The influence of physician information on patient's medical decision-making in mHealth services (Preprint)

BACKGROUND As a new way to share medical information, mHealth is currently booming, which provides a new solution for the improvement of physician-patient relationship. On the one hand, mHealth service breaks the limitation of time and space, reduces the cost of searching for information for patients, and makes medical service “at your fingertips”. However, on the other hand, it makes information overload and brings difficulties to patients' decision-making. OBJECTIVE This study aims to discover the physician information that plays a key role in patient’s decision-making and to explore the mechanism by which this information contributes to patient’s decision-making. Therefore, enriching the theoretical basis of information selection and processing of patients, which play a guiding role in the future APPs construction and information management of mHealth from the perspective of improving patient’s satisfaction. METHODS In the study, eye tracking experiment is designed to discover key factors that influence a patient’s medical decision-making in choosing a physician. Then based on the SOR model and online trust theory, from the perspective of cognitive trust and affective trust, the patient expertise is used as the moderating variable to construct the research model of physician information on patient's medical decision-making. RESULTS The results of the eye tracking experiment reveal that there are 7 aspects of physician information which play a key role in patients' medical decision-making. The results of the research model reveal that (1) physician’s profile photo information affects patient's medical decision-making by positively influencing affective trust (P<.001); (2) physician’s non profile photo information affects patient's medical decision-making by positively influencing cognitive trust (P<.001); (3) patient-generated information affects patient's medical decision-making by positively affecting cognitive trust (P<.001) and affective trust (P<.001), and the patient expertise plays a positive moderating role in both paths (P=.04 and P=.01, respectively); and (4) cognitive trust and affective trust both positively affect patient’s medical decision-making but affective trust plays a more significant role (P<.001 and P<.001, respectively). CONCLUSIONS It is concluded that 7 aspects of physician information are mainly resorted to by patients when they make their medical decision-making, and trust plays an important role in it. In addition, the level of patient expertise is an important variable in moderating physician information and patients’ trust.

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The Influence of Physician Information on Patients’ Choice of Physician in mHealth Services Using China’s Chunyu Doctor App: Eye-Tracking and Questionnaire Study

JMIR mhealth and uhealth ◽

10.2196/15544 ◽

2019 ◽

Vol 7 (10) ◽

pp. e15544 ◽

Cited By ~ 1

Author(s):

Wei Shan ◽

Ying Wang ◽

Jing Luan ◽

Pengfei Tang

Keyword(s):

Eye Tracking ◽

Structural Equation ◽

Medical Information ◽

Questionnaire Study ◽

Equation Modeling ◽

Research Model ◽

Cognitive Trust ◽

Affective Trust ◽

Patient Expertise ◽

Moderating Role

Background Mobile health (mHealth) is becoming more popular as a way of sharing medical information. For the patient, it saves time, reduces the need for travel, reduces the cost of searching for information, and brings medical services “to your fingertips.” However, it also brings information overload and makes the patient’s choice of physician more difficult. Objective This study aimed to identify the types of physician information that play a key role in patients’ choice of physician and to explore the mechanism by which this information contributes to this choice. Methods Based on the stimulus-organism-response (SOR) model and online trust theory, we proposed a research model to explain the influence of physician information on patients’ choice of physician. The model was based on cognitive trust and affective trust and considered the moderating role of patient expertise. Study 1 was an eye-tracking experiment (n=42) to identify key factors affecting patients’ choice of physician. Study 2 was a questionnaire study (n=272); Partial Least Squares Structural Equation Modeling was used to validate the research model. Results The results of Study 1 revealed that seven types of physician information played a key role in patients’ choice of physician. The results of Study 2 revealed that (1) physicians’ profile photo information affected patients’ choice of physician by positively influencing affective trust (P<.001); (2) physicians’ nonprofile photo information affected patients’ choice of physician by positively influencing cognitive trust (P<.001); (3) patient-generated information affected patients’ choice of physician by positively affecting cognitive trust (P<.001) and affective trust (P<.001), and patient expertise played a positive moderating role on both (P=.04 and P=.01, respectively); and (4) cognitive trust and affective trust both positively affected patients’ choice of physician, with affective trust playing a more significant role (P<.001 and P<.001, respectively). Conclusions Seven types of physician information were mainly used by patients when choosing physicians offering mHealth services; trust played an important role in this choice. In addition, the level of patient expertise was an important variable in moderating the influence of physician information and patients’ trust. This paper supports the theoretical basis of information selection and processing by patients. These findings can help guide app developers in the construction of medical apps and in the management of physician information in order to facilitate patients’ choice of physician.

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Support for management medical decisions and the nature of uncertainty in them

Biomedical Radioelectronics ◽

10.18127/j15604136-202104-12 ◽

2021 ◽

Author(s):

S.Yu. Zhuleva ◽

A.V. Kroshilin ◽

S.V. Kroshilina

Keyword(s):

Decision Making ◽

Medical Decision Making ◽

Medical Information ◽

General Scheme ◽

The Body ◽

Medical Decision ◽

Problem Situation ◽

Medical Decisions ◽

Inaccurate Information ◽

Individual Decisions

The process of making a medical decision is characterized by a lack of knowledge and inconsistency of the available information, the lack of the possibility of attracting competent medical experts, limited time resources, incomplete or inaccurate information about the patient's condition. These aspects may be the causes of medical errors, which lead to further aggravation of the problem situation. Purpose – it is necessary to define and justify managerial medical decisions and types of medical information in conditions of uncertainty, when each variant of the sets of outcomes of the situation (recommendations) has its own unique set of values. The fundamental difference between this process for medical use is the concept of the "best medical solution", in which the key role is given to the patient's state of health in obtaining and evaluating alternatives, as well as the need to take into account the time, adverse reactions of the body and the costs of implementing this solution. In the medical field, support for medical decision-making can be classified as organizational-managerial and therapeutic-diagnostic, but both are determined by the position of the person making the medical decision and are aimed at effective management of the medical institution as a whole. The article describes the causes and factors of the nature of uncertainty in the tasks of supporting medical decision-making in medical-diagnostic and organizational-managerial areas. The analysis of the features of supporting medical decision-making in conditions of uncertainty is carried out. Approaches and directions in this area, as well as the concept of “solution”, are considered. The essence of the management medical decision is reflected. The classification of management medical decisions is given, the requirements that are imposed on them are highlighted. The features of the development of management medical solutions in the conditions of incompleteness and uncertainty, the problems that arise when they are implemented in information systems are presented. The general scheme of the process of creating a management medical solution is shown. The features of making group and individual decisions are reflected. The algorithm of actions of the person making the medical decision in the conditions of uncertainty, incompleteness and risk in medical subject areas is presented.

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Culture, Self, and Medical Decision Making in Australia and China: A Structural Model Analysis

MDM Policy & Practice ◽

10.1177/2381468319871018 ◽

2019 ◽

Vol 4 (2) ◽

pp. 238146831987101 ◽

Cited By ~ 2

Author(s):

Hankiz Dolan ◽

Dana L. Alden ◽

John M. Friend ◽

Ping Yein Lee ◽

Yew Kong Lee ◽

...

Keyword(s):

Decision Making ◽

Medical Decision Making ◽

Medical Information ◽

Personal Values ◽

Total Variance ◽

Medical Decision ◽

Equation Modeling ◽

Individual Level ◽

Study Results ◽

Variance Explained

Objective. To explore and compare the influences of individual-level cultural values and personal attitudinal values on the desire for medical information and self-involvement in decision making in Australia and China. Methods. A total of 288 and 291 middle-aged adults from Australia and China, respectively, completed an online survey examining cultural and personal values, and their desired level of self-influence on medical decision making. Structural equation modeling was used to test 15 hypotheses relating to the effects of cultural and personal antecedents on the individual desire for influence over medical decision making. Results. Similar factors in both Australia and China (total variance explained: Australia 29%; China 35%) predicted desire for medical information, with interdependence (unstandardized path coefficient βAustralia = 0.102, P = 0.014; βChina = 0.215, P = 0.001), independence (βAustralia = 0.244, P < 0.001; βChina = 0.123, P = 0.037), and health locus of control (βAustralia = −0.140, P = 0.018; βChina = −0.138, P = 0.007) being significant and positive predictors. A desire for involvement in decisions was only predicted by power distance, which had an opposite effect of being negative for Australia and positive for China (total variance explained: Australia 11%; China 5%; βAustralia = 0.294, P < 0.001; China: βChina = −0.190, P = 0.043). National culture moderated the effect of independence on desire for medical information, which was stronger in Australia than China ( Z score = 1.687, P < 0.05). Conclusions. Study results demonstrate that in both countries, desire for medical information can be influenced by individual-level cultural and personal values, suggesting potential benefits of tailoring health communication to personal mindsets to foster informed decision making. The desired level of self-involvement in decision making was relatively independent of other cultural and personal values in both countries, suggesting caution against cultural stereotypes. Study findings also suggest that involvement preferences in decision making should be considered separately from information needs at the clinical encounter.

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Patients' Desire to Participate in Decision-Making in Psychiatry: A Questionnaire Survey in Japan

Psychological Reports ◽

10.2466/pr0.2000.86.2.389 ◽

2000 ◽

Vol 86 (2) ◽

pp. 389-399 ◽

Cited By ~ 7

Author(s):

Chieko Hasui ◽

Miki Hayashi ◽

Atsuko Tomoda ◽

Maki Kohro ◽

Kyoko Tanaka ◽

...

Keyword(s):

Decision Making ◽

Medical Decision Making ◽

Medical Information ◽

Psychiatric Patients ◽

Educational Background ◽

The Self ◽

Case Vignette ◽

Medical Decision ◽

Personality Factors ◽

Types Of Information

Japanese national sentiment has been described as paternalistic, which has potentially wide-ranging implications for the manner in which psychiatric patients should participate in medical decision-making. To examine the extent and possible determinants of the desire to participate in medical decision-making among Japanese people, we distributed a packet of questionnaires to 747 (nonmedical) university students and 114 of their parents. The questionnaires included an imaginary case vignette of psychotic depression. The participants were asked whether they would want various types of medical information, i.e., diagnosis, aetiology, treatment, outcomes, medical charts, etc., disclosed to them were they in such a psychiatric condition. Also included was the 1995 Scale for Independent and Interdependent Construal of the Self by Kiuchi. More than half of the participants wanted all the types of medical information disclosed to them. Those participants who wanted to have all types of information disclosed to them ( n = 413) as compared to those who did not want to know at least one type of information ( n = 445), tended to be male and to have an educational background in psychiatry (9.7% vs 5.4%) as well as an assertive attitude as indicated by a higher score on Independence on the Scale for Independence and Interdependent Construal of the Self. These results suggest that the Japanese in this sample are more likely to want to make an autonomous contribution to the psychiatric decision-making process and that less desire for information can be predicted by some demographic and personality factors.

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From Medical Data to Health Knowledge

Methods of Information in Medicine ◽

10.1055/s-0038-1635481 ◽

1987 ◽

Vol 26 (01) ◽

pp. 3-12 ◽

Cited By ~ 1

Author(s):

J. M. Martin ◽

L. Benamghar ◽

B. Junod ◽

P. Marrel

Keyword(s):

Decision Making ◽

Medical Decision Making ◽

Health Knowledge ◽

Medical Information ◽

Computer Systems ◽

Medical Knowledge ◽

Medical Data ◽

Medical Decision ◽

Decision Making Process ◽

The Way

SummaryThe problems of assisting in the medical decision-making process are attracting more and more attention.Actually a certain number of computer systems have considerably improved the availability of medical data. However, we encounter some difficulties when extending these systems. In order to surmount these problems, it is necessary to proceed further in the analysis and comprehension of medical information and processes.To accomplish this goal, it is necessary to have a better understanding of the way in which a group of medical data is derived from one piece of medical knowledge and also how a chunk of medical knowledge is related to its corresponding medical data.This article is a beginning in the study of the transition from medical data to health knowledge, and this transition represents only part of the global entity, the nature, the representation, and use of medical information.

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