The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index.
Uncertainty and COVID-19: how are we to respond?
Open accessAbstract
As if writing prophetically about the global Covid-19 pandemic, in 1984 Eddy suggested, “Uncertainty creeps into medical practice through every pore. Whether a physician is defining a disease, making a diagnosis, selecting a procedure, observing outcomes, assessing probabilities, assigning preferences, or putting it all together, he (or she) is walking on very slippery terrain” 1. Covid-19 has rapidly become a disease associated with unbridled uncertainty with its aetiology and management, for the healthcare systems and health professionals who provide care, and among its ultimate victims, patients and their families.
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“The protracted, inherently complex, and unpredictable nature of such adversities translates into numerous situational uncertainties about personal prospects and the possibility of achieving life goals [43,44].”
From Impact of Media-Induced Uncertainty on Mental Health: Narrative-Based Perspective. (2025) · cites this paper as [43]
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Cites
Wynants, L., Van Calster, B., Bonten, M. M., Collins, G. S., Debray, T. P., De Vos, M., Haller, M. C., Heinze, G., Moons, K. G., Riley, R. D., et al. (2020) · doi:10.1101/2020.03.24.20041020 · Cited by 3,070
Coping with Uncertainty: A Naturalistic Decision-Making Analysis
Lipshitz, R., & Strauss, O. (1997) · Organizational Behavior and Human Decision Processes · doi:10.1006/obhd.1997.2679 · Cited by 922
ICU-Acquired Weakness and Recovery from Critical Illness
Kress, J. P., & Hall, J. B. (2014) · New England Journal of Medicine · doi:10.1056/nejmra1209390 · Cited by 902
Yang, Y., Yang, M., Shen, C., Wang, F., Yuan, J., Li, J., Zhang, M., Wang, Z., Xing, L., Wei, J., et al. (2020) · doi:10.1101/2020.02.11.20021493 · Cited by 836 · cited 1×
“positive for COVID-19 and those who have not, particularly if they present in emergency departments, a concern as the COVID-19 nasopharyngeal swab has a relatively high false-negative rate.(11) If patients are falsely screened-negative they may be sent to a ‘clean ward’ environment where they are potentially subjectin…”
BackgroundVariations in Physician Practice: The Role of Uncertainty
Eddy, D. M. (1984) · Health Affairs · doi:10.1377/hlthaff.3.2.74 · Cited by 573 · cited 1×
“Whether a physician is defining a disease, making a diagnosis, selecting a procedure, observing outcomes, assessing probabilities, assigning preferences, or putting it all together, he (or she) is walking on very slippery terrain’.(1) COVID-19 has rapidly become a disease associated with unbridled uncertainty with its…”
BackgroundTolerating Uncertainty — The Next Medical Revolution?
Simpkin, A. L., & Schwartzstein, R. M. (2016) · New England Journal of Medicine · doi:10.1056/nejmp1606402 · Cited by 527 · cited 3×
“It also affects health professionals and it has been argued their tolerance of uncertainty can affect levels of investigation, patient safety, as well as healthcare resource use.(5) The authors of this commentary – an ITU physician, a palliative care physician and two social scientists – critically synthesise evidence…”
BackgroundInfluentialBernacki, R., Hutchings, M., Vick, J. B., Smith, G., Paladino, J., Lipsitz, S. R., Gawande, A. A., & Block, S. D. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-009032 · Cited by 468 · cited 1×
“Patients therefore may need assistance to recognise possible ‘trade-offs’ among their values and to understand the relationship between what is important to them and their families and treatment preferences.(22) If they are not able to obtain timely and accessible information and updates about loved ones, families mig…”
BackgroundDying with Dignity in the Intensive Care Unit
Cook, D., & Rocker, G. M. (2014) · New England Journal of Medicine · doi:10.1056/nejmra1208795 · Cited by 331
Etkind, S. N., Bristowe, K., Bailey, K., Selman, L. E., & Murtagh, F. E. (2016) · Palliative Medicine · doi:10.1177/0269216316647610 · Cited by 150 · cited 1×
“Where uncertainty about their situation is present, patients become preoccupied to such an extent that their sense of self is changed.(19) Patients and their families often want to discuss their situation of uncertainty; however, this rarely happens.”
BackgroundSelf-citationPalliating a Pandemic: “All Patients Must Be Cared For”
Downar, J., & Seccareccia, D. (2010) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2009.11.241 · Cited by 122 · cited 1×
“including paramedics; liaison across provider networks to access knowledge for clinicians needing consultation support.(23)”
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Items 301–305 of 305
Facemask memories: a qualitative approach to people’s construal of protective health behaviours
Perach, R., Murakami, K., & Loveday, C. (2026) · European Review of Applied Psychology · doi:10.1016/j.erap.2026.101178
Covid-19 Vulnerability: A Societal Implication and Community Response
Verma, D. C., Yadav, J. K., Jangirala, S., Prasad, M., & Singh, S. (2026) · Springer eBooks · doi:10.1007/978-3-032-22171-1_9
Guan, M., Yang, Q., Carey, P., Wolff, A. E., & Cao, W. (2026) · Health Communication · doi:10.1080/10410236.2026.2678930
Trends in PTSD Among IDF Soldiers in Combat Over the Years: A Representative Cohort Study
Bechor, U., Shacham, M., Kedem, R., Rotschield, J., & Shelef, L. (2026) · International Journal of Psychology · doi:10.1002/ijop.70227
Cross-Level Weaving: The Co-Construction of Structure-Practice in Crisis Governance
Cai, C., Shen, Q., & Yang, L. (2026) · Public Performance & Management Review · doi:10.1080/15309576.2026.2699898
Metadata
- Authors
- Koffman, J., Gross, J., Etkind, S. N., & Selman, L.
- Affiliations
- King's College London (GB)
- London North West Healthcare NHS Trust (GB)
- University of Bristol (GB)
- Corresponding author
- Koffman, Jonathan
- Venue
- Journal of the Royal Society of Medicine
- Publisher
- SAGE Publications
- Published
- 2020-06
- Volume
- 113
- Issue
- 6
- Pages
- 211-216
- ISSN
- 0141-0768 (ISSN-L)
- 1758-1095
- PMC
- PMC7439590
- OpenAlex
- W3025624029
- Cited by
- 305
- References
- 19
- Citations by year
- 2026: 11 · 2025: 22 · 2024: 57 · 2023: 76 · 2022: 67 · 2021: 67 · 2020: 5
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of the Royal Society of Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (submittedVersion, other-oa)
- Apollo (University of Cambridge) (submittedVersion)
- Apollo
- Funders
- National Institute for Health and Care Research (ACF-2012-17-020, CDF-2018-11-ST2-009)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- COVID-19 pandemic, uncertainty, clinical decision-making, clinical uncertainty, pandemic response, diagnosis, treatment management
- MeSH terms
- Clinical Decision-Making, Betacoronavirus, COVID-19, SARS-CoV-2, Family, Health Personnel, Humans, Physician's Role, Pneumonia, Viral, Prognosis, Coronavirus Infections, Critical Pathways, Needs Assessment, Uncertainty, Emotional Intelligence, Pandemics
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