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Do Physicians Understand Cancer Screening Statistics? : A National Survey of Primary Care Physicians in the United States

Do Physicians Understand Cancer Screening Statistics? : A National Survey of Primary Care Physicians in the United States

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WEGWARTH, Odette, Lisa M. SCHWARTZ, Steven WOLOSHIN, Wolfgang GAISSMAIER, Gerd GIGERENZER, 2012. Do Physicians Understand Cancer Screening Statistics? : A National Survey of Primary Care Physicians in the United States. In: Annals of Internal Medicine. 156(5), pp. 340-349. ISSN 0003-4819. eISSN 1539-3704

@article{Wegwarth2012-03-06Physi-28048, title={Do Physicians Understand Cancer Screening Statistics? : A National Survey of Primary Care Physicians in the United States}, year={2012}, doi={10.7326/0003-4819-156-5-201203060-00005}, number={5}, volume={156}, issn={0003-4819}, journal={Annals of Internal Medicine}, pages={340--349}, author={Wegwarth, Odette and Schwartz, Lisa M. and Woloshin, Steven and Gaissmaier, Wolfgang and Gigerenzer, Gerd} }

2014-06-30T15:22:10Z Background: Unlike reduced mortality rates, improved survival rates and increased early detection do not prove that cancer screen- ing tests save lives. Nevertheless, these 2 statistics are often used to promote screening.<br /><br /><br />Objective: To learn whether primary care physicians understand which statistics provide evidence about whether screening saves lives.<br /><br /><br />Design: Parallel-group, randomized trial (randomization controlled for order effect only), conducted by Internet survey. (ClinicalTrials. gov registration number: NCT00981019)<br /><br /><br />Setting: National sample of U.S. primary care physicians from a research panel maintained by Harris Interactive (79% cooperation rate).<br /><br /><br />Participants: 297 physicians who practiced both inpatient and out- patient medicine were surveyed in 2010, and 115 physicians who practiced exclusively outpatient medicine were surveyed in 2011.<br /><br /><br />Intervention: Physicians received scenarios about the effect of 2 hypothetical screening tests: The effect was described as improved 5-year survival and increased early detection in one scenario and as decreased cancer mortality and increased incidence in the other.<br /><br /><br />Measurements: Physicians’ recommendation of screening and per- ception of its benefit in the scenarios and general knowledge of screening statistics.<br /><br /><br />Results: Primary care physicians were more enthusiastic about the screening test supported by irrelevant evidence (5-year survival increased from 68% to 99%) than about the test supported by relevant evidence (cancer mortality reduced from 2 to 1.6 in 1000 persons). When presented with irrelevant evidence, 69% of physi- cians recommended the test, compared with 23% when presented with relevant evidence (P < 0.001). When asked general knowl- edge questions about screening statistics, many physicians did not distinguish between irrelevant and relevant screening evidence; 76% versus 81%, respectively, stated that each of these statistics proves that screening saves lives (P = 0.39). About one half (47%) of the physicians incorrectly said that finding more cases of cancer in screened as opposed to unscreened populations “proves that screening saves lives.”<br /><br /><br />Limitation: Physicians’ recommendations for screening were based on hypothetical scenarios, not actual practice.<br /><br /><br />Conclusion: Most primary care physicians mistakenly interpreted improved survival and increased detection with screening as evi- dence that screening saves lives. Few correctly recognized that only reduced mortality in a randomized trial constitutes evidence of the benefit of screening. Annals of Internal Medicine ; 156 (2012), 5. - S. 340-349 Gaissmaier, Wolfgang Woloshin, Steven Woloshin, Steven Wegwarth, Odette Gaissmaier, Wolfgang Gigerenzer, Gerd Do Physicians Understand Cancer Screening Statistics? : A National Survey of Primary Care Physicians in the United States Wegwarth, Odette eng 2012-03-06 2014-06-30T15:22:10Z Gigerenzer, Gerd Schwartz, Lisa M. Schwartz, Lisa M. deposit-license

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