Currently submitted to: JMIR Preprints
Date Submitted: Feb 2, 2025
Open Peer Review Period: Jan 31, 2025 - Jan 16, 2026
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The utility of measuring behavioral variability as a marker of provider uncertainty in clinical scenarios
ABSTRACT
Among the countless decisions healthcare providers make daily, many clinical scenarios do not have clear guidelines, despite a recent shift towards the practice of evidence-based medicine. Even in clinical scenarios where guidelines do exist, these guidelines do not universally recommend one treatment option over others. As a result, the limitations of existing guidelines presumably create an inherent variability in provider decision-making and the corresponding distribution of provider behavioral variability in a clinical scenario, and such variability differs across clinical scenarios. We define this variability as a marker of provider uncertainty, where scenarios with a wide distribution of provider behaviors have more uncertainty than scenarios with a narrower provider behavior distribution. We propose four exploratory analyses of provider uncertainty: (1) field-wide overview; (2) subgroup analysis; (3) provider guideline adherence; and (4) pre-/post-intervention evaluation. We also propose that uncertainty analysis can also be used to help guide interventions in focusing on clinical decisions with the highest amounts of provider uncertainty and therefore the greatest opportunity to improve care.
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