Measuring acceptability of clinical decision rules: validation of the Ottawa acceptability of decision rules instrument (OADRI) in four countries
| Autor: | Arthur L. Kellerman, Suzanne Mason, Alison Lott, Anne-Maree Kelly, Debra Eagles, Catherine M. Clement, Ian D. Graham, Monica Taljaard, Jamie C. Brehaut, Ian G. Stiell, Timothy J. Wood |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Decision support system
Canada Emergency Medical Services Target audience Context (language use) Health informatics Sensitivity and Specificity Decision Support Techniques Emergency medical services Medicine Craniocerebral Trauma Humans Operations management Statistical hypothesis testing Actuarial science Australasia business.industry Health Policy Construct validity Decision rule Decision Support Systems Clinical United Kingdom United States Spinal Injuries Brain Injuries Cervical Vertebrae Emergency Medicine Diffusion of Innovation business Tomography X-Ray Computed |
| Zdroj: | Medical decision making : an international journal of the Society for Medical Decision Making. 30(3) |
| ISSN: | 1552-681X |
| Popis: | Background. Clinical decision rules can benefit clinicians, patients, and health systems, but they involve considerable up-front development costs and must be acceptable to the target audience. No existing instrument measures the acceptability of a rule. The current study validated such an instrument. Methods. The authors administered the Ottawa Acceptability of Decision Rules Instrument (OADRI) via postal survey to emergency physicians from 4 regions (Australasia, Canada, United Kingdom, and United States), in the context of 2 recently developed rules, the Canadian C-Spine Rule (C-Spine) and the Canadian CT Head Rule (CT-Head). Construct validity of the 12-item instrument was evaluated by hypothesis testing. Results. As predicted by a priori hypotheses, OADRI scores were 1) higher among rule users than nonusers, 2) higher among those using the rule ‘‘all of the time’’ v. ‘‘most of the time’’ v. ‘‘some of the time,’’ and 3) higher among rule nonusers who would consider using a rule v. those who would not. We also examined explicit reasons given by respondents who said they would not use these rules. Items in the OADRI accounted for 85.5% (C- Spine) and 90.2% (CT-Head) of the reasons given for not considering a rule acceptable. Conclusions. The OADRI is a simple, 12-item instrument that evaluates rule acceptability among clinicians. Potential uses include comparing multiple ‘‘protorules’’ during development, examining acceptability of a rule to a new audience prior to implementation, indicating barriers to rule use addressable by knowledge translation interventions, and potentially serving as a proxy measure for future rule use. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|