Why do primary care physicians in the United States and France order prostate-specific antigen tests for asymptomatic patients?
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.
Sorum
Paul Clay
PC
Department of Medicine, Albany Medical Center, Albany, NY, USA. sorump@mail.amc.edu
Shim
Junseop
J
Chasseigne
Gérard
G
Bonnin-Scaon
Sylvie
S
Cogneau
Joël
J
Mullet
Etienne
E
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
D017430:Prostate-Specific Antigen