Clinical decision-making following abnormal Papanicolaou smear reports.
OBJECTIVE
Interpretation of abnormal Papanicolaou smear reports and the subsequent management of the patient frequently present significant decision-making problems for clinicians. The purpose of this study was to evaluate family physician clinical decision-making strategies for abnormal cervical cytology reports using simulation techniques.


METHODS
One hundred fifteen practicing family physicians evaluated two simulations of women with abnormal cervical cytology, the first with inflammatory cytology and the second with a high-grade squamous intraepithelial lesion.


RESULTS
Most physicians (66%) selected an etiology evaluation and specific treatment approach to an inflammatory report, while 26% of respondents chose empiric treatment. For the high-grade squamous intraepithelial lesion simulation, 88% of physicians chose the appropriate management response of colposcopic evaluation.


CONCLUSIONS
Practice experience, level of involvement, clinician gender, and type of cervical cytology classification influenced family physician clinical decision-making. The majority of responses to an inflammatory or high-grade squamous intraepithelial lesion report was appropriate based on current scientific data.
Ferris
D G
DG
Department of Family Medicine, Medical College of Georgia, Augusta 30912-3500.
Miller
M D
MD
Wagner
P
P
Walaitis
E
E
Lawler
F H
FH
D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology; D002983:Clinical Competence; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065006:Papanicolaou Test; D002577:Uterine Cervical Diseases / Q000628:therapy*; D014626:Vaginal Smears