This study assessed variation between neurologists in the United States and United Kingdom in their diagnostic and treatment decisions for commonly encountered neurologic presentations, and identified explanatory factors for any observed variation.
All 210 consultant neurologists in the United Kingdom and a nationally representative sample of 595 US neurologists received mailed surveys containing three detailed clinical scenarios depicting patients with (1) a single unprovoked seizure occurring 3 days previously, (2) early Parkinson's disease, and (3) dementia.
The main study outcome measures were self-reported decisions regarding diagnostic test ordering and treatment, which were assessed after each scenario.
Neurologists'practice characteristics, certainty about the diagnosis, and attitudes toward uncertainty were also measured.
Survey response rates were 92% of US and 63% of UK neurologists.
A higher proportion of US than UK neurologists indicated they would order additional diagnostic tests for all three scenarios (all p<0.05) ; 77% of UK compared with 26% of US neurologists would manage a single unprovoked seizure without antiepileptic medication (p<0.0001), but treatment of early Parkinson's disease was not different.
Nearly all US and UK neurologists would obtain a neuroimaging study in the evaluation of dementia. (...)
Mots-clés Pascal : Médecin, Spécialité médicale, Système nerveux, Etats Unis, Amérique du Nord, Amérique, Royaume Uni, Europe, Prise décision, Critère décision, Pratique professionnelle, Etude comparative, Agent santé, Homme
Mots-clés Pascal anglais : Physician, Medical specialty, Nervous system, United States, North America, America, United Kingdom, Europe, Decision making, Decision criterion, Professional practice, Comparative study, Health worker, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0311765
Code Inist : 002B30A05. Création : 27/11/1998.