Physician Judgment
Conditions
Keywords
Judgment, risk assessment, clinical deterioration, cardiac arrest, Rothman Index
Brief summary
The purpose of the study is to compare the ability of physicians and a statistical index (the Rothman score) to predict clinical deterioration over the next 24 hours. Clinical deterioration is defined as concern in change in vital signs or patient status requiring a call to the rapid response team, cardiopulmonary arrest, or transfer to the ICU.
Detailed description
The proposed study will ask interns, residents, and attending physicians from general internal medicine teaching teams in a large teaching hospital to make predictions about the probability of their patient having a clinical deterioration in the next 24 hours. The investigators will compare these judgments to the Rothman index.
Interventions
OTHERClinical deterioration
Patients at risk of clinical deterioration
Sponsors
Carnegie Mellon University
University of Pittsburgh
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Interns, residents, attendings in the Department of Medicine, Division of General Internal Medicine, University of Pittsburgh. * Rotating on the general medical service at the University of Pittsburgh Medical Center - Presbyterian Hospital.
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Difference between physician prediction of risk of clinical deterioration and Rothman Index | Six months | Physicians will make judgments about the probability of clinical deterioration for each of their patients on a 0 (definitely won't) to 100 (certainly will) scale. Clinical deterioration is defined as rapid response, cardiopulmonary arrest, or ICU transfer in the next 24 hours. The Rothman Index is an index that predicts clinical deterioration. The area under the receiver operating curve (AUROC) will be calculated for physicians and the Rothman Index. The AUROC measures the association between the physician's judgment or Rothman Index and actual clinical deterioration. The AUROC of these two measures will then be statistically compared. |
Countries
United States
Outcome results
None listed