Abstract
Relatively little is known about the extent or nature of doctors’ uncertainty in clinical practice. While clinical decision making has been studied extensively by workers such as Elstein [Elstein et al 1978], Gale and Marsden [1985] and Johnson [Johnson 1982; Johnson et al. 1983], none of these studies shed much light on the question of when, or how frequently, doctors themselves feel uncertain about diagnosis or management. This is surprising considering the number of efforts under way to develop clinical decision aids. Since a major factor in determining the readiness (or reluctance) of users to take up a new technology is the extent to which the technology meets users’ felt needs, determining detailed requirements is important. As the emphasis in designing systems shifts towards the user interface and integration systems [Shneiderman 1987; Shortliffe, 1987], the lack of information about how, when and where doctors experience uncertainty is a significant limitation.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Barrett, M and Roberts, H (1978) Doctors and their patients: the social control of women in general practice. in C Smart and B Smart (eds). Women, Sexuality and Social Control. Routledge and Kegan Paul, London. pp 41–52.
Bentsen BG (1970) Illness and General Practice. Universitetsforlaget, Oslo.
Brooke JB, Rector AL and Sheldon MG (1983). A review of studies of decision making in general practice. Medical Informatics 9:45–54.
Brooke JB and Sheldon MG (1985). Clinical decision = patient with problem + doctor with problem. In MG Sheldon, JB Brooke and AL Rector (eds). Decision Making in General Practice. MacMillaPress Ltd, London. pp 95–107.
Cartwright, A and Anderson, R (1981) General Practice Revisited: A Second Study of Patients and their Doctors. Routledge and Kegan Paul, London.
Elstein AS, Shulman LS & Sprafka SA (1978). Medical Problem Solving. Harvard University Press, Cambridge Massachusetts.
Fox J, Glowinski A, O’Neil M (1987). The Oxford System of Medicine: a prototype information system for primary care. in J Fox, M Fieschi and R Engelbrecht (eds) Proceedings of AIME-87.
Gale J and Marsden P (1985). Diagnosis: process not product. in MG Sheldon JB Brooke and AL Rector (eds) Decision Making in General Practice. MacMillan Press Ltd, London pp 59–91.
Howie JGR (1972). Diagnosis — the achilles heel? Journal of the Royal College of General Practitioners 22:33–57.
Johnson PE (1983). What kind of expert should a system be?. Journal of Medicine and Philosophy 8:77–97.
Johnson PE, Duran AS, Moller J, Pietula M, Feltovich PJ and Swanson DB (1983). Expertise and error in diagnostic reasoning. Cognitive Science 3:235–283.
Rector AL (1985). The knowledge based medical record — IMMEDIATE-I — a basis for clinical decision support in general practice in Stefanelli M (ed) Proceedings of the International Conference on Artificial Intelligence in Medicine, AIME-85. North Holland Press, pp 37–49.
Rector AL (1986). Medical records, clinical information and knowledge based systems — the IMMEDIATE project. in J Bryant, J Roberts, and P Windsor (eds). Current Perspectives in Health Computing. BISL London pp 15–24.
Rector AL, Newton PD and Marsden PH (1985) What kind of system does an expert need? In Proceedings of HCI-85, Cambridge University Press, Cambridge, pp 239–247.
Roberts, H (1985) The Patient Patients. Pandora, London.
Royal College of General Practitioners (1984). New classification of diseases and problems. Journal of the Royal College of General Practitioners 34:125–7.
Shneiderman, B (1987) Designing the User Interface. Addison Wessley, Reading, Mass.
Shortliffe EH (1987). Computer programs to support clinical decision making. Journal of the American Medical Association 258:63–68
Wilder G, Mackie, D and Cooper J (1985) Gender and computers: two surveys of computer-related attitudes. Sex Roles 13:: 215–228.
Young G (1981) A woman in medicine: Reflections from the inside. in H Roberts (ed) Women, Health and Reproduction. Routledge and Kegan Paul, London, pp. 144–162.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1989 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Rector, A.L., Brooke, J.B., Sheldon, M.G., Newton, P.D. (1989). An Analysis of Uncertainty in British General Practice: Implications of a Preliminary Survey. In: Hunter, J., Cookson, J., Wyatt, J. (eds) AIME 89. Lecture Notes in Medical Informatics, vol 38. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-93437-7_29
Download citation
DOI: https://doi.org/10.1007/978-3-642-93437-7_29
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-51543-2
Online ISBN: 978-3-642-93437-7
eBook Packages: Springer Book Archive