Family physicians overestimate diagnosis probabilities regardless of the test results

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dc.authorid0000-0001-8984-9673
dc.authorid0000-0003-1669-3107
dc.authorid0000-0002-9235-5647
dc.authorid0000-0002-6593-7000
dc.authorid0000-0001-5490-6877
dc.authorid0000-0002-8545-3660
dc.authorid0000-0001-6744-1343
dc.contributor.authorAtaç, Ömer
dc.contributor.authorKüçükali, Hüseyin
dc.contributor.authorTokaç Farımaz, Ayşe Zülal
dc.contributor.authorPalteki, Ayşe Seval
dc.contributor.authorÇavdar, Sabanur
dc.contributor.authorAslan, Melek Nur
dc.contributor.authorAtak, Muhammed
dc.contributor.authorSezerol, Mehmet Akif
dc.contributor.authorTaşçı, Yusuf
dc.contributor.authorHayran, Osman
dc.date.accessioned2024-02-09T10:20:38Z
dc.date.available2024-02-09T10:20:38Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Halk Sağlığı Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Halk Sağlığı Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Sağlık Bilimleri Enstitüsü, Epidemiyoloji Ana Bilim Dalı
dc.description.abstractIntroduction: As useful tools for clinical decision-making, diagnostic tests require careful interpretation in order to prevent underdiagnosis, overdiagnosis or misdiagnosis. The aim of this study was to explore primary care practitioners’ understanding and interpretation of the probability of disease before and after test results for six common clinical scenarios. Methods: This cross-sectional study was conducted with 414 family physicians who were working at primary care in Istanbul via face-to-face interviews held between November 2021 and March 2022. The participants were asked to estimate the probability of diagnosis in six clinical scenarios provided to them. Clinical scenarios were about three cancer screening cases (breast, cervical and colorectal), and three infectious disease cases (pneumonia, urinary tract infection, and COVID-19). For each scenario participants estimated the probability of the diagnosis before application of a diagnostic test, after a positive test result, and after a negative test result. Their estimates were compared with the true answers derived from relevant guidelines. Results: For all scenarios, physicians’ estimates were significantly higher than the scientific evidence range. The minimum overestimation was positive test result for COVID-19 and maximum was pre-test case for cervical cancer. In the hypothetical control question for prevalence and test accuracy, physicians estimated disease probability as 95.0% for a positive test result and 5.0% for a negative test result while the correct answers were 2.0 and 0%, respectively (p < 0.001). Discussion: Comparing the scientific evidence, overestimation in all diagnostic scenarios, regardless of if the disease is an acute infection or a cancer, may indicate that the probabilistic approach is not conducted by the family physicians. To prevent inaccurate interpretation of the tests that may lead to incorrect or unnecessary treatments with adverse consequences, evidence-based decision-making capacity must be strengthened.
dc.identifier.citationAtaç, Ö., Küçükali, H., Tokaç Farımaz, A. Z., Palteki, A. S., Çavdar, S., Aslan, M. N. ... Hayran, O. (2024). Family physicians overestimate diagnosis probabilities regardless of the test results. Frontiers in Medicine, 10. https://dx.doi.org/10.3389/fmed.2023.1123689
dc.identifier.doi10.3389/fmed.2023.1123689
dc.identifier.issn2296-858X
dc.identifier.pmid38259829
dc.identifier.scopus2-s2.0-85182664813
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://dx.doi.org/10.3389/fmed.2023.1123689
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12258
dc.identifier.volume10
dc.identifier.wos001154747900001en_US
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.institutionauthorAtaç, Ömer
dc.institutionauthorKüçükali, Hüseyin
dc.institutionauthorTokaç Farımaz, Ayşe Zülal
dc.institutionauthorPalteki, Ayşe Seval
dc.institutionauthorÇavdar, Sabanur
dc.institutionauthorAtak, Muhammed
dc.institutionauthorSezerol, Mehmet Akif
dc.language.isoen
dc.publisherFrontiers Media SA
dc.relation.ispartofFrontiers in Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectFamily Medicine
dc.subjectGeneral Practice
dc.subjectDiagnostic Tests
dc.subjectLikelihood Ratios
dc.titleFamily physicians overestimate diagnosis probabilities regardless of the test results
dc.typeArticle

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