Observational studyANZ journal of surgery
Looking Good From the End of Bed: Surgical Clinical Intuition.
Observational study in ANZ journal of surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Looking Good From the End of Bed: Surgical Clinical Intuition.ANZ journal of surgeryObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study sought to assess clinician ability to correctly identify unwell surgical patients from the 'end-of-bed' to determine the validity of this commonly utilised clinical tool, and whether accurate assessment increases with experience.
methodsThis prospective observational study recruited patients at the time of surgical admission. Patients were filmed responding to three standard questions concerning their presentation. Each patient video was then viewed by five participants from various groups: surgical consultants, registrars, interns, medical students and orderlies (control group). Five 'Yes/No' questions were answered for each video, regarding how unwell patients appeared and their likely clinical trajectory. Assessor answers were compared with 'correct' answers as determined by the investigators, utilising patient clinical data. For each group, the percentage of questions answered correctly was calculated across 99 patients. The mean and standard deviation for the percentage correct was calculated as well as Cohen's Kappa Score when comparing the score for each assessor group with the 'correct' answer.
resultsThe percentage of correctly answered questions was highest in the registrar group (82.21%), closely followed by consultants (82.04%), interns (80.47%), medical students (79.74%) and orderlies (79.44%) (p values < 0.001, except students' p value 0.0729). The order of Cohen's Kappa for correctly answered questions found consultants to have the highest agreement (0.26-fair agreement), followed by registrars (0.25-fair agreement) and lastly medical students (0.14-slight agreement) (p values < 0.001).
conclusionThe 'end-of-bed' assessment is a potential initial tool for assessing disease severity and clinical trajectory of surgical patients and improves with clinician experience.
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Registered trials
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