Evidence map›Paper›PMID 37129072›Full record

ArticlePrimary health care research & development2023

Clinical decision rules in primary care: necessary investments for sustainable healthcare.

Jorn S Heerink, Ruud Oudega, Rogier Hopstaken, Hendrik Koffijberg, Ron Kusters

Abstract read
In one paragraph

Article in Primary health care research & development, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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. Article
  2. Review
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  4. Review
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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

5 authors.

Jorn S HeerinkDepartment of Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.ORCID 0000-0002-3802-4302
Ruud OudegaDepartment of Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Rogier HopstakenStar-shl Diagnostic Centres, Etten-Leur, the Netherlands.ORCID 0000-0002-8357-5197
Hendrik KoffijbergDepartment of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands.ORCID 0000-0002-1753-0652
Ron KustersDepartment of Clinical Chemistry and Haematology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.ORCID 0000-0003-1279-5448

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Clinical judgement in primary care is more often decisive than in the hospital. Clinical decision rules (CDRs) can help general practitioners facilitating the work-through of differentials that follows an initial suspicion, resulting in a concrete 'course of action': a 'rule-out' without further testing, a need for further testing, or a specific treatment. However, in daily primary care, the use of CDRs is limited to only a few isolated rules. In this paper, we aimed to provide insight into the laborious path required to implement a viable CDR. At the same time, we noted that the limited use of CDRs in primary care cannot be explained by implementation barriers alone. Through the case study of the Oudega rule for the exclusion of deep vein thrombosis, we concluded that primary care CDRs come out best if they are tailor-made, taking into consideration the specific context of primary health care. Current CDRs should be evaluated frequently, and future decision rules should anticipate the latest developments such as the use of point-of-care (POC) tests. Hence, such new powerful diagnostic CDRs could improve and expand the possibilities for patient-oriented primary care.

Indexed as

Clinical Decision RulesDecision Support TechniquesDelivery of Health CareHealth FacilitiesHumansPrimary Health Careclinical decision ruleD-dimerdeep vein thrombosisOudega rulepoint-of-carewells rule

Identifiers

PMID37129072
PMCPMC10156469

What OpenQuestion holds

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Registered trials

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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.