title: Why do primary care physicians in the United States and France order prostate-specific antigen tests for asymptomatic patients?
abstract: OBJECTIVE
  To understand why many primary care physicians in the United States and France order prostate-specific antigen (PSA) tests routinely for their asymptomatic male patients despite "evidence-based" recommendations.
  
  
  METHODS
  Thirty-two U.S. general internists and family practitioners and 33 French generalists judged, for 32 hypothetical male patients seen for routine preventive care, the probability that the patients had asymptomatic prostate cancer and the likelihood that they would order PSA tests. They were also asked about beliefs, attitudes, and knowledge related to prostate cancer.
  
  
  RESULTS
  The significant predictors of ordering more PSA tests in the scenarios were physicians' higher ratings of regret if untested patients were found to have advanced cancer, their greater discomfort if they suspected that patients had illnesses but could not know for sure, and their perceptions of official recommendations as favoring routine testing.
  
  
  CONCLUSIONS
  Nonrational factors can impede physicians' adoption of "evidence-based" recommendations.
authors.affiliation: Department of Medicine, Albany Medical Center, Albany, NY, USA. sorump@mail.amc.edu
authors.forename: Paul Clay
authors.initials: PC
authors.lastname: Sorum
authors.forename: Junseop
authors.initials: J
authors.lastname: Shim
authors.forename: Gérard
authors.initials: G
authors.lastname: Chasseigne
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bonnin-Scaon
authors.forename: Joël
authors.initials: J
authors.lastname: Cogneau
authors.forename: Etienne
authors.initials: E
authors.lastname: Mullet
mesh_terms: D000368:Aged; D003661:Decision Support Techniques; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D005194:Family Practice; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000276:immunology; D014481:United States
chemical_list: D017430:Prostate-Specific Antigen