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The Physician Recommendation Coding System (PhyReCS)

Author

Listed:
  • Karen A. Scherr
  • Angela Fagerlin
  • Lillie D. Williamson
  • J. Kelly Davis
  • Ilona Fridman
  • Natalie Atyeo
  • Peter A. Ubel

Abstract

Background. Physicians’ recommendations affect patients’ treatment choices. However, most research relies on physicians’ or patients’ retrospective reports of recommendations, which offer a limited perspective and have limitations such as recall bias. Objective. To develop a reliable and valid method to measure the strength of physician recommendations using direct observation of clinical encounters. Methods. Clinical encounters ( n = 257) were recorded as part of a larger study of prostate cancer decision making. We used an iterative process to create the 5-point Physician Recommendation Coding System (PhyReCS). To determine reliability, research assistants double-coded 50 transcripts. To establish content validity, we used 1-way analyses of variance to determine whether relative treatment recommendation scores differed as a function of which treatment patients received. To establish concurrent validity, we examined whether patients’ perceived treatment recommendations matched our coded recommendations. Results. The PhyReCS was highly reliable (Krippendorf’s alpha = 0.89, 95% CI [0.86, 0.91]). The average relative treatment recommendation score for each treatment was higher for individuals who received that particular treatment. For example, the average relative surgery recommendation score was higher for individuals who received surgery versus radiation (mean difference = 0.98, SE = 0.18, P

Suggested Citation

  • Karen A. Scherr & Angela Fagerlin & Lillie D. Williamson & J. Kelly Davis & Ilona Fridman & Natalie Atyeo & Peter A. Ubel, 2017. "The Physician Recommendation Coding System (PhyReCS)," Medical Decision Making, , vol. 37(1), pages 46-55, January.
    • Handle: RePEc:sae:medema:v:37:y:2017:i:1:p:46-55
    DOI: 10.1177/0272989X16654692
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    References listed on IDEAS

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    1. Gavan J. Fitzsimons & Donald R. Lehmann, 2004. "Reactance to Recommendations: When Unsolicited Advice Yields Contrary Responses," Marketing Science, INFORMS, vol. 23(1), pages 82-94, September.
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