Will a new clinical decision rule be widely used? The case of the Canadian C-spine rule

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Jamie BrehautIan D Graham

Abstract

The reasons why some clinical decision rules (CDRs) become widely used and others do not are not well understood. The authors wanted to know the following: 1) To what extent is widespread use of a new, relatively complex CDR an attainable goal? 2) How do physician perceptions of the new CDR compare with those of a widely used rule? 3) To what extent do physician subgroups differ in likelihood to use a new rule? A survey of 399 Canadian emergency physicians was conducted using Dillman's Tailored Design Method for postal surveys. The physicians were queried regarding the Canadian Cervical-Spine Rule (C-Spine Rule). Results were analyzed via frequency distributions, tests of association, and logistic regression. Response rate was 69.2% (262/376). Most respondents (83.6%) reported having already seen the Canadian C-Spine Rule, while 63.0% reported already using it. Of those who did not currently use the rule, 74.2% reported that they would consider using it in the future despite the fact that, compared with another widely used rule (the Ottawa Ankle Rules), the C-Spine Rule was rated as less easy to learn (z = 6.68, p < 0.001), remember (z = 7.37, p < 0.001), and use (z = 5.90, p < 0.001). Those who had never seen the rule before w...Continue Reading

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Sep 25, 2008·Pediatric Radiology·Joshua Seth Broder
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