Further observations on diagnosis and management of general practice respiratory illness using simulated patient consultations

Br Med J. 1974 Jun 8;2(5918):540-3. doi: 10.1136/bmj.2.5918.540.

Abstract

Twenty general practitioners co-operated in a study of the decision-making process in general practice respiratory illness. Ten simulated standard-patient consultations were used, each being included twice, once to make a decision on diagnosis and once to make a decision on management.Comparison of simulated behaviour with previous studies of observed and self-recorded behaviour showed encouraging agreement. Examination of 200 pairs of management and treatment decisions showed that fewer pieces of information were required for a management than a diagnostic decision on 111 occasions; in 43 pairs the quantity required was the same for each decision. The exact information required to make a decision on diagnosis was included in the information required to decide management on only 30 (15%) of the 200 possible occasions.When disagreement was found over management of a simulated case a decision to prescribe an antibiotic required less information than a decision not to prescribe an antibiotic.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Decision Making
  • Family Practice*
  • Female
  • Humans
  • Male
  • Medical Records
  • Models, Biological*
  • Models, Psychological
  • Physician-Patient Relations*
  • Referral and Consultation
  • Respiratory Tract Diseases / diagnosis*
  • Respiratory Tract Diseases / therapy

Substances

  • Anti-Bacterial Agents