Additional patient outcomes and pathways in evaluations of testing

Bossuyt, Patrick M. M.; McCaffery, Kirsten

doi:10.1177/0272989x09347013

Cited by 97Health Systems, Economic Evaluations, Quality of LifeClinical Reasoning and Diagnostic SkillsPatient-Provider Communication in Healthcare

Additional patient outcomes and pathways in evaluations of testing

Bossuyt, Patrick M. M., McCaffery, Kirsten·2009·Medical Decision Making

DOI 10.1177/0272989x09347013

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Abstract

Before medical tests are introduced into practice, they should be properly evaluated. Randomized trials and other comprehensive evaluations of tests and test strategies can best be designed based on an understanding of how tests can benefit or harm patients. Tests primarily affect patients' health by guiding clinical decision making and downstream management, such as the decision to order more tests or to start, stop, or modify treatment. In this article, the authors demonstrate that tests can have additional effects on patient outcome, which may be cognitive, emotional, social, or behavioral. They present a framework to help researchers and policy makers consider the cognitive, emotional, social, and behavioral effects of testing. These additional effects may be important themselves and may also influence the clinical outcomes of testing through different pathways. The authors provide examples from test evaluations in the literature to illustrate how these additional effects can be important in the evaluation of testing or indeed any health intervention.

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“Furthermore, false-positive results have direct and indirect downstream consequences (75) and can result in a delay in obtaining the correct diagnosis and potentially inappropriate or no treatment.”
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Authors: Bossuyt, P. M. M., & McCaffery, K.
Affiliations: Amsterdam UMC Location University of Amsterdam (NL)
The University of Sydney (AU)
ORCID: Bossuyt, Patrick M. M.
McCaffery, Kirsten
Venue: Medical Decision Making
Publisher: SAGE Publications
Published: 2009-09
Volume: 29
Issue: 5
Pages: E30-E38
ISSN: 0272-989X (ISSN-L)
1552-681X
DOI: 10.1177/0272989x09347013
OpenAlex: W2120635598
Cited by: 97
References: 56
Citations by year: 2026: 4 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 2 · 2019: 8 · 2018: 5 · 2017: 10 · 2016: 4 · 2015: 8 · 2014: 7 · 2013: 8 · 2012: 17
FWCI: 18.71
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Medical Decision Making (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Topics: Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords: patient outcomes, cognitive effects, emotional impact, social consequences, behavioral effects, test evaluation, clinical decision-making, health interventions, evaluation framework
MeSH terms: Cognition, Diagnostic Tests, Routine, Emotions, Humans, Outcome Assessment, Health Care

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