Imperial College London
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Dr Martine Nurek

Faculty of Medicine, Department of Surgery & Cancer

Research Associate
 
 
 
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Contact

 

+44 (0)20 7594 3062m.nurek

 
 
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Location

 

504Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kostopoulou:2020:10.1177/0272989X20936212,
author = {Kostopoulou, O and Nurek, M and Delaney, B and Kostopoulou, O and Nurek, M and Delaney, B},
doi = {10.1177/0272989X20936212},
journal = {Medical Decision Making},
pages = {746--755},
title = {Disentangling the relationship between physician and organizational performance: a signal detection approach},
url = {http://dx.doi.org/10.1177/0272989X20936212},
volume = {40},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background. In previous research, we employed a signal detection approach to measure the performance of general practitioners (GPs) when deciding about urgent referral for suspected lung cancer. We also explored associations between provider and organizational performance. We found that GPs from practices with higher referral positive predictive value (PPV; chance of referrals identifying cancer) were more reluctant to refer than those from practices with lower PPV. Here, we test the generalizability of our findings to a different cancer. Methods. A total of 252 GPs responded to 48 vignettes describing patients with possible colorectal cancer. For each vignette, respondents decided whether urgent referral to a specialist was needed. They then completed the 8-item Stress from Uncertainty scale. We measured GPs’ discrimination (d′) and response bias (criterion; c) and their associations with organizational performance and GP demographics. We also measured correlations of d′ and c between the 2 studies for the 165 GPs who participated in both. Results. As in the lung study, organizational PPV was associated with response bias: in practices with higher PPV, GPs had higher criterion (b = 0.05 [0.03 to 0.07]; P < 0.001), that is, they were less inclined to refer. As in the lung study, female GPs were more inclined to refer than males (b = −0.17 [−0.30 to −0.105]; P = 0.005). In a mediation model, stress from uncertainty did not explain the gender difference. Only response bias correlated between the 2 studies (r = 0.39, P < 0.001). Conclusions. This study confirms our previous findings regarding the relationship between provider and organizational performance and strengthens the finding of gender differences in referral decision making. It also provides evidence that response bias is a relatively stable feature of GP referral decision making.
AU  - Kostopoulou,O
AU  - Nurek,M
AU  - Delaney,B
AU  - Kostopoulou,O
AU  - Nurek,M
AU  - Delaney,B
DO  - 10.1177/0272989X20936212
EP  - 755
PY  - 2020///
SN  - 0272-989X
SP  - 746
TI  - Disentangling the relationship between physician and organizational performance: a signal detection approach
T2  - Medical Decision Making
UR  - http://dx.doi.org/10.1177/0272989X20936212
UR  - https://journals.sagepub.com/doi/full/10.1177/0272989X20936212
UR  - http://hdl.handle.net/10044/1/80485
VL  - 40
ER  -
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