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Why do Primary Care Physicians in the United States and France Order Prostate-Specific Antigen Tests for Asymptomatic Patients?

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  • Paul Clay Sorum
  • Junseop Shim
  • Gérard Chasseigne
  • Sylvie Bonnin-Scaon
  • Joël Cogneau
  • Etienne Mullet

Abstract

Purpose. To understand why many primary care physicians in the United States and France order prostate-specific antigen (PSA) tests routinely for their asymptomatic male patients despite “evidence-based†recommendations. Methods. Thirty-two U.S. general internists and family practitioners and 33 French generalists judged, for 32 hypothetical male patients seen for routine preventive care, the probability that the patients had asymptomatic prostate cancer and the likelihood that they would order PSA tests. They were also asked about beliefs, attitudes, and knowledge related to prostate cancer. Results. The significant predictors of ordering more PSA tests in the scenarios were physicians' higher ratings of regret if untested patients were found to have advanced cancer, their greater discomfort if they suspected that patients had illnesses but could not know for sure, and their perceptions of official recommendations as favoring routine testing. Implications. Nonrational factors can impede physicians' adoption of “evidence-based†recommendations.

Suggested Citation

  • Paul Clay Sorum & Junseop Shim & Gérard Chasseigne & Sylvie Bonnin-Scaon & Joël Cogneau & Etienne Mullet, 2003. "Why do Primary Care Physicians in the United States and France Order Prostate-Specific Antigen Tests for Asymptomatic Patients?," Medical Decision Making, , vol. 23(4), pages 301-313, July.
    • Handle: RePEc:sae:medema:v:23:y:2003:i:4:p:301-313
    DOI: 10.1177/0272989X03256010
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    References listed on IDEAS

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    1. Epstein, A.M. & Begg, C.B. & McNeil, B.J., 1984. "The effects of physicians' training and personality on test ordering for ambulatory patients," American Journal of Public Health, American Public Health Association, vol. 74(11), pages 1271-1273.
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    Cited by:

    1. Tritter, Jonathan Q. & Lutfey, Karen & McKinlay, John, 2014. "What are tests for? The implications of stuttering steps along the US patient pathway," Social Science & Medicine, Elsevier, vol. 107(C), pages 37-43.
    2. repec:cup:judgdm:v:1:y:2006:i::p:134-145 is not listed on IDEAS
    3. Michael L. DeKay & John C. Hershey & Mark D. Spranca, & Peter A. Ubel & David A. Asch, 2006. "Are medical treatments for individuals and groups like single-play and multiple-play gambles?," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 1, pages 134-145, November.

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