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Titolo:
PRACTICE STYLES OF US COMPARED TO UK NEUROLOGISTS
Autore:
VICKREY BG; GIFFORD DR; BELIN TR; MARTIN PJ; SMITH D; DELRAHIM S; CHADWICK DW;
Indirizzi:
UCLA,DEPT NEUROL,BOX 951769,710 WESTWOOD PLAZA LOS ANGELES CA 90095 UCLA,DEPT PSYCHIAT & BIOBEHAV SCI LOS ANGELES CA 90095 UCLA,DEPT BIOSTAT LOS ANGELES CA 90095 BROWN UNIV,DEPT MED PROVIDENCE RI 02912 UNIV LIVERPOOL,DEPT NEUROL SCI LIVERPOOL L69 3BX MERSEYSIDE ENGLAND WALTON CTR NEUROL & NEUROSURG LIVERPOOL MERSEYSIDE ENGLAND
Titolo Testata:
Neurology
fascicolo: 6, volume: 50, anno: 1998,
pagine: 1661 - 1668
SICI:
0028-3878(1998)50:6<1661:PSOUCT>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
NATIONAL-HEALTH-SERVICE; 1ST UNPROVOKED SEIZURE; UNITED-KINGDOM; PHYSICIAN WORKFORCE; RECURRENCE; BRITISH; MALPRACTICE; STATES; CARE; UNCERTAINTY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
43
Recensione:
Indirizzi per estratti:
Citazione:
B.G. Vickrey et al., "PRACTICE STYLES OF US COMPARED TO UK NEUROLOGISTS", Neurology, 50(6), 1998, pp. 1661-1668

Abstract

Objective: This study assessed variation between neurologists in the United States and United Kingdom in their diagnostic and treatment decisions for commonly encountered neurologic presentations, and identified explanatory factors for any observed variation. Methods: All 210 consultant neurologists in the United Kingdom and a nationally representative sample of 595 US neurologists received mailed surveys containingthree detailed clinical scenarios depicting patients with (1) a single unprovoked seizure occurring 3 days previously, (2) early Parkinson's disease, and (3) dementia. The main study outcome measures were self-reported decisions regarding diagnostic test ordering and treatment, which were assessed after each scenario. Neurologists' practice characteristics, certainty about the diagnosis, and attitudes toward uncertainty were also measured. Survey response rates were 92% of US and 63% of UK neurologists, Results: A higher proportion of US than UK neurologists indicated they would order additional diagnostic tests for all three scenarios (all p < 0.05); 77% of UK compared with 26% of US neurologists would manage a single unprovoked seizure without antiepilepticmedication (p < 0.0001), but treatment of early Parkinson's disease was not different. Nearly all US and UK neurologists would obtain a neuroimaging study in the evaluation of dementia. International differences persisted after adjustment for differences in demographic and practice characteristics and for attitudes toward test use and clinical uncertainty. Conclusions: We identified large international variation in clinical decisions across three common neurologic conditions, Cross-country collaboration should explore these differences to develop consensus on standards of care.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 08:45:33