Structured Clinical Decision Aids Are Seldom Compared With Subjective Physician Judgment, and Are Seldom Superior David L. Schriger, MD, MPH, Joshua.

Slides:

Advertisements

Similar presentations

Young Woman With Abdominal Pain David Jones, MD Annals of Emergency Medicine Volume 64, Issue 4, (October 2014) DOI: /j.annemergmed

Advertisements

An Early Look at Performance on the Emergency Care Measures Included in Medicare's Hospital Inpatient Value-Based Purchasing Program Megan McHugh, PhD,

Colorado Cannabis Legalization and Its Effect on Emergency Care

Can Vasopressors Safely Be Administered Through Peripheral Intravenous Catheters Compared With Central Venous Catheters? J. Michael Brewer, MD Annals.

The Use of Noninvasive Ventilation in Emergency Department Patients With Acute Cardiogenic Pulmonary Edema: A Systematic Review Sean P. Collins, MD,

Annals of Emergency Medicine

David McD. Taylor, MD, MPH, Celene Y. L. Yap, MSc, Jonathan C

The Presence of Outcome Bias in Emergency Physician Retrospective Judgments of the Quality of Care Malkeet Gupta, MD, MS, David L. Schriger, MD, MPH,

Pacemaker Extrusion Annals of Emergency Medicine

The Use of Noninvasive Ventilation in Emergency Department Patients With Acute Cardiogenic Pulmonary Edema: A Systematic Review Sean P. Collins, MD,

No SIRS; Quick SOFA Instead

Man With Finger Injury Annals of Emergency Medicine

Alan E. Jones, MD, Michael A. Puskarich, MD

Thread of Idealism a Lifeline to Developing Countries

A Sample Rule-Out Tuberculosis Protocol

Discharge Glucose Is Not Associated With Short-Term Adverse Outcomes in Emergency Department Patients With Moderate to Severe Hyperglycemia Brian E.

Insurance Status and Access to Urgent Primary Care Follow-up After an Emergency Department Visit in 2016 Shih-Chuan Chou, MD, MPH, Yanhong Deng, MPH,

Annals of Emergency Medicine

Procedural Sedation: Is Two Better Than One?

Maria C. Raven, MD, MPH, Margot Kushel, MD, Michelle J

Managing Nontraumatic Acute Back Pain

A Woman With a Click in Her Throat

Selective Use of Computed Tomography Compared With Routine Whole Body Imaging in Patients With Blunt Trauma Malkeet Gupta, MD, MS, David L. Schriger,

Changing Dispensers May Prevent Intoxication From Isopropanol and Ethyl Alcohol- Based Hand Sanitizers Scott G. Weiner, MD, MPH Annals of Emergency Medicine

Observers in the Medical Setting

Michael A. LaMantia, MD, MPH, Frank C. Messina, MD, Cherri D

Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States,

Man With Acute Respiratory Distress

Middle-Aged Man With Rash

The Neonatal Airway and the Goldilocks Phenomenon

A Clinical Decision Rule for Thoracolumbar Spine Imaging in Blunt Trauma? Jeff Riddell, MD, Kenji Inaba, MD, FRCSC, FACS, Paul Jhun, MD, Mel Herbert,

Elderly Woman With a Cough

An Infant With Fever and Rash

Andrea W. Thorp, MD, David L. Schriger, MD, MPH

David McD. Taylor, MD, MPH, Celene Y. L. Yap, MSc, Jonathan C

Sangeeta Lamba, MD, Tammie E. Quest, MD Annals of Emergency Medicine

Man With Suprapubic Pain

Lee Cearnal Annals of Emergency Medicine

Does “Not Different” Equal “The Same”?

Levocetirizine and Prednisone Are Not Superior to Levocetirizine Alone for the Treatment of Acute Urticaria: A Randomized Double-Blind Clinical Trial

Emergency Ultrasound Guidelines

Clinical Features From the History and Physical Examination That Predict the Presence or Absence of Pulmonary Embolism in Symptomatic Emergency Department.

Nupur Garg, MD, Michael Gottlieb, MD Annals of Emergency Medicine

Teenager With Scalp Mass

Newborn With a Rash Annals of Emergency Medicine

Measuring and Explaining Computed Tomography Use in the United States and Canada: A Consideration of Health Economics and Use Versus Appropriateness,

Emergency Department Planning and Resource Guidelines

Anthony Eidelman, MD, Jocelyn M. Weiss, MPH, Joseph Lau, MD, Daniel B

Young Woman With Abdominal Pain

Eric Berger Annals of Emergency Medicine

A Refractory Wart? Annals of Emergency Medicine

Woman With Hip Pain Annals of Emergency Medicine

Abscess Incision and Drainage With or Without Ultrasonography: A Randomized Controlled Trial Romolo J. Gaspari, MD, PhD, Alexandra Sanseverino, MD, Timothy.

Steven M. Green, MD, Michael L. Callaham, MD

Analysis of Emergency Department Length of Stay for Mental Health Patients at Ten Massachusetts Emergency Departments Mark D. Pearlmutter, MD, Kristin.

Chad Kessler, MD, MHPE, Nathaniel L

Kuo-Chen Cheng, MD Annals of Emergency Medicine

Images in Emergency Medicine

Penetrating Neck Injury: What’s In and What’s Out?

Images in Emergency Medicine

Continuing Care for Patients Choosing the Emergency Department as a Site for Primary Care: Feasibility, Benefits, and EMTALA Considerations David L.

Michael D. Menchine, MD, MPH, David L. Schriger, MD, MPH, Tyler W

Woman With Unresponsiveness

Woman With Vision Loss in Left Eye

Critical Care Management ofVerapamil and Diltiazem Overdose With a Focus on Vasopressors: A 25-Year Experience at a Single Center Michael Levine, MD,

Young Boy With Shedding Nails

Man With Acute Eye Lesion

D. Stevenson, T. Long, J.P. Green, J. Rose

Young Man with Foreign-Body Sensation in the Right Eye

Value Over Volume Annals of Emergency Medicine

Presentation transcript:

Structured Clinical Decision Aids Are Seldom Compared With Subjective Physician Judgment, and Are Seldom Superior David L. Schriger, MD, MPH, Joshua W. Elder, MD, MPH, Richelle J. Cooper, MD, MSHS Annals of Emergency Medicine Volume 70, Issue 3, Pages 338-344.e3 (September 2017) DOI: 10.1016/j.annemergmed.2016.12.004 Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 1 Study flow diagram with results. This figure depicts how we identified and selected the 131 prospective evaluations of aids for decisionmaking in the 2,060 research articles in 1998 to 2015 Annals articles. It also depicts what percentage of these articles compared the aid's performance with independent physician judgment overall and stratified by when the aid to decisionmaking was a formal clinical decision instrument or not. Finally, it examines these data stratified on the intent of the rule (top shaded box) and the type of decision being aided (bottom shaded box). CDI, Clinical decision instrument. *We found 6 unique articles that contained a comparison with physician judgment and were relevant to 9 articles in our sample that did not contain such a comparison. Annals of Emergency Medicine 2017 70, 338-344.e3DOI: (10.1016/j.annemergmed.2016.12.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure 2 For each year, the graph depicts the total number of studies about decision aids and indicates how often the aid was compared with physician judgment either in the article (black bars) or in “another article” (light gray bars). There is no obvious trend over time. Annals of Emergency Medicine 2017 70, 338-344.e3DOI: (10.1016/j.annemergmed.2016.12.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions

Figure E1 This graph depicts the number of research articles in each year's Annals issues that assessed the performance of any decision aid (heights of lighter bars) or, specifically, a clinical decision instrument (darker bars). There is no evidence of a trend over time. Annals of Emergency Medicine 2017 70, 338-344.e3DOI: (10.1016/j.annemergmed.2016.12.004) Copyright © 2016 American College of Emergency Physicians Terms and Conditions