What influences the clinical decision-making of dentists? A cross-sectional study

PLoS One. 2020 Jun 5;15(6):e0233652. doi: 10.1371/journal.pone.0233652. eCollection 2020.

Abstract

Clinical decision-making is a complex process influenced by clinical and non-clinical factors. The aim of this study was to investigate the association between provider, patient, and practice factors with clinical decision-making among dentists in Ontario, Canada's most populated province and its largest dental care market. This was a cross-sectional, self-administered survey of a random sample of general dentists in Ontario (n = 3,201). The 46-item survey collected demographic, professional, and practice information. The outcome (treatment intensity) was measured using a set of clinical scenarios, which categorized dentists as either relatively aggressive or conservative in their treatment decisions. Associations were assessed using bivariate analysis and logistic regressions. One thousand and seventy-five dentists responded (33.6% response rate). Age (p = 0.001), place of initial training (p<0.001), number of dependents (p = 0.001), number of hygienists employed (p = 0.001), and perceptions of practice loans (p = 0.020) were associated with treatment intensity. Dentists who were <40-years old (OR = 2.06, 95% CI:1.39-3.06, p<0.001), American-trained (OR = 2.48, 95% CI:1.51-4.06, p<0.001), and perceived their practice loans as large (OR = 1.57, 95% CI:1.02-2.42, p = 0.039), were relatively more aggressive in their treatment decisions. Various non-clinical factors appear to influence the clinical decision-making of dentists in Ontario.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clinical Decision-Making*
  • Cross-Sectional Studies
  • Dentists* / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ontario
  • Practice Patterns, Dentists'*
  • Surveys and Questionnaires

Grants and funding

We would like to acknowledge the generous financial support of the Canadian Dental Protective Association and Green Shield Canada.