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Risk preference and laboratory test selection
Insights
Physician risk preferences influence laboratory test ordering. Those avoiding potential loss ordered twice as many tests as those accepting certain loss, impacting healthcare costs.
Area of Science:
- Medical Decision Making
- Health Economics
- Physician Behavior
Background:
- Physician test ordering varies significantly.
- Understanding factors influencing test ordering is crucial for cost-effective healthcare.
- Risk preferences are a potential, yet understudied, determinant of physician behavior.
Purpose of the Study:
- To investigate the correlation between physician risk preferences and the number of laboratory tests ordered.
- To explore if risk-taking in potential loss scenarios influences diagnostic test selection.
Main Methods:
- 67 physicians' risk preferences were assessed in hypothetical gain and loss scenarios.
- Participants reviewed identical outpatient charts and selected laboratory tests.
- Test selection was correlated with expressed risk preferences regarding life expectancy.
Main Results:
- Physicians exhibiting higher risk tolerance in loss scenarios ordered significantly more laboratory tests (twice as many) compared to risk-averse physicians.
- A statistically significant difference was observed (p < 0.025).
- This suggests a link between risk preference and diagnostic intensity.
Conclusions:
- Physician risk preferences, particularly in situations involving potential loss, are associated with the number of laboratory tests ordered.
- This finding offers insight into inter-physician variability in diagnostic test utilization.
- Further research could explore interventions to align test ordering with evidence-based guidelines, considering physician risk attitudes.
Abstract:
The risk preferences in situations of potential gain, and of potential loss, expressed by 67 physicians were correlated with the numbers of laboratory tests they selected after review of identical copies of two outpatient charts. Physicians who chose a 50/50 gamble of losing ten or no years of life expectancy over an equivalent certain loss of five years selected twice as many tests as those who chose the loss (p less than 0.025). Risk preferences may provide some insight into why some physicians order more laboratory tests than do others.