Table 4.
Rationale for selecting Level 1 or Level 3 clinical management strategies, stratified by physician characteristics and self-reported factors that influence clinical practice (N = 79)
| Selected rationale | Clinical strategy |
Physician characteristics |
Self-reported factors that influence clinical practice |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
Clinical practice includes primary care |
Attending physician |
Malpractice concerns |
Practice guidelines |
||||||||||
| Yes, % | No, % | P value | Yes, % | No, % | P value | Yes, % | No, % | P value | Yes, % | No, % | P value | ||
|
Supportive evidence |
Level 1 |
64 |
62 |
0.97 |
64 |
62 |
0.67 |
57 |
64 |
0.32 |
63 |
64 |
0.87 |
|
Level 3 |
30 |
30 |
0.70 |
31 |
29 |
0.72 |
29 |
30 |
0.79 |
30 |
31 |
0.81 |
|
|
Local practice patterns |
Level 1 |
38 |
38 |
0.80 |
31 |
41 |
0.16 |
12 |
43 |
< 0.001 |
37 |
38 |
0.98 |
|
Level 3 |
29 |
28 |
0.94 |
27 |
30 |
0.39 |
11 |
32 |
< 0.001 |
28 |
31 |
0.43 |
|
|
Rule out more serious conditions |
Level 1 |
19 |
17 |
0.17 |
20 |
17 |
0.15 |
27 |
16 |
0.18 |
19 |
14 |
0.17 |
|
Level 3 |
27 |
25 |
0.51 |
28 |
25 |
0.26 |
31 |
25 |
0.53 |
28 |
20 |
0.13 |
|
|
Supervisor expectations |
Level 1 |
9 |
26 |
< 0.001 |
3 |
26 |
< 0.001 |
1 |
21 |
0.003 |
21 |
4 |
0.004 |
|
Level 3 |
6 |
22 |
< 0.001 |
2 |
21 |
< 0.001 |
1 |
17 |
0.005 |
17 |
5 |
0.02 |
|
|
Academic purposes |
Level 1 |
2 |
3 |
0.26 |
1 |
3 |
0.40 |
1 |
3 |
0.36 |
3 |
1 |
0.16 |
|
Level 3 |
3 |
3 |
0.69 |
2 |
4 |
0.20 |
2 |
4 |
0.33 |
4 |
2 |
0.43 |
|
| Malpractice concerns |
Level 1 |
2 |
4 |
0.02 |
1 |
4 |
0.02 |
1 |
4 |
0.11 |
4 |
1 |
0.04 |
| Level 3 | 3 | 5 | 0.10 | 2 | 5 | 0.01 | 2 | 4 | 0.13 | 5 | 2 | 0.36 | |