Article Text

Healthcare provider perceptions of clinical prediction rules
  1. Safiya Richardson1,
  2. Sundas Khan1,
  3. Lauren McCullagh1,
  4. Myriam Kline2,
  5. Devin Mann3,
  6. Thomas McGinn1
    1. 1Department of Medicine, Hofstra North Shore—LIJ School of Medicine, Manhasset, New York, USA
    2. 2Biostatistics Division, Feinstein Institute for Medical Research, Manhasset, New York, USA
    3. 3Department of Medicine, Boston University, Boston, Massachusetts, USA
    1. Correspondence to Dr Sundas Khan; SKhan31{at}nshs.edu

    Abstract

    Objectives To examine internal medicine and emergency medicine healthcare provider perceptions of usefulness of specific clinical prediction rules.

    Setting The study took place in two academic medical centres. A web-based survey was distributed and completed by participants between 1 January and 31 May 2013.

    Participants Medical doctors, doctors of osteopathy or nurse practitioners employed in the internal medicine or emergency medicine departments at either institution.

    Primary and secondary outcome measures The primary outcome was to identify the clinical prediction rules perceived as most useful by healthcare providers specialising in internal medicine and emergency medicine. Secondary outcomes included comparing usefulness scores of specific clinical prediction rules based on provider specialty, and evaluating associations between usefulness scores and perceived characteristics of these clinical prediction rules.

    Results Of the 401 healthcare providers asked to participate, a total of 263 (66%), completed the survey. The CHADS2 score was chosen by most internal medicine providers (72%), and Pulmonary Embolism Rule-Out Criteria (PERC) score by most emergency medicine providers (45%), as one of the top three most useful from a list of 24 clinical prediction rules. Emergency medicine providers rated their top three significantly more positively, compared with internal medicine providers, as having a better fit into their workflow (p=0.004), helping more with decision-making (p=0.037), better fitting into their thought process when diagnosing patients (p=0.001) and overall, on a 10-point scale, more useful (p=0.009). For all providers, the perceived qualities of useful at point of care, helps with decision making, saves time diagnosing, fits into thought process, and should be the standard of clinical care correlated highly (≥0.65) with overall 10-point usefulness scores.

    Conclusions Healthcare providers describe clear preferences for certain clinical prediction rules, based on medical specialty.

    • INTERNAL MEDICINE
    • HEALTH SERVICES ADMINISTRATION & MANAGEMENT
    • MEDICAL EDUCATION & TRAINING

    This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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