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Search All Research Studies
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- Blood Clots (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 7 of 7 Research Studies DisplayedSchoenfeld EM, Poronsky KE, Westafer LM
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Both ultrasound and CT scan can be used for diagnosis of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone), but the majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. The investigators developed a decision aid to facilitate SDM in this scenario. The objective of this study was to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Poronsky KE, Westafer LM .
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Trials 2021 Mar 10;22(1):201. doi: 10.1186/s13063-021-05140-9..
Keywords: Emergency Department, Shared Decision Making, Kidney Disease and Health, Imaging, Diagnostic Safety and Quality
Schoenfeld EM, Houghton C, Patel PM
Shared decision making in patients with suspected uncomplicated ureterolithiasis: a decision aid development study.
The objective of this study was to develop a decision aid (DA) to facilitate shared decision making (SDM) around whether to obtain computed tomography (CT) imaging in patients presenting to the emergency department (ED) with suspected uncomplicated ureterolithiasis. Using stakeholder engagement and qualitative inquiry, the investigators developed their evidence-based DA. They indicated that future research will test the efficacy of the DA in facilitating SDM.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Houghton C, Patel PM .
Shared decision making in patients with suspected uncomplicated ureterolithiasis: a decision aid development study.
Acad Emerg Med 2020 Jul;27(7):554-65. doi: 10.1111/acem.13917..
Keywords: Shared Decision Making, Emergency Department, Imaging, Diagnostic Safety and Quality
Carayon P, Hoonakker P, Hundt AS
Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.
This study used a scenario-based simulation to compare a human factor (HF)-based clinician decision support (CDS) with a web-based CDS (MDCalc) for clinicians to diagnose pulmonary embolism (PE) in the emergency department. A total of 32 emergency physicians participated using both CDS types. Emergency physicians made more appropriate diagnoses decisions with the PE-Dx CDS (94%) than with the web-based CDS (84%). Experimental tasks were also performed faster (average 96 seconds per scenario versus 117 seconds). They also reported lower workload and higher satisfaction with the HF-based CDS.
AHRQ-funded; HS024342; HS024558; HS022086.
Citation: Carayon P, Hoonakker P, Hundt AS .
Application of human factors to improve usability of clinical decision support for diagnostic decision-making: a scenario-based simulation study.
BMJ Qual Saf 2020 Apr;29(4):329-40. doi: 10.1136/bmjqs-2019-009857..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Diagnostic Safety and Quality, Emergency Department
Dugas AF, Hsieh YH, LoVecchio F
Derivation and validation of a clinical decision guideline for influenza testing in 4 US emergency departments.
This study looked at which patients should be tested for influenza among adult emergency department (ED) patients with fever or respiratory symptoms who met criteria for antiviral treatment per 2013 CDC guidelines. A prospective cohort study was conducted at 4 US EDs from November 2013 to April 2014. All 1941 enrolled participants were tested for influenza using polymerase chain reaction (PCR), and 183 patients (9.4%) had influenza. The CDC clinical decision guidelines (CDGs) for influenza testing includes new or increased cough (2 points), headache (1 point), subjective fever (1 point), and triage temperature >100.4F degrees. The CDG had a sensitivity and specificity of 94.1% and 36.6% respectively in the derivation set and the validation set.
AHRQ-funded; HS009699.
Citation: Dugas AF, Hsieh YH, LoVecchio F .
Derivation and validation of a clinical decision guideline for influenza testing in 4 US emergency departments.
Clin Infect Dis 2020 Jan;70(1):49-58. doi: 10.1093/cid/ciz171..
Keywords: Guidelines, Shared Decision Making, Influenza, Respiratory Conditions, Emergency Department, Evidence-Based Practice, Diagnostic Safety and Quality
Hoonakker PLT, Carayon P, Salwei ME
The design of PE Dx, a CDS to support pulmonary embolism diagnosis in the ED.
One possible explanation for user resistance to clinical decision support (CDS) procedures may be poor CDS design. This study describes the design of PE Dx, a CDS built to aid in the diagnosis of pulmonary embolism in the emergency department using human factors methods.
AHRQ-funded; HS022086.
Citation: Hoonakker PLT, Carayon P, Salwei ME .
The design of PE Dx, a CDS to support pulmonary embolism diagnosis in the ED.
Stud Health Technol Inform 2019 Aug 9;265:134-40. doi: 10.3233/shti190152..
Keywords: Blood Clots, Clinical Decision Support (CDS), Shared Decision Making, Diagnostic Safety and Quality, Emergency Department, Respiratory Conditions
Aronson PL, Schaeffer P, Fraenkel L
Physicians' and nurses' perspectives on the decision to perform lumbar punctures on febrile infants </=8 weeks old.
This paper discusses the reasons for wide variation in the decision to perform lumbar punctures (LPs) in febrile infants 8 weeks or less. Semi-structured interviews were conducted with 15 pediatric and general emergency medicine physicians and 8 pediatric emergency medicine nurses at an urban, academic medical center. Five themes emerged from the interviews that included: age of the infant, the physician’s clinical experience, physician’s use of research findings, the physician’s values, and the role of the primary care pediatrician.
AHRQ-funded; HS026006.
Citation: Aronson PL, Schaeffer P, Fraenkel L .
Physicians' and nurses' perspectives on the decision to perform lumbar punctures on febrile infants </=8 weeks old.
Hosp Pediatr 2019 Jun;9(6):405-14. doi: 10.1542/hpeds.2019-0002..
Keywords: Newborns/Infants, Shared Decision Making, Provider: Physician, Provider: Nurse, Provider: Clinician, Provider, Emergency Department, Diagnostic Safety and Quality
Medford-Davis LN, Singh H, Mahajan P
Diagnostic decision-making in the emergency department.
Emergency providers must often diagnose from undifferentiated symptoms, without previous knowledge of the patient. Failure to provide an accurate assessment of the problem or to communicate the problem to the patient is diagnostic error. This article considers methods to monitor diagnostic error in emergency departments.
AHRQ-funded; HS024953.
Citation: Medford-Davis LN, Singh H, Mahajan P .
Diagnostic decision-making in the emergency department.
Pediatr Clin North Am 2018 Dec;65(6):1097-105. doi: 10.1016/j.pcl.2018.07.003..
Keywords: Emergency Department, Diagnostic Safety and Quality, Shared Decision Making, Medical Errors, Patient Safety