Early diagnostic suggestions improve accuracy of family physicians: a randomized controlled trial in Greece.

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Title: Early diagnostic suggestions improve accuracy of family physicians: a randomized controlled trial in Greece.
Authors: Kostopoulou, O
Lionis, C
Angelaki, A
Ayis, S
Durbaba, S
Delaney, BC
Item Type: Journal Article
Abstract: BACKGROUND: In a recent randomized controlled trial, providing UK family physicians with 'early support' (possible diagnoses to consider before any information gathering) was associated with diagnosing hypothetical patients on computer more accurately than control. Another group of physicians, who gathered information, gave a diagnosis, and subsequently received a list of possible diagnoses to consider ('late support'), were no more accurate than control, despite being able to change their initial diagnoses. OBJECTIVE: To replicate the UK study findings in another country with a different primary health care system. METHODS: All study materials were translated into Greek. Greek family physicians were randomly allocated to one of three groups: control, early support and late support. Participants saw nine scenarios in random order. After reading some information about the patient and the reason for encounter, they requested more information to diagnose. The main outcome measure was diagnostic accuracy. RESULTS: One hundred fifty Greek family physicians participated. The early support group was more accurate than control [odds ratio (OR): 1.67 (1.21-2.31)]. Like their UK counterparts, physicians in the late support group rarely changed their initial diagnoses after receiving support. The pooled OR for the early support versus control comparison from the meta-analysis of the UK and Greek data was 1.40 (1.13-1.67). CONCLUSION: Using the same methodology with a different sample of family physicians in a different country, we found that suggesting diagnoses to consider before physicians start gathering information was associated with more accurate diagnoses. This constitutes further supportive evidence of a generalizable effect of early support.
Issue Date: 30-Jun-2015
Date of Acceptance: 23-Mar-2015
ISSN: 1460-2229
Publisher: Oxford University Press (OUP)
Start Page: 323
End Page: 328
Journal / Book Title: Family Practice
Volume: 32
Issue: 3
Copyright Statement: This is a pre-copyedited, author-produced PDF of an article accepted for publication in Family Practice following peer review. The version of record Olga Kostopoulou, Christos Lionis, Agapi Angelaki, Salma Ayis, Stevo Durbaba, and Brendan C Delaney Early diagnostic suggestions improve accuracy of family physicians: a randomized controlled trial in Greece Family Practice (2015) 32 (3): 323-328 first published online March 23, 2015 is available online at:
Sponsor/Funder: European Commission FP7
Keywords: Decision making
decision support systems
diagnostic error.
Cross-Cultural Comparison
Decision Making
Decision Support Systems, Clinical
Delayed Diagnosis
Diagnosis, Differential
Diagnostic Errors
Early Diagnosis
Great Britain
Outcome and Process Assessment (Health Care)
Physicians, Family
Primary Health Care
Public Health
1117 Public Health And Health Services
Publication Status: Published
Appears in Collections:Division of Surgery

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