What difference do two days make? The inertia of physicians' sequential prognostic judgments for critically ill patients
| Autor: | Fiore J. Copare, William E. Scott, Carolyn Bekes, Roy M. Poses |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
medicine.medical_specialty
Time Factors Critical Care Population Teaching hospital 03 medical and health sciences House officer Judgment 0302 clinical medicine Intensive care Physicians medicine Hospital discharge Humans 030212 general & internal medicine Prospective Studies education education.field_of_study Likelihood Functions business.industry Critically ill 030503 health policy & services Health Policy Clinical course Reproducibility of Results Prognosis Survival Analysis ROC Curve Emergency medicine Cohort Linear Models 0305 other medical science business |
| Zdroj: | Medical decision making : an international journal of the Society for Medical Decision Making. 10(1) |
| ISSN: | 0272-989X |
| Popis: | Medical authorities have asserted the importance of observing a patient's clinical course over time. Distinguished committees have suggested that changes over time in physicians' prognostic estimates should influence decisions to transfer patients out of intensive care units (ICUs). This study evaluated how the opportunity to observe patients over time affected physicians' prognostic estimates for a cohort of 269 critically ill patients sequentially admitted to a medical-surgical ICU in a teaching hospital. As soon as possible after admission and again 48 hours later, the authors obtained a quantitative estimate of the probability of survival through hospital discharge from each patient's house officer and primary attending physician, and the critical care attending physician on duty. They independently determined each patient's survival. From this population they analyzed 181 pairs of judgments made by the same house officers, 211 pairs by the same primary attendings, and 172 pairs by the same critical care attendings. The physicians' 48-hour estimates were little changed from their previous estimates for the same patients. The correlation coefficient for the house officers' paired estimates was 0.84 (p |
| Databáze: | OpenAIRE |
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