The Visualization of Uncertainty in Clinical Diagnostic Reasoning for Pulmonary Embolism

Not Applicable

Completed

• Conditions: Pulmonary Embolism; Diagnostic Uncertainty; Clinical Reasoning; Evidence Based Medicine; Visualization of Uncertainty
• Interventions: Other: Visualized pulmonary embolism computer task model; Other: Didactic review lecture

• Registration Number: NCT01752673
• Lead Sponsor: University of Calgary

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2011-03
• Primary Completion: 2011-10
• Study Completion: 2011-10
• Status Verified: 2012-12
• Study First Submitted: 2012-12-12
• Study First Submitted QC: 2012-12-14
• Last Update Submitted: 2012-12-14
• Study First Posted: 2012-12-19
• Last Update Posted: 2012-12-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 30

Inclusion Criteria

• 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.

Exclusion Criteria

• Physicians in the subspecialty of Haematology or Respiratory

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Visualized pulmonary embolism computer task model	Visualized pulmonary embolism computer task model	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.
Didactic review pulmonary embolism lecture	Didactic review lecture	This group of participants was presented with a didactic lecture covering the diagnostic approach of pulmonary embolism.

Primary Outcome Measures

Name	Time	Method
Concordance with medical diagnostic reasoning pathway for pulmonary embolism.	Paper-based clinical case scenarios were completed within 2 hour after either intervention.	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.

Secondary Outcome Measures

Name	Time	Method
Time.	Paper-based clinical case scenarios were completed within 2 hour after either intervention.	The overall time taken to solve each clinical scenario may give insight to which decision making process was predominant to solve each clinical scenario.

Trial Locations

Locations (1)

University of Calgary; 🇨🇦 Calgary, Alberta, Canada