Factors Associated With Acceptance of an Optional Diagnosis, 2024, Matthews

https://journals.lww.com/qmhcjourna...ciated_with_acceptance_of_an_optional.94.aspx

Original Article
Factors Associated With Acceptance of an Optional Diagnosis

Matthews, Cortney BS; Ring, David MD, PhD; Teunis, Teun MD, PhD; Ramtin, Sina MD

Author Information
Author Affiliations: Department of Surgery and Perioperative Care, Dell Medical School – The University of Texas at Austin, Austin, Texas (Mr Matthews and Drs Ring and Ramtin); and Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Teunis).

Correspondence: David Rign, MD, Dell Medical School – The University of Texas at Austin, 1701 Trinity St., Austin, TX 78704 (David.Ring@austin.utexas.edu).


Quality Management in Health Care ():10.1097/QMH.0000000000000476, October 23, 2024. | DOI: 10.1097/QMH.0000000000000476

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Abstract
Background:
A sensation becomes a symptom (a concern) when a person associates it with potential illness. In the absence of objective evidence of a pathophysiological process that has important health consequences without treatment, assigning a diagnosis to the sensation is optional. This is important because labeling of benign bodily sensations as pathophysiology has potential advantages and disadvantages.

Question:
We asked what patient and clinician factors are associated with willingness to accept an optional diagnosis.

Methods:
In a survey administered using Amazon M-Turk, 536 people anonymously completed validated measures for symptoms of anxiety and depression, intolerance of uncertainty, and skepticism regarding the healthcare system. They then viewed fictional personal medical scenarios in which they were asked to imagine they experienced certain symptoms, and were offered an optional diagnosis of a nerve problem, muscle pain syndrome, or fatigue syndrome, and were asked to rate their willingness to accept the diagnosis on an 12-point ordinal scale from 0 indicating “I do not accept it at all” to 11 indicating “I accept it with enthusiasm.” The language of the scenarios was varied to attempt to reflect critical thinking, denigration of other doctors, an alternative mental health focus, or a hopeful outlook. Multilevel linear regression was used to identify factors associated with likelihood of accepting an optional diagnosis.

Results:
Threshold likelihood of accepting an optional diagnosis greater than 5.5 on a 0 to 11 ordinal scale was independently associated with greater symptoms of anxiety (regression coefficient [RC] = 0.38, 95% confidence interval [95% CI] = 0.30-0.47, P < .001), greater skepticism regarding the healthcare system (RC = 0.11, 95% CI = 0.076-0.13, P < .001), and delivery tones characterized by either denigration of other doctors (RC = 0.39, 95% CI = 0.19-0.60, P < .001) or a hopeful outlook (RC = 0.50, 95% CI = 0.26-0.73, P < .001).

Conclusion:
Likelihood of accepting an optional diagnosis may be a sign of relative vulnerability from feelings of distress or distrust of medical evidence. Given this potential vulnerability, clinicians can take care to limit persuasive communication styles that can influence acceptance of optional diagnoses.

Level of Evidence:
III prognostic.

 

Imagine you had these then imagine choosing between these eccentric options and do these surveys of mood issues

what on Earth do these people think they are doing? They aren’t measuring ANYTHING just bartering in make believe

the business literature would LAUGH at the idea of getting someone to ‘imagine’ or ‘predict their own behaviour’ in ANYTHING it's NONSENSE

except what this with the first question is REALLY asking is dividing whether the partipants have any EMPATHY as a skill - which we know seems to be abnormally distributed - some missing that module completely, others able to be intellectually curious and transport themselves using theory of mind

so again I don’t think these people have a clue what they think they’ve tested - just thrown crap at a wall then made up inference for what they fished around to correlate between these nonsense ‘factors’

It’s cod something but I’m not sure I can even a subject to insult for the other half of that term