Physician characteristics: Do they influence the evaluation and treatment of breast cancer in older women?
Physician characteristics: Do they influence the evaluation and treatment of breast cancer in older women?
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DOI：
10.1016/s0002-9343(97)00156-3
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发表时间：
1997-10-01
影响因子：
5.9
通讯作者：
McKinlay, JB
中科院分区：
文献类型：
--
作者：
Burns, RB;Freund, KM;McKinlay, JB
BACKGROUND: TO determine if physician specialty, length of time in practice, and fear of malpractice influence the diagnosis and management of breast cancer in older women.METHODS: We used a fractional factorial design that controlled for patient age (65 or 80 years), race, socioeconomic status, mobility, comorbidity, and assertive behavior through 2 videotaped scenarios (a potential breast cancer [no. 1] and a known stage IIA breast cancer [no. 2]). One hundred twenty-eight white male physicians equally divided by specialty (surgeon versus nonsurgeon) and time in practice (less than or equal to 15 or >15 years) viewed the videotapes and made recommendations.RESULTS: The physician subjects saw 46 patients per week, 59% female, and 47% age greater than or equal to 65. Their concern over malpractice was 4.7 (on a 10-point Likert scale with a higher score indicating more concern) and did not differ by specialty or time in practice (P values > 0.7). After viewing scenario no. 1, surgeons were less likely than nonsurgeons to consider breast cancer as the principal diagnosis (odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.2 to 0.9) and to obtain a tissue diagnosis (OR = 0.3, 95% CI = 0.1 to 0.9). However, In scenario no. 2, surgeons were more likely to offer reconstruction (OR = 3.8, 95% CI = 1.4 to 10.4). Physicians in practice less than or equal to 15 years were more likely than those in practice
