
%0 Journal Article
%A Callaghan, Kathleen 
%T Factors influencing diagnostic decision-making
%J Journal of Primary Health Care
%D 2012/09/01
%V 4
%N 3
%P 223-230
%K 
%R https://doi.org/10.1071/HC12223
%U https://www.publish.csiro.au/paper/HC12223 
%X INTRODUCTION: Identifying influences on diagnostic decisions is important because diagnostic errors often have far-reaching consequences for an individual&#x92;s future within the workforce and their eligibility for Accident Compensation Corporation&#x96;funded treatment. Most investigations of factors biasing decision making have used quantitative techniques rather than qualitative methods. AIM: To identify factors influencing GPs&#x92; diagnostic decision-making and to develop a valid questionnaire to determine the desirability and importance of each factor&#x92;s influence. METHODS: Focus groups and the Delphi method were combined with Rasch analysis to identify factors influencing GPs&#x92; diagnostic decision-making and then examine the strength and stability of ratings of the factors&#x92; desirability and importance. RESULTS: Thirty-nine factors were identified. Factors demonstrating high stability but no consensus included the importance of evidence-based medicine, the potential ramifications of a diagnosis, and the desirability of medicolegal issues. Factors for which there was disagreement in the first Delphi round but consensus in the second round included the importance of patient advocacy/support groups and the desirability of examination findings. Rasch analysis indicated that the questionnaire was close to the model (88.6% and 86.2% of variance in the ratings of importance and desirability explained). DISCUSSION: Participants readily identified factors influencing GPs&#x92; diagnostic decision-making. Their ratings did not appear to support a prescriptive model of medicine, yet two cornerstones of prescriptive medicine, clinical information and probability of disease, were rated as highly desirable and important. KEYWORDS: Decision-making; diagnosis; bias; Rasch analysis; general practitioners 
