Uncertainty in health care: Towards a more systematic program of research

Objective: To promote a more systematic approach to research on uncertainty in health care, and to explore promising starting points and future directions for this research. Methods: We 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. Results: A 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. Conclusion: Uncertainty 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 Implications: A more systematic approach to investigating uncertainty in health care can help elucidate how the clinical communication of uncertainty might be improved. (C) 2019 Elsevier B.V. All rights reserved.