Measuring Acceptability of Clinical Decision Rules: Validation of the                Ottawa Acceptability of Decision Rules Instrument (OADRI) in Four                Countries

Brehaut, Jamie; Graham, Ian D.; Wood, Timothy J.; Taljaard, Monica; Eagles, Debra; Lott, Alison; Clement, Catherine M.; Kelly, Anne‐Maree; Mason, Suzanne; Kellerman, Arthur L.; Stiell, Ian G.

doi:10.1177/0272989x09344747

Cited by 54 publications

(56 citation statements)

References 36 publications

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“…According to our findings, the number of traumatic and cardiovascular conditions in the ED could be a good reason to use rule-based decisions to reduce human error15–17 where such rules are available for these patients 31. Regardless, the benefits of event-driven decision making in symptomatic treatment, and the number of event-driven decisions in the study, shows that the urgency of patients may make doctors attempt to stabilise patients before diagnosis 24 25.…”

Section: Discussionmentioning

confidence: 82%

How do Iranian emergency doctors decide? Clinical decision making processes in practice

Ghafouri

Shokraneh²,

Saidi³

et al. 2011

Emerg Med J

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Section: Discussionmentioning

confidence: 82%

How do Iranian emergency doctors decide? Clinical decision making processes in practice

Ghafouri

Shokraneh²,

Saidi³

et al. 2011

Emerg Med J

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“…40 Our survey-based results reflect attitudes and self-reported behaviors rather than actual behaviors. 41,42 The results of our survey may have been biased by the nature and focus of its introduction and by its questions toward favorable reporting regarding attitudes toward ED CVC.…”

Section: Limitationsmentioning

confidence: 84%

Emergency Physician Perspectives on Central Venous Catheterization in the Emergency Department: A Survey‐based Study

Ballard

Reed

Rauchwerger

et al. 2014

Academic Emergency Medicine

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Objectives: The objective was to assess clinician experience, training, and attitudes toward central venous catheterization (CVC) in adult emergency department (ED) patients in a health system promoting increased utilization of CVC for severely septic ED patients. Methods:The authors surveyed all emergency physicians (EPs) within a 21-hospital integrated health care delivery system that had recently instituted a modified Rivers protocol for providing early goaldirected therapy (EGDT) to patients with severe sepsis or septic shock, including CVC if indicated. This initiative was accompanied by a structured, but optional, systemwide hands-on training for EPs in realtime ultrasound-guided CVC (US CVC). EPs' responses to questions regarding self-reported experience with CVC in the ED are reported. Data included frequency of CVC (by type) and US CVC training opportunities: both during and after residency and informal ("on-the-job training involving actual ED patients under the oversight of someone more experienced than yourself") and formal ("off-the-job training not involving actual ED patients"). The survey also asked respondents to report their comfort levels with different types of CVC as well as their agreement with possible barriers (philosophical, timerelated, equipment-related, and complication-related) to CVC in the ED. Multivariable ordinal logistic regression was used to identify provider characteristics and responses associated with higher yearly CVC volumes. Results:The survey response rate among eligible participants was 365 of 465 (78%). Overall, 154 of 365 (42%) respondents reported performing 11 or more CVCs a year, while 46 of 365 (13%) reported doing two or fewer. Concerning CVC techniques, 271 of 358 (76%) of respondents reported being comfortable with the internal jugular approach with US guidance, compared to 200 of 345 (58%) with the subclavian approach without US. Training rates were reported as 1) in residency, formal 167 of 358 (47%) and informal 189 of 364 (52%); and 2) postresidency, formal 236 of 359 (66%) and informal 260 of 365 (71%). The most commonly self-reported barriers to CVC were procedural time (56%) and complication risk (61%). After multivariate adjustment, the following were significantly associated with greater selfreported CVC use (p < 0.01): 1) informal bedside CVC training after residency, 2) male sex, 3) disagreement with complication-related barrier questions, and 4) self-reported comfort with placing USguided internal jugular catheters. Conclusions:In this cross-sectional survey-based study, EPs reported varying experience with CVC in the ED and reported high comfort with the US CVC technique. Postresidency informal training experience, male sex, negative responses to complication-related barrier questions, and comfort with placing US-guided internal jugular catheters were associated with yearly CVC volume. These results suggest that higher rates of CVC in eligible patients might be achieved by informal training programs in From The Permanente

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“…Modified version of the Ottawa Acceptability of Decision Rules Instrument (OADRI)97: This 12-item questionnaire assesses the acceptability of clinical decision rules by physicians. The questionnaire has good internal consistency (0.80–0.86) and good construct validity 97.…”

Section: Methods and Analysismentioning

confidence: 99%

“…The questionnaire has good internal consistency (0.80–0.86) and good construct validity 97. Ten items will be used in the present study as some information will not be available to ED physicians at the time of assessment.…”

Section: Methods and Analysismentioning

confidence: 99%

A prospective cohort study to refine and validate thePanic Screening Scorefor identifying panic attacks associated with unexplained chest pain in the emergency department

et al. 2013

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IntroductionPanic-like anxiety (panic attacks with or without panic disorder), a highly treatable condition, is the most prevalent condition associated with unexplained chest pain in the emergency department. Panic-like anxiety may be responsible for a significant portion of the negative consequences of unexplained chest pain, such as functional limitations and chronicity. However, more than 92% of panic-like anxiety cases remain undiagnosed at the time of discharge from the emergency department. The 4-item Panic Screening Score (PSS) questionnaire was derived in order to increase the identification of panic-like anxiety in emergency department patients with unexplained chest pain.Methods and analysisThe goals of this prospective cohort study were to (1) refine the PSS; (2) validate the revised version of the PSS; (3) measure the reliability of the revised version of the PSS and (4) assess the acceptability of the instrument among emergency physicians. Eligible and consenting patients will be administered the PSS in a large emergency department. Patients will be contacted by phone for administration of the criterion standard for panic attacks as well as by a standardised interview to collect information for other predictors of panic attacks. Multivariate analysis will be used to refine the PSS. The new version will be prospectively validated in an independent sample and inter-rater agreement will be assessed in 10% of cases. The screening instrument acceptability will be assessed with the Ottawa Acceptability of Decision Rules Instrument.Ethics and disseminationThis study protocol has been reviewed and approved by the Alphonse-Desjardins research ethics committee. The results of the study will be presented in scientific conferences and published in peer-reviewed scientific journals. Further dissemination via workshops and a dedicated website is planned.

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Measuring Acceptability of Clinical Decision Rules: Validation of the Ottawa Acceptability of Decision Rules Instrument (OADRI) in Four Countries

Cited by 54 publications

References 36 publications

How do Iranian emergency doctors decide? Clinical decision making processes in practice

How do Iranian emergency doctors decide? Clinical decision making processes in practice

Emergency Physician Perspectives on Central Venous Catheterization in the Emergency Department: A Survey‐based Study

A prospective cohort study to refine and validate thePanic Screening Scorefor identifying panic attacks associated with unexplained chest pain in the emergency department

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