Religious values of physicians affect their clinical practice

A meta-analysis of individual participant data from 7 countries

Alex Kappel Kørup*, Jens Søndergaard, Giancarlo Lucchetti, Parameshwaran Ramakrishnan, Klaus Baumann, Eunmi Lee, Eckhard Frick, Arndt Büssing, Nada A Alyousefi, Azimatul Karimah, Esther Schouten, Inga Wermuth, Niels Christian Hvidt

*Corresponding author for this work

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Abstract

BACKGROUND: Observational studies indicate that religious values of physicians influence clinical practice. The aim of this study was to test prior hypotheses of prevalence of this influence using a meta-analysis design.

METHODS: Based on a systematic literature search we performed individual participant data meta-analysis (IPDMA) on data based on 2 preselected questionnaires. Ten samples from 7 countries remained after exclusion (n = 3342). IPDMA was performed using a random-effects model with 2 summary measures: the mean value of the scale "Religiosity of Health Professionals"; and a dichotomized value of the question "My religious beliefs influence my practice of medicine." Also, a sensitivity analysis was performed using a mixed-models design controlling for confounders.

RESULTS: Mean score of religiosity (95% confidence interval [CI]) was significantly lower in the European subgroup (8.46 [6.96-9.96]) compared with the Asian samples India (10.46 [9.82-10.21]) and Indonesia (12.52 [12.19-12.84]), whereas Brazil (9.76 [9.54-9.99]) and USA (10.02 [9.82-10.21]) were placed in between. The proportion of the European physicians who agreed to the statement "My religious beliefs influence my practice of medicine" (95% CI) was 42% (26%-59%) compared with Brazil (36% [29%-43%]), USA (57% [54%-60%]), India (58% [52%-63%]), and Indonesia (91% [84%-95%]).

CONCLUSIONS: Although large cross-cultural variations existed in the samples, 50% of physicians reported to be influenced by their religious beliefs. Religiosity and influence of religious beliefs were most pronounced in India, Indonesia, and a European faith-based hospital. Education regimes of current and future physicians should encompass this influence, and help physicians learn how their personal values influence their clinical practice.

Original languageEnglish
Article numbere17265
JournalMedicine
Volume98
Issue number38
ISSN0025-7974
DOIs
Publication statusPublished - Sep 2019

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Meta-Analysis
Religion
Indonesia
Physicians
Medicine
Confidence Intervals
Education
Health

Keywords

  • medical ethics
  • meta-analysis
  • physicians
  • religion
  • value neutrality

Cite this

Kørup, Alex Kappel ; Søndergaard, Jens ; Lucchetti, Giancarlo ; Ramakrishnan, Parameshwaran ; Baumann, Klaus ; Lee, Eunmi ; Frick, Eckhard ; Büssing, Arndt ; Alyousefi, Nada A ; Karimah, Azimatul ; Schouten, Esther ; Wermuth, Inga ; Hvidt, Niels Christian. / Religious values of physicians affect their clinical practice : A meta-analysis of individual participant data from 7 countries. In: Medicine. 2019 ; Vol. 98, No. 38.
@article{5b13db6d6d5f49c7b19220c7699a7313,
title = "Religious values of physicians affect their clinical practice: A meta-analysis of individual participant data from 7 countries",
abstract = "BACKGROUND: Observational studies indicate that religious values of physicians influence clinical practice. The aim of this study was to test prior hypotheses of prevalence of this influence using a meta-analysis design.METHODS: Based on a systematic literature search we performed individual participant data meta-analysis (IPDMA) on data based on 2 preselected questionnaires. Ten samples from 7 countries remained after exclusion (n = 3342). IPDMA was performed using a random-effects model with 2 summary measures: the mean value of the scale {"}Religiosity of Health Professionals{"}; and a dichotomized value of the question {"}My religious beliefs influence my practice of medicine.{"} Also, a sensitivity analysis was performed using a mixed-models design controlling for confounders.RESULTS: Mean score of religiosity (95{\%} confidence interval [CI]) was significantly lower in the European subgroup (8.46 [6.96-9.96]) compared with the Asian samples India (10.46 [9.82-10.21]) and Indonesia (12.52 [12.19-12.84]), whereas Brazil (9.76 [9.54-9.99]) and USA (10.02 [9.82-10.21]) were placed in between. The proportion of the European physicians who agreed to the statement {"}My religious beliefs influence my practice of medicine{"} (95{\%} CI) was 42{\%} (26{\%}-59{\%}) compared with Brazil (36{\%} [29{\%}-43{\%}]), USA (57{\%} [54{\%}-60{\%}]), India (58{\%} [52{\%}-63{\%}]), and Indonesia (91{\%} [84{\%}-95{\%}]).CONCLUSIONS: Although large cross-cultural variations existed in the samples, 50{\%} of physicians reported to be influenced by their religious beliefs. Religiosity and influence of religious beliefs were most pronounced in India, Indonesia, and a European faith-based hospital. Education regimes of current and future physicians should encompass this influence, and help physicians learn how their personal values influence their clinical practice.",
keywords = "medical ethics, meta-analysis, physicians, religion, value neutrality",
author = "K{\o}rup, {Alex Kappel} and Jens S{\o}ndergaard and Giancarlo Lucchetti and Parameshwaran Ramakrishnan and Klaus Baumann and Eunmi Lee and Eckhard Frick and Arndt B{\"u}ssing and Alyousefi, {Nada A} and Azimatul Karimah and Esther Schouten and Inga Wermuth and Hvidt, {Niels Christian}",
year = "2019",
month = "9",
doi = "10.1097/MD.0000000000017265",
language = "English",
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Religious values of physicians affect their clinical practice : A meta-analysis of individual participant data from 7 countries. / Kørup, Alex Kappel; Søndergaard, Jens; Lucchetti, Giancarlo; Ramakrishnan, Parameshwaran; Baumann, Klaus; Lee, Eunmi; Frick, Eckhard; Büssing, Arndt; Alyousefi, Nada A; Karimah, Azimatul; Schouten, Esther; Wermuth, Inga; Hvidt, Niels Christian.

In: Medicine, Vol. 98, No. 38, e17265, 09.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Religious values of physicians affect their clinical practice

T2 - A meta-analysis of individual participant data from 7 countries

AU - Kørup, Alex Kappel

AU - Søndergaard, Jens

AU - Lucchetti, Giancarlo

AU - Ramakrishnan, Parameshwaran

AU - Baumann, Klaus

AU - Lee, Eunmi

AU - Frick, Eckhard

AU - Büssing, Arndt

AU - Alyousefi, Nada A

AU - Karimah, Azimatul

AU - Schouten, Esther

AU - Wermuth, Inga

AU - Hvidt, Niels Christian

PY - 2019/9

Y1 - 2019/9

N2 - BACKGROUND: Observational studies indicate that religious values of physicians influence clinical practice. The aim of this study was to test prior hypotheses of prevalence of this influence using a meta-analysis design.METHODS: Based on a systematic literature search we performed individual participant data meta-analysis (IPDMA) on data based on 2 preselected questionnaires. Ten samples from 7 countries remained after exclusion (n = 3342). IPDMA was performed using a random-effects model with 2 summary measures: the mean value of the scale "Religiosity of Health Professionals"; and a dichotomized value of the question "My religious beliefs influence my practice of medicine." Also, a sensitivity analysis was performed using a mixed-models design controlling for confounders.RESULTS: Mean score of religiosity (95% confidence interval [CI]) was significantly lower in the European subgroup (8.46 [6.96-9.96]) compared with the Asian samples India (10.46 [9.82-10.21]) and Indonesia (12.52 [12.19-12.84]), whereas Brazil (9.76 [9.54-9.99]) and USA (10.02 [9.82-10.21]) were placed in between. The proportion of the European physicians who agreed to the statement "My religious beliefs influence my practice of medicine" (95% CI) was 42% (26%-59%) compared with Brazil (36% [29%-43%]), USA (57% [54%-60%]), India (58% [52%-63%]), and Indonesia (91% [84%-95%]).CONCLUSIONS: Although large cross-cultural variations existed in the samples, 50% of physicians reported to be influenced by their religious beliefs. Religiosity and influence of religious beliefs were most pronounced in India, Indonesia, and a European faith-based hospital. Education regimes of current and future physicians should encompass this influence, and help physicians learn how their personal values influence their clinical practice.

AB - BACKGROUND: Observational studies indicate that religious values of physicians influence clinical practice. The aim of this study was to test prior hypotheses of prevalence of this influence using a meta-analysis design.METHODS: Based on a systematic literature search we performed individual participant data meta-analysis (IPDMA) on data based on 2 preselected questionnaires. Ten samples from 7 countries remained after exclusion (n = 3342). IPDMA was performed using a random-effects model with 2 summary measures: the mean value of the scale "Religiosity of Health Professionals"; and a dichotomized value of the question "My religious beliefs influence my practice of medicine." Also, a sensitivity analysis was performed using a mixed-models design controlling for confounders.RESULTS: Mean score of religiosity (95% confidence interval [CI]) was significantly lower in the European subgroup (8.46 [6.96-9.96]) compared with the Asian samples India (10.46 [9.82-10.21]) and Indonesia (12.52 [12.19-12.84]), whereas Brazil (9.76 [9.54-9.99]) and USA (10.02 [9.82-10.21]) were placed in between. The proportion of the European physicians who agreed to the statement "My religious beliefs influence my practice of medicine" (95% CI) was 42% (26%-59%) compared with Brazil (36% [29%-43%]), USA (57% [54%-60%]), India (58% [52%-63%]), and Indonesia (91% [84%-95%]).CONCLUSIONS: Although large cross-cultural variations existed in the samples, 50% of physicians reported to be influenced by their religious beliefs. Religiosity and influence of religious beliefs were most pronounced in India, Indonesia, and a European faith-based hospital. Education regimes of current and future physicians should encompass this influence, and help physicians learn how their personal values influence their clinical practice.

KW - medical ethics

KW - meta-analysis

KW - physicians

KW - religion

KW - value neutrality

U2 - 10.1097/MD.0000000000017265

DO - 10.1097/MD.0000000000017265

M3 - Journal article

VL - 98

JO - Medicine

JF - Medicine

SN - 0025-7974

IS - 38

M1 - e17265

ER -