The nature of medical evidence and its inherent uncertainty for the clinical consultation: qualitative study

Frances Griffiths, Eileen Green, Maria Tsouroufli

    Research output: Contribution to journalArticlepeer-review

    71 Citations (Scopus)

    Abstract

    Objective: To describe how clinicians deal with the uncertainty inherent in medical evidence in clinical consultations. Design: Qualitative study. Setting: Clinical consultations
    related to hormone replacement therapy, bone densitometry, and breast
    screening in seven general practices and three secondary care clinics in
    the UK NHS. Participants: Women aged 45-64. Results: 45 of the 109 relevant consultations included sufficient discussion for analysis. The consultations
    could be categorised into three groups: focus on certainty for now and
    this test, with slippage into general reassurance; a coherent account of
    the medical evidence for risks and benefits, but blurring of the uncertainty inherent in the evidence and giving an impression of certainty; and acknowledging the inherent uncertainty of the medical evidence and negotiating a provisional decision. Conclusion: Strategies health professionals use to cope with the uncertainty inherent in medical evidence in clinical consultations include the
    use of provisional decisions that allow for changing priorities and
    circumstances over time, to avoid slippage into general reassurance from
    a particular test result, and to avoid the creation of a myth of certainty.

    Original languageEnglish
    Pages (from-to)511-515
    Number of pages5
    JournalBMJ
    Volume330
    Issue number7490
    DOIs
    Publication statusPublished - 2005

    Keywords

    • DECISIONS
    • WOMEN
    • PHYSICIANS
    • RISKS

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