Patients' free choice of physicians is not always good.
Ontology highlight
ABSTRACT:
SUBMITTER: Li X
PROVIDER: S-EPMC9292273 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description: Not available
| S-EPMC7661864 | biostudies-literature
Project description:BackgroundIt is not currently known what is the patient's viewpoint of a "good" physician. We set out to define patient's priorities regarding different physician's attributes in 3 domains important in medical care.MethodsPatients hospitalized or attending clinics at a large teaching hospital selected the 4 attributes that they considered most important out of 21 listed arbitrarily in a questionnaire. The questionnaire included 7 items each in the domains of patient autonomy, professional expertise and humanism.ResultsParticipating patients (n = 445, mean age 57.5 +/- 16 years) selected professional expertise (50%), physician's patience and attentiveness (38% and 30%, respectively), and informing the patient, representing the patient's interests, being truthful and respecting patient's preferences (25-36% each) as the most essential attributes. Patient's selections were not significantly influenced by different demographic or clinical background. Selections of attributes in the domain of patient's autonomy were significantly more frequent and this was the preferred domain for 31% and as important as another domain for 16%--significantly more than the domain of professional expertise (P = 0.008), and much more than the domain of humanism and support (P < 0.0005).ConclusionsPatients studied want their physicians to be highly professional and expert clinicians and show humaneness and support, but their first priority is for the physician to respect their autonomy.
| S-EPMC520754 | biostudies-literature
Project description:BackgroundNowadays, patients are seeking physician information more frequently via the internet. Physician-rating websites (PRWs) have been recognized as the most convenient way to gain insight and detailed information about specific physicians before receiving consultation. However, little is known about how the information provided on PRWs may affect patients' decisions to seek medical advice.ObjectiveThis study aimed to examine whether the physicians' online efforts and their reputation have a relationship with patients' choice of physician on PRWs.MethodsA model, based on social exchange theory, was developed to analyze the factors associated with the number of online patients. A 3-wave data collection exercise, covering 4037 physicians on China's Good Doctor website, was conducted during the months of February, April, and June 2017. Increases in consultation in a 60-day period were used as the dependent variable, whereas 2 series of data were analyzed using linear regression modeling. The fixed-effect model was used to analyze the 3-wave data.ResultsThe adjusted R2 value in the linear regression models were 0.28 and 0.27, whereas in the fixed-effect model, it was .30. Both the linear regression and fixed-effect models yielded a good fit. A positive effect of physicians' effort on the aggregated number of online patients was identified in all models (R2=0.30 and R2=0.37 in 2 regression models; R2=0.23 in fixed effect model; P<.001). The proxies of physicians' reputations indicated different results, with total number of page views of physicians' homepages (R2=0.43 and R2=0.46; R2=0.16; P<.001) and number of votes received (R2=0.33 and R2=0.27; R2=0.43; P<.001) being seen as positive. Virtual gifts were not significant in all models, whereas thank-you messages were only significant in the fixed-effect model (R2=0.11; P=.02). The effort made by physicians online is positively associated with their aggregated number of patients consulted, whereas the effect of a physician's reputation remains uncertain. The control effect of a physician's title and hospital's level was not significant in all linear regressions.ConclusionsBoth the effort and reputation of physicians online contribute to the increased number of online patients' consultation; however, the influence of a physician's reputation varies. This may imply that physicians' online effort and reputation are critical in attracting patients and that strategic manipulation of physician profiles is worthy of study. Practical insights are also discussed.
| S-EPMC6429049 | biostudies-literature
Project description:We place an upper bound on the degree to which policies aimed at improving the information deficiencies of patients may lead to greater adherence to clinical guidelines and recommended practices. To do so, we compare the degree of adherence attained by a group of patients that should have the best possible information on health care practices-i.e., physicians as patients-with that attained by a comparable group of non-physician patients, taking various steps to account for unobservable differences between the two groups. Our results suggest that physicians, at best, do only slightly better in adhering to both low- and high-value care guidelines than non-physicians.
| S-EPMC7855422 | biostudies-literature
Project description:This study aimed to evaluate the efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). A search of PUBMED, EMBASE, Central Register of Controlled Trials (CENTRAL), Web of Science, Chinese Biomedicine Literature (CBM), China National Knowledge Infrastructure (CNKI), Wang-Fang Database, Chinese Scientific Journal Database (VIP), and other available resources was made for studies (up to February 2019). Searches were limited to studies published in English and Chinese. Only randomized controlled trials (RCTs) related to the efficacy and/or safety of acupuncture for CP/CPPS were included. Two investigators independently evaluated the quality of the studies. A total of 11 studies were included, involving 748 participants. The results revealed that compared with sham acupuncture (MD: -6.53 [95% CI: -8.08 to -4.97]) and medication (MD: -4.72 [95% CI: -7.87 to -1.56]), acupuncture could lower total NIH-CPSI score more effectively. However, there are no significant differences between acupuncture and sham acupuncture in terms of IPSS score. In terms of NIH-CPSI voiding domain subscore, no significant differences were found between acupuncture and medication. Compared with sham acupuncture (OR: 0.12 [95% CI: 0.04 to 0.40) and medication (OR: 3.71 [95% CI: 1.83 to 7.55]), the results showed favorable effects of acupuncture in improving the response rate. Acupuncture plus medication is better than the same medication in improving NIH-CPSI total score and NIH-CPSI pain domain subscore. In conclusion, the evidence suggests that acupuncture may be an effective intervention for patients with CP/CPPS. However, due to the heterogeneity of the methods and high risk of bias, we cannot draw definitive conclusions about the entity of the acupuncture's effect on alleviating the symptoms of CP/CPPS. The adverse events of acupuncture are mild and rare.
| S-EPMC7085851 | biostudies-literature
Project description:Policy makers increasingly use choice defaults to promote "good" causes by influencing socially relevant decisions in desirable ways, e.g., to increase pro-environmental choices or pro-social behavior in general. Such default nudges are remarkably successful when judged by their effects on the targeted behaviors in isolation. However, there is scant knowledge about possible spillover effects of pro-social behavior that was induced by defaults on subsequent related choices. Behavioral spillover effects could eliminate or even reverse the initially positive effects of choice defaults, and it is thus important to study their significance. We report results from a laboratory experiment exploring the subsequent behavioral consequences of pro-social choice defaults. Our results are promising: Pro-social behavior induced by choice defaults does not result in adverse spillover effects on later, subsequent behavior. This finding holds for both weak and strong choice defaults. JEL Classification: C91, D01, D04.
| S-EPMC6379727 | biostudies-literature
Project description:Sedentary Behavior (SB), defined as sitting with minimal physical activity, is an emergent public health topic. However, the measurement of SB considers either posture (e.g., activPal) or physical activity (e.g., ActiGraph), and thus neglects either active sitting or inactive standing. The aim of this study was to determine the true amount of active sitting and inactive standing in daily life, and to analyze by how much these behaviors falsify the single sensors' sedentary estimates. Sedentary time of 100 office workers estimated with activPal and ActiGraph was therefore compared with Bland-Altman statistics to a combined sensor analysis, the posture and physical activity index (POPAI). POPAI classified each activPal sitting and standing event into inactive or active using the ActiGraph counts. Participants spent 45.0% [32.2%-59.1%] of the waking hours inactive sitting (equal to SB), 13.7% [7.8%-21.6%] active sitting, and 12.0% [5.7%-24.1%] inactive standing (mean [5th-95th percentile]). The activPal overestimated sedentary time by 30.3% [12.3%-48.4%] and the ActiGraph by 22.5% [3.2%-41.8%] (bias [95% limit-of-agreement]). The results showed that sitting is not always inactive, and standing is not always active. Caution should therefore be paid when interpreting the activPal (ignoring active sitting) and ActiGraph (ignoring inactive standing) measured time as SB.
| S-EPMC7730923 | biostudies-literature
Project description:There are many clinical trials underway for the development of gene therapies, and some have resulted in gene therapy products being commercially approved already. Significant progress was made to develop safer and more effective strategies to deliver and regulate genetic products. An unsolved aspect is the immune system, which can affect the efficiency of gene therapy in different ways. Here we present an overview of approved gene therapy products and the immune response elicited by gene delivery systems. These include responses against the vector or its content after delivery and against the product of the corrected gene. Strategies to overcome the hurdles include hiding the vector or/and the transgene product from the immune system and hiding the immune system from the vector/transgene product. Combining different strategies, such as patient screening and intelligent vector design, gene therapy is set to make a difference in the life of patients with severe genetic diseases.
| S-EPMC9295005 | biostudies-literature
Project description:This research explores reasons for the attitude-behavior gap of consumers involved with sustainable food choice. For this purpose, the Food Choice Process Model by was applied. The study follows a qualitative approach. Data were collected through ethnographical fieldwork. Over the course of nine months, researchers repeatedly accompanied six families. Each visit lasted several hours and included multiple in-depth discussions, food shopping observations and participation in everyday food behavior. Findings show that beliefs, positive attitudes, and behavioral intentions do play an important role for sustainable choice. Rooted in one's personal life course experiences and the socio-cultural conditions one grew up in, however, their determinacy is heavily impaired by household realities and by various personal and situational factors. Sustainability attributes, even if dominant on an abstract level, tend to be inferior for actual choice, especially when competing with the taste, price, and preferences of other household members. Product evaluation and food choice are seldomly a result of comprehensive information processing, but rather based on simplifications and strategies. Conflicts are aggravated by competing sustainability values and attributes. Confronted with diverse product-related, personal, external, and situational influences, sustainable choices come with conflicts, tensions, and ambivalences forcing participants to make compromises and remain flexible in their decisions. However, participants were aware of their inadequacies and accept personal inconsistencies, without showing much dissonance. This research extends current knowledge about the impact and the origin of attitudes towards and barriers for sustainable food choice behavior that help to understand the complexity of the phenomena in its natural setting. It points out practical implications for practitioners, updates the theoretical framework, and can widen researchers' perspective on sustainable food choice behavior.
| S-EPMC8226450 | biostudies-literature
Project description:Although vertebrates have been reported to gain higher reproductive outputs by choosing mates, few studies have been conducted on threatened species. However, species recovery should benefit if natural mate choice could improve reproductive output (i.e. pair performance related to offspring number, such as increased clutch size, numbers of fertilized egg and fledglings). We assessed the evidence for major histocompatibility complex (MHC)-based mate preference in the endangered crested ibis (Nipponia nippon) and quantified the impacts of such choice on reproductive output. We tested the hypothesis that crested ibis advertise "good genes" through external traits, by testing whether nuptial plumage characteristics and body morphology mediate mate choice for underlying genetic MHC variation. We found differences between males and females in preferred MHC genotypes, external traits used in mate choice and contributions to reproductive outputs. Females preferred MHC-heterozygous males, which had darker [i.e. lower total reflectance and ultraviolet (UV) reflectance] nuptial plumage. Males preferred females lacking the DAB*d allele at the MHC class II DAB locus, which had higher average body mass. DAB*d-free females yielded heavier eggs and more fledglings, while MHC-heterozygous males contributed to more fertilized eggs and fledglings. Fledging rate was highest when both parents had the preferred MHC genotypes (i.e. MHC-heterozygous father and DAB*d-free mother). Comparisons showed that free-mating wild and semi-natural pairs yielded more fertilized eggs and more fledglings, with a higher fledging rate, than captive pairs matched artificially based on pedigree. Conservation programmes seldom apply modern research results to population management, which could hinder recovery of threatened species. Our results show that mate choice can play an important role in improving reproductive output, with an example in which an endangered bird selects mates using UV visual capability. Despite the undoubted importance of pedigree-based matching of mates in conservation programmes, we show that free mating can be a better alternative strategy.
| S-EPMC6899946 | biostudies-literature