statin therapy would prevent a cardiovascular event in the next 5 years was 20% (IQR 5%-50%) vs evidence of an ARR of 0.3% to 2% based on an RRR of 19% to 33%. Estimates of the chance that a treatment would prevent an adverse outcome exceeded estimates of the absolute chance of that outcome for 60% to 70% of clinicians. Clinicians whose overestimations were greater were more likely to report using that treatment for patients in their practice (eg, use of warfarin: correlation coefficient, 0.46; 95% CI, 0.40-0.53; P < .001). Conclusions and relevance: In this survey study, clinicians significantly overestimated the benefits of treatment to individual patients. Clinicians with greater overestimates were more likely to report using treatments in actual patients.en_US
dc.description.urihttps://doi.org/10.1001/jamanetworkopen.2021.19747en_US
dc.language.isoenen_US
dc.publisherAmerican Medical Associationen_US
dc.relation.ispartofJAMA Network Openen_US
dc.subjectcliniciansen_US
dc.subjectconceptualizationen_US
dc.subjectbenefits of treatmenten_US
dc.subject.meshHealth Personnelen_US
dc.subject.meshPatientsen_US
dc.subject.meshTherapeuticsen_US
dc.titleClinician Conceptualization of the Benefits of Treatments for Individual Patientsen_US
dc.typeArticleen_US
dc.identifier.doi10.1001/jamanetworkopen.2021.19747
dc.identifier.pmid34287630
dc.source.volume4
dc.source.issue7
dc.source.beginpagee2119747
dc.source.endpage
dc.source.countryUnited States


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