Evidence map›Paper›PMID 36178728›Full record

ArticleJMIR human factors2022

Electronic Diagnostic Support in Emergency Physician Triage: Qualitative Study With Thematic Analysis of Interviews.

Matthew Sibbald, Bashayer Abdulla, Amy Keuhl, Geoffrey Norman, Sandra Monteiro, Jonathan Sherbino

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JMIR human factors, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Matthew Sibbald *McMaster Education Research, Innovation & Theory (MERIT) Program, Department of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0002-0022-2370
Bashayer Abdulla *McMaster Education Research, Innovation & Theory (MERIT) Program, Department of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0003-3833-6709
Amy Keuhl *McMaster Education Research, Innovation & Theory (MERIT) Program, Department of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-6039-9453
Geoffrey Norman *McMaster Education Research, Innovation & Theory (MERIT) Program, Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0003-1053-7998
Sandra Monteiro *McMaster Education Research, Innovation & Theory (MERIT) Program, Department of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0001-8723-5942
Jonathan Sherbino *McMaster Education Research, Innovation & Theory (MERIT) Program, Department of Medicine, McMaster University, Hamilton, ON, Canada.ORCID https://orcid.org/0000-0003-0344-8057
McMaster University · CAImpact · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNot thinking of a diagnosis is a leading cause of diagnostic error in the emergency department, resulting in delayed treatment, morbidity, and excess mortality. Electronic differential diagnostic support (EDS) results in small but significant reductions in diagnostic error. However, the uptake of EDS by clinicians is limited.

objectiveWe sought to understand physician perceptions and barriers to the uptake of EDS within the emergency department triage process.

methodsWe conducted a qualitative study using a research associate to rapidly prototype an embedded EDS into the emergency department triage process. Physicians involved in the triage assessment of a busy emergency department were provided the output of an EDS based on the triage complaint by an embedded researcher to simulate an automated system that would draw from the electronic medical record. Physicians were interviewed immediately after their experience. Verbatim transcripts were analyzed by a team using open and axial coding, informed by direct content analysis.

resultsIn all, 4 themes emerged from 14 interviews: (1) the quality of the EDS was inferred from the scope and prioritization of the diagnoses present in the EDS differential; (2) the trust of the EDS was linked to varied beliefs around the diagnostic process and potential for bias; (3) clinicians foresaw more benefit to EDS use for colleagues and trainees rather than themselves; and (4) clinicians felt strongly that EDS output should not be included in the patient record.

conclusionsThe adoption of an EDS into an emergency department triage process will require a system that provides diagnostic suggestions appropriate for the scope and context of the emergency department triage process, transparency of system design, and affordances for clinician beliefs about the diagnostic process and addresses clinician concern around including EDS output in the patient record.

Indexed as

adoptionartificial intelligenceattitudeautomationclinical reasoningdiagnosisdiagnosticdiagnostic errorelectronic differential diagnostic supportemergencyhuman factorsnatural language processingsupport systemtriage

Identifiers

PMID36178728
PMCPMC9568817
OpenAlexW4293661949

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.