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<0.025). Risk preferences may provide some insight into why some physicians order more laboratory tests than do others.
Similar content being viewed by others
References
Eisenberg JM. Physician utilization. The state of research about physicians’ practice patterns. Med Care 1985;23:461–83
Schroeder SA, Kenders K, Cooper JK, Piemme TE. Use of laboratory tests and pharmaceuticals. Variation among physicians and effect of cost audit on subsequent use. JAMA 1973;225:969–73
White RE, Skipper BJ, Applegate WB, Bennett MD, Chilton LA. Ordering decision and clinic cost among resident physicians. West J Med 1984;141:117–22
Schroeder SA, Schliftman A, Piemme TE. Variation among physicians in use of laboratory tests: relation to quality of care. Med Care 1974;12:709–13
Epstein AM, Begg CB, McNeil BJ. The effects of physicians’ training and personality on test ordering for ambulatory patients. Am J Public Health 1984;74:1271–3
Daniels M, Schroeder SA. Variation among physicians in use of laboratory tests. II. Relation to clinical productivity and outcomes of care. Med Care 1977;15:482–7
Schroeder SA, Myers LP, McPhee SJ, et al. The failure of physician education as a cost containment strategy. Report of a prospective trial at a university hospital. JAMA 1984;252:225–30
Williams SV, Eisenberg JM. A controlled trial to decrease the unnecessary use of diagnostic tests. J Gen Intern Med 1986;1:8–13
Eisenberg JM. An educational program to modify laboratory use by house staff. J Med Ed 1977;52:578–81
Nanji AA. Medical grand rounds and laboratory use. JAMA 1983;249:2890
Hogarth RM. Judgment and choice. The psychology of decision. Chichester, England: John Wiley and Sons, 1980
Kahneman D, Slovic P, Tversky A: Judgment under uncertainty: heuristics and biases. Cambridge, England, Cambridge University Press, 1982
Tversky A, Kahneman D: The framing of decisions and the psychology of choice. Science 1981;211:453–8
Zar JH: Biostatistical analysis. Second edition. Englewood Cliffs, NJ, Prentice-Hall, 1984
Eraker SA, Sox HC: Assessment of patients’ preferences for therapeutic outcomes. Med Decis Making 1981;1:29–39
Feinstein AR: The “chagrin factor” and qualitative decision analysis. Arch Intern Med 1985;145:1257–9
Author information
Authors and Affiliations
Additional information
Received from the Division of General Internal Medicine/Primary Care, Cook County Hospital, Chicago, Illinois.
Rights and permissions
About this article
Cite this article
Nightingale, S.D. Risk preference and laboratory test selection. J Gen Intern Med 2, 25–28 (1987). https://doi.org/10.1007/BF02596246
Issue Date:
DOI: https://doi.org/10.1007/BF02596246