PCP factors comprised personal characteristics and attributes of physicians in clinical practice.Ĭritical appraisal and data extraction were undertaken independently by two authors. Studies examining the effect or perceptions and experiences of PCP factors on use of tests and referrals for symptomatic patients with any cancer were included. We searched MEDLINE, Embase, Scopus, CINAHL and PsycINFO between January 1990 and March 2021 for relevant citations. To synthesise evidence evaluating the influence of PCP factors on decisions to investigate symptoms of possible cancer. Primary care physician (PCP) factors have been suggested to affect decisions to investigate cancer, but their influence is poorly understood. Missed opportunities for diagnosing cancer cause patients harm and have been attributed to suboptimal use of tests and referral pathways in primary care. Reducing overconfidence has the potential to improve diagnostic performance in the long term. Checklists appear promising for reducing overconfidence without negatively impacting normal or simple ECGs. Future research should evaluate this effect in more experienced GPs. In both normal and abnormal cases, checklist use improved confidence-accuracy calibration, though accuracy and confidence were not significantly affected. Additionally, residents’ calibration improved when using a checklist (phase 1: R ² =0.14, phase 2: R ² =0.40). Time to diagnose decreased with a checklist (M=147s (77)) compared to without a checklist (M=189s (80), Z =−3.10, p=0.002). Additionally, confidence-accuracy calibration was assessed.Īccuracy, confidence, and patient management were not significantly affected by checklist use. ![]() We measured residents’ diagnostic accuracy, confidence, patient management, and time taken to diagnose. ![]() One week later, they were randomly assigned to diagnose the ECGs again with either a debiasing or content-specific checklist. In this randomized experiment, 42 first year general practice residents interpreted normal, simple abnormal, and complex abnormal ECGs without a checklist. We investigated how content-specific and debiasing checklists impacted performance for normal and abnormal cases in electrocardiogram (ECG) diagnosis. Existing studies primarily use abnormal cases, leaving it unclear how the diagnosis of normal cases is affected by checklist use. Evidence on checklist effectiveness is mixed and seems to depend on checklist type, case difficulty, and participants’ expertise. Checklists that aim to support clinicians’ diagnostic reasoning processes are often recommended to prevent diagnostic errors.
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