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Uncertainty in health care: Towards a more systematic program of research
Authors:Paul KJ Han  Austin Babrow  Marij A Hillen  Pål Gulbrandsen  Ellen M Smets  Eirik H Ofstad
Institution:1. Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, USA;2. Tufts University School of Medicine, Boston, USA;3. School of Communication Studies, Ohio University, Athens, USA;4. Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands;5. Institute of Clinical Medicine, University of Oslo, Oslo, Norway;6. HØKH Research Center, Akershus University Hospital, Lørenskog, Norway;7. Department of Medicine, Nordland Hospital Trust, Bodø, Norway;8. Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
Abstract:ObjectiveTo promote a more systematic approach to research on uncertainty in health care, and to explore promising starting points and future directions for this research.MethodsWe examine three fundamental aspects of medical uncertainty that a systematic research program should ideally address: its nature, effects, and communication. We summarize key insights from past empirical research and explore existing conceptual models that can help guide future research.ResultsA diverse body of past research on medical uncertainty has produced valuable empirical insights and conceptual models that provide useful starting points for future empirical and theoretical work. However, these insights need to be more fully developed and integrated to answer remaining questions about what uncertainty is, how it affects people, and how and why it should be communicated.ConclusionUncertainty in health care is an extremely important but incompletely understood phenomenon. Improving our understanding of the many important aspects of uncertainty in health care will require a more systematic program of research based upon shared, integrative conceptual models and active, collaborative engagement of the broader research community.Practice ImplicationsA more systematic approach to investigating uncertainty in health care can help elucidate how the clinical communication of uncertainty might be improved.
Keywords:Corresponding author at: Center for Outcomes Research and Evaluation  Maine Medical Center Research Institute  509 Forest Avenue  Suite 200  Portland  ME 04101  USA    Uncertainty  Medical uncertainty
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