The Influence of a Physician's Use of a Diagnostic Decision Aid on the Malpractice Verdicts of Mock Jurors

• Published in: Medical decision making Vol. 28; no. 2; pp. 201 - 208
• Main Authors: Arkes, Hal R., Shaffer, Victoria A., Medow, Mitchell A.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-03-2008; Sage Publications, Inc
• Subjects: Adolescent; Adult; Age Factors; Analysis; Appendicitis; Appendicitis - therapy; Care and treatment; Decision Support Techniques; Diagnosis; Female; Humans; Judgment; Male; Malpractice; Malpractice - legislation & jurisprudence; Medical personnel; Middle Aged; Physicians; Physicians - legislation & jurisprudence; Practice; Prevention; Severity of Illness Index; Sex Factors; Socioeconomic Factors; decision aids; jury decision making; malpractice
• ISSN: 0272-989X; 1552-681X
• DOI: 10.1177/0272989X07313280

Background
. One reason why physicians may be reluctant to use diagnostic decision aids is that such usage might increase the likelihood of an unfavorable malpractice verdict. The authors tested this hypothesis by sending a DVD of a malpractice trial to a national sample of jury-eligible adults.
Methods.
There were 3 independent variables: 1) the physician did or did not use a diagnostic aid, 2) the patient's symptoms either were or were not consistent with a diagnosis of probable appendicitis, and 3) the physician's decision to operate or not operate was either concordant or discordant with the severity of the patient's symptoms. Jurors rendered a verdict, and if they deemed the physician not to have met the standard of care, they indicated how punitive they felt toward the physician.
Results
. Mock jurors were more likely to side with the physician-defendant if he recommended an operation when there were many symptoms and refrained when there were few symptoms compared with a physician who did the converse. The use of a decision aid had no influence on this binary standard-of-care decision. Among those physicians deemed liable by the jurors, defying the aid resulted in heightened punishment compared with heeding it.
Conclusion
. Contrary to many physicians' fears, use of a diagnostic decision aid did not influence the likelihood of an adverse malpractice verdict. Complying with the aid's recommendation provided a measure of protection against jurors' punitiveness for those physicians deemed liable for malpractice.