The Visualization of Uncertainty in Clinical Diagnostic Reasoning for Pulmonary Embolism

NCT01752673 | Completed

• 1 other identifier: 23231
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Medical reasoning is a form of inquiry that examines the thought processes involved in making medical decisions. When physicians are faced with patients' symptoms or signs, their thought processes follow either direct shortcuts to suspect a diagnosis or go into a deeper and more analytic process to reach a diagnosis. The second pathway is less prone to biases and errors. This study explores whether the use of an interactive visual display of probabilities of pulmonary embolism generated from positive or negative test results will increase the adherence to evidence based guidelines in the diagnosis of pulmonary embolism.

Conditions

Pulmonary Embolism; Diagnostic Uncertainty; Clinical Reasoning; Evidence Based Medicine; Visualization of Uncertainty

Keywords

randomized controlled study

Outcome Measures

Primary Outcomes (1)

• Concordance with medical diagnostic reasoning pathway for pulmonary embolism.

  Concordance with medical diagnostic reasoning pathway for a case presentation suggestive of pulmonary embolism will be reflected by whether participants are stopping prematurely or proceeding with diagnostic steps inappropriately.

  Paper-based clinical case scenarios were completed within 2 hour after either intervention.

Secondary Outcomes (1)

• Time.

  Paper-based clinical case scenarios were completed within 2 hour after either intervention.

Other Outcomes (1)

• Survey.

  Survey was completed within 2 hours after completion of either intervention.

Study Arms (2)

Visualized pulmonary embolism computer task model

EXPERIMENTAL

This group of participants was presented and trained to use a visual representation of diagnostic pathway for pulmonary embolism. The design of this visual representation is based on Bayes theorem and cognition enhancing visual design principles.

Other: Visualized pulmonary embolism computer task model

Didactic review pulmonary embolism lecture

ACTIVE COMPARATOR

This group of participants was presented with a didactic lecture covering the diagnostic approach of pulmonary embolism.

Other: Didactic review lecture

Interventions

Visualized pulmonary embolism computer task model OTHER

This group of participants was presented and trained to use a visual representation of diagnostic pathway for pulmonary embolism. The design of this visual representation is based on Bayes theorem and cognition enhancing visual design principles.

Visualized pulmonary embolism computer task model

Didactic review lecture OTHER

This group of participants was presented with a didactic lecture covering the diagnostic approach of pulmonary embolism.

Didactic review pulmonary embolism lecture

Eligibility Criteria

• Age: 24 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Medical students, University of Calgary, in clerkship who finished at least 4 weeks of a block of medicine rotation at any hospital site.
• First year subspecialty or Internal Medicine residents.
• Practicing physicians in the subspecialties of Internal Medicine or Emergency Medicine.

You may not qualify if:

• Physicians in the subspecialty of Haematology or Respiratory

Sponsors & Collaborators

• University of Calgary: lead

Study Sites (1)

University of Calgary

Calgary, Alberta, T2V1P9, Canada

Location

MeSH Terms

Conditions

Pulmonary Embolism

Condition Hierarchy (Ancestors)

Lung Diseases; Respiratory Tract Diseases; Embolism; Embolism and Thrombosis; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Ghazwan Altabbaa, MD MSc

  University of Calgary

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor

Study Record Dates

• First Submitted: December 12, 2012
• First Posted: December 19, 2012
• Study Start: March 1, 2011
• Primary Completion: October 1, 2011
• Study Completion: October 1, 2011
• Last Updated: December 19, 2012

Record last verified: 2012-12

Locations

CA (1)