Difference between revisions of "Patient-Care Questions that Physicians Are Unable to Answer"

Revision as of 17:41, 9 November 2007

Patient-Care Questions that Physicians Are Unable to Answer John W. Ely, MD, MSPHa,*, Jerome A. Osheroff, MDb,c, Saverio M. Maviglia, MDd,e,f and Marcy E. Rosenbaum, PhDa, JAMIA 2007;14:407-414

Introduction: Physicians cannot find answers to a lot of questions readily which might be due to that physician does not search for an answer or the answer is difficukt to find and these unanswered questions can lead to failings in health care, patient safety and cost effectiveness. Some physicians cited lack of time and dubt about the existence of relevant answers for not pursuing the answers. This study was done to understand why some questions go unanswered and develop recommendation to improve the liklihood of finding answers.

Method: The unanswered questions were selected from the 1062 questions asked previously in a study. A qualitative analysis technique was done to identify recurring types of questions whose content or format might explain why they went unanswered. Also, during looking for the answers the authors also took note on what the physicias could have done to find the answer better.

Result: 48 of the physicians took part in the study and each physician was observed for 16 hours. Physicians did not pursue answers to 477 (45%) of the 1062 questions usually because they doubted that they could find a good answer quickly. Of the remaining 585 questions that were pursued, physicians were unable to find answers to 237 (41%) in print and electronic resources.

Discussion: In this study, physicians unanswered questions were readily grouped into generic types and most questions fit into one of three types: questions about abnormal findings, conditional questions, and compound questions. There were deficiencies identified in the question phrasing and resource selection. The taxonomy of unanswered questions served as an intermediate step in developing the taxonomy of recommendations, but they did not force one-to-one links between question types and recommendations because their attempts to answer questions seemed to provide a more direct path to the recommendations. In retrospect, however, they found that one or more recommendations could be applied to each question type.

Limitations: The study had several limitations like answering strategies which work well with difficult questions might not work with easy questions. There was no attempt to check the accuracy of the answer.This study is done on a relatively small number of questions which was asked to a small numbr of physicians in a small geographic place.

Conclusion: Authors found that rephrasing the question often helps but there were gaps in the information provided by clinical resources. Filling these gaps with evidence-based information, supplemented with opinion and best practices as appropriate, is needed to successfully answer questions that are currently unanswered.

-Nitika Gupta