Developers: Karen A. Scherr, Angela Fagerlin, Lillie D. Williamson, J. Kelly Davis, Ilona Fridman, Natalie Atyeo, Peter A. Ubel

Year of publication: 2016

Date last updated: 12 May 2023

Setting in which the tool was originally developed/validated: Patients receiving diagnoses of early stage prostate and discussing their treatment options with a physician

Restriction to setting(s): None

Target group: Clinicians who are discussing treatment options directly with patients during clinic visits

Language(s): English

Specific constructs/behaviours:


Tool topics:

Intended application: Education

Reference(s) to development/validation paper(s):

Scherr, K. A., Fagerlin, A., Williamson, L. D., Davis, J. K., Fridman, I., Atyeo, N., & Ubel, P. A. (2017). The physician recommendation coding system (PhyReCS) a reliable and valid method to quantify the strength of physician recommendations during clinical encounters. Medical Decision Making, 37(1), 46-55.

Tool used in:
Scherr, K. A., Fagerlin, A., Hofer, T., Scherer, L. D., Holmes-Rovner, M., Williamson, L. D., ... & Ubel, P. A. (2017). Physician recommendations trump patient preferences in prostate cancer treatment decisions. Medical Decision Making, 37(1), 56-69.

Delaney, R. K., Sisco-Taylor, B. L., Wang, X., Scherr, K., Ubel, P. A., Haaland, B., ... & Fagerlin, A. (2022). Two Specialists, Two Recommendations: Discordance Between Urologists’& Radiation Oncologists’ Prostate Cancer Treatment Recommendations. Urology, 169, 156-161.

Tool/manual available: Yes. (Codebook that can be adapted for other clinical settings from the website)

Tool description by the author:

The PhyReCS (physician recommendation coding system) provides a tool to systematically, reliably capture the strength of clinicians’ recommendation(s) towards or against multiple treatment options during a clinical encounter. It was developed in the context of early stage prostate cancer, a clinical context in which patients and clinicians engage in shared decision making to choose between multiple treatment potential options. Clinician recommendations are one of the strongest predictors of patient treatment choice, and it is important to be able to accurately capture clinician recommendations during clinical appointments. Once clinician recommendations are accurately captured, there are a number of important research questions that can be answered. For example, the PhyReCS has been used to examine predictors of patient treatment choice and compare urologist versus radiation oncologist recommendations for the same patient. The tool could be easily adapted to other clinical settings. No specific training is needed, but coders should undergo standard training for qualitative coding as outlined in the original validation paper.