Healthcare & patient safety

Patients may enter a clinical pathway via presenting to a general practitioner (GP) in a primary care setting a symptom or combination of symptoms that are of concern; via admittance to a secondary healthcare setting such as a hospital in an emergency; or via a screening programme. A number of clinical pathways may involve decisionmaking where there is an option or a combination of options to be considered (Nelson, Schwartz and Pavel, 2001; von Wagner et al., 2009). A high proportion of patients expect to be informed of such options and to be involved in the decisionmaking process (Bastiaannet et al., 2009; Mazur and Hickam, 1997). Patient attitudes and perceptions may impact their decision-making (Nelson, Schwartz and Pavel, 2001; von Wagner et al., 2009) and this paper presents a vignette study that was designed and developed to understand such attitudes and perceptions in a diagnostic context.