Clinicians' risk–benefit appraisals
| Question/dimension | All clinicians combined (n=58) | ED physicians (n=23) | Neurospecialists (n=35) | p Value |
|---|---|---|---|---|
| Routine LP justified? ‘No’ | 23 (40%) | 14 (61%) | 9 (26%) | |
| Routine LP justified? ‘Yes’ | 35 (60%) | 9 (39%) | 26 (74%) | 0.007 |
| Investigative inertia ‘No’ | 45 (78%) | 20 (87%) | 25 (71%) | |
| Investigative inertia ‘Yes’ | 13 (22%) | 3 (13%) | 10 (29%) | 0.2 |
| Required LP pick-up rate: ≥1 SAH every 100 LPs | 25 (44%) | 12 (52%) | 13 (38%)* | |
| 1 SAH every 101–500 LPs | 19 (33%) | 8 (35%) | 11 (32%)* | |
| 1 SAH for every >500 LPs | 13 (23%) | 3 (13%) | 10 (29%)* | 0.3 |
| Risk–benefit trade off† | ||||
| Non-invasive test | ||||
| Yes | 12 (21%) | 8 (38%)‡ | 4 (11%) | 0.018 |
| No | 44 (79%) | 13 (62%)‡ | 31 (89%) | |
| Quicker test | ||||
| Yes | 5 (9%) | 2 (10%)‡ | 3 (9%)* | 0.9 |
| No | 50 (89%) | 19 (90%)‡ | 31 (89%)* | |
| Cheaper test | ||||
| Yes | 5 (9%) | 2 (10%)‡ | 3 (9%)* | 0.9 |
| No | 50 (89%) | 19 (90%)‡ | 31 (89%)* | |
| Experience of previous missed SAH ‘No’ | 5 (9%) | 2 (9%) | 3 (9%)* | |
| Experience of previous missed SAH ‘Yes’ | 52 (91%) | 21 (91%) | 31 (91%)* | 0.9 |
*Question omitted by one consultant.
†Participants were asked if they would accept a higher risk of missed SAH in the given scenarios: quicker, cheaper or non-invasive test.
‡Question omitted by two consultants.
LP, lumbar puncture.