Doctors More Likely to Test for Conditions Recently Diagnosed in Other Patients

If an emergency medicine physician sees a condition in a recent patient, they are more likely to test for that condition in subsequent patients, according to a study published online Aug. 6 in the Annals of Emergency Medicine.

Dan P. Ly, M.D., Ph.D., from the VA Greater Los Angeles Healthcare System, examined whether the availability heuristic influences physician testing in a common, high-risk clinical scenario (e.g., assessing patients with shortness of breath for the risk of pulmonary embolism). The analysis included 7,370 emergency medicine physicians who had 416,720 patient visits at 104 Veterans Affairs hospitals for shortness of breath.

Ly found that the mean rate of pulmonary embolism testing was 9 percent. However, in the 10 days after a patient visit with a pulmonary embolism diagnosis, their physicians' rate of pulmonary embolism testing for subsequent patients increased by 1.4 percentage points, which is approximately 15 percent relative to the mean rate of pulmonary embolism testing. Ly observed no significant changes in rates of testing for the subsequent 50 days.

"After having a recent patient visit with a pulmonary embolism diagnosis, physicians increase their rates of pulmonary embolism testing for subsequent patients, but this increase does not persist," Ly writes. "These results provide large-scale evidence that the availability heuristic may play a role in complex testing decisions."