Lack of Standardized Definitions Creates Challenges in Identifying Prevalence of Burnout
Researchers systematically reviewed clinical trial databases for published studies on burnout prevalence in practice physicians.
Physicians tend to vary in regard to their definition of and subjective feelings about burnout, primarily because of the lack of a standardized definition and set criteria for assessing burnout in physicians of multiple disciplines, according to a study published in JAMA.
A team of investigators sought to understand the methods commonly used to characterize burnout and to gain insight into the prevalence of burnout in clinical practice, regardless of the specialty. The researchers systematically reviewed clinical trial databases for published studies on burnout prevalence in practice physicians. A total of 182 studies, including 109,628 physicians across 45 countries, were included in the analysis. The primary outcome of interest was the point or period burnout prevalence, as assessed by questionnaire.
The Maslach Burnout Inventory was used in 85.7% of studies to assess burnout among physicians. Variability was observed among studies reporting overall burnout (67.0%) or subcomponents of burnout, including emotional exhaustion (72.0%), depersonalization (68.1%), and low personal accomplishment (63.2%). A total of 142 unique definitions for overall burnout and burnout subscale criteria were used in all studies.
Variability was also noted among studies in regard to the definition of burnout based on predefined cutoff scores, and all studies relied on varying cutoff definitions for burnout. For studies using the Maslach Burnout Inventory, overall burnout was defined through 47 different definitions, whereas the number of distinct definitions for emotional exhaustion, depersonalization, and low personal accomplishment prevalence were similar among Maslach Burnout Inventory studies (29, 26, and 26, respectively).
Substantial heterogeneity among studies resulted in a range of overall burnout prevalence of 0% to 80.5%, and a range of 0% to 86.2%, 0% to 89.9%, and 0% to 87.1% for emotional exhaustion, depersonalization, and low personal accomplishment prevalence, respectively.
According to the researchers, the findings from this analysis "preclude definitive conclusions about the prevalence of burnout and highlight the importance of developing a consensus definition of burnout and of standardizing measurement tools to assess the effects of chronic occupational stress on physicians."
Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of burnout among physicians: a systematic review. JAMA. 2018;320(11):1131-1150.