scholarly journals Assessment of clinical judgment accuracy provided by emergency physicians in comparison with Peak Flowmetry in the severity and discharge criteria of patients with asthma attack

2019 ◽  
Vol 6 (10) ◽  
pp. 3405-3411
Author(s):  
Mohammad Davood Sharifi ◽  
Hamideh Feiz Disfani ◽  
Hamid Reza Rahmatzadeh
2007 ◽  
Vol 37 (3) ◽  
pp. 400-409 ◽  
Author(s):  
Charles R. Ridley ◽  
Mary Shaw-Ridley

Clinical judgment is foundational to psychological practice. Accurate judgment forms the basis for establishing reasonable goals and selecting appropriate treatments, which in turn are essential in achieving positive therapeutic outcomes. Therefore, Spengler and colleagues' meta-analytic finding—clinical judgment accuracy improves marginally with traditional education, training, and clinical experience—is disconcerting and should serve as a wake-up call. Now is the time to move with urgency. The authors urge the development of a comprehensive, standardized, and scientifically based metatheory to inform clinical judgment. A metatheory should describe the content of clinical judgment, the process of clinical judgment, and the self-reflection of clinicians. Without employment of such a metatheory and concomitant improvement in clinicians' judgment, professional psychologists are on soft footing in extolling their claim as scientist—practitioners and ethical professionals.


2007 ◽  
Author(s):  
Paul M. Spengler ◽  
Michael J. White ◽  
Stefania Aegisdottir

2001 ◽  
Vol 10 (5) ◽  
pp. 313-319 ◽  
Author(s):  
L Copeland-Fields ◽  
T Griffin ◽  
T Jenkins ◽  
M Buckley ◽  
LC Wise

BACKGROUND: Critical care nurses must collaborate with physicians, patients, and patients' families when making decisions about aggressiveness of care. However, few studies address nurses' ability to predict outcomes. OBJECTIVES: To compare predictions of survival outcomes made by nurses, by physicians, and by using the Mortality Prediction Model. METHODS: Predictions of survival and function and attitudes toward aggressiveness of care based on the predictions were recorded on questionnaires in the emergency department by emergency and intensive care unit physicians and by intensive care unit nurses at the time of admission to the unit between February and September 1995 for 235 consecutive adult nontrauma patients. Scores on the Mortality Prediction Model were calculated on admission. Data on 85 of the 235 patients were analyzed by using descriptive, chi 2, and correlational statistics. Nurses' predictions of function were compared with patients' actual outcomes 6 months after admission. RESULTS: Nurses' predictions of survival were comparable to those of emergency physicians and superior to those obtained by using the objective tool. Years of nursing experience had no relationship to attitudes toward aggressiveness of care. Nurses accurately predicted functional outcomes in 52% of the followed-up cases. Intensive care physicians were more accurate than nurses and emergency physicians in predicting survival. All predictions made by clinicians were superior to those obtained by using the model. CONCLUSIONS: Nurses can predict survival outcomes as accurately as physicians do. Greater sensitivity and specificity are necessary before clinical judgment or predictive tools can be considered as screens for determining aggressiveness of care.


2021 ◽  
Vol 40 (3) ◽  
pp. 100836
Author(s):  
Louis Delamarre ◽  
Mohamed Srairi ◽  
Lionel Bouvet ◽  
Jean-Marie Conil ◽  
Olivier Fourcade ◽  
...  

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Zeynep Karakaya ◽  
Şerafettin Demir ◽  
Sönmez Serkan Sagay ◽  
Olcay Karakaya ◽  
Serife Özdinç

Simultaneous bilateral spontaneous pneumothorax (SBSP) and pneumomediastinum are complications rarely observed synchronously during an acute asthma attack. It is a clinical condition that manifests itself with serious respiratory distress and must be rapidly diagnosed and treated. Although bilateral spontaneous pneumothorax has already been reported in asthma patients in the literature, its concurrence with subcutaneous emphysema and pneumomediastinum is extremely rare except for iatrogenic conditions. By sharing this case about a 39-year-old patient who presented to the emergency room with severe respiratory distress and developed cardiopulmonary arrest during his physical examination, our aim is to emphasize that a rapid diagnosis and treatment by the emergency physicians is the only way for survival in these patients.


2007 ◽  
Vol 37 (3) ◽  
pp. 350-399 ◽  
Author(s):  
Paul M. Spengler ◽  
Michael J. White ◽  
Stefanía Ægisdóttir ◽  
Alan S. Maugherman ◽  
Linda A. Anderson ◽  
...  

Clinical and educational experience is one of the most commonly studied variables in clinical judgment research. Contrary to clinicians' perceptions, clinical judgment researchers have generally concluded that accuracy does not improve with increased education, training, or clinical experience. In this meta-analysis, the authors synthesized results from 75 clinical judgment studies where the experience of 4,607 clinicians was assessed in relation to the accuracy of their judgments about mental health (e.g., diagnosis, prognosis, treatment) and psychological issues (e.g., vocational, personality). The authors found a small but reliable effect, d = .12, showing that experience, whether educational or clinical, is positively associated with judgment accuracy. This small effect was robust across several tested moderator models, indicating experienced counselors and clinicians acquire, in general, almost a 13% increase in their decision-making accuracy, regardless of other factors. Results are discussed in light of their implications for clinical judgment research and for counseling psychology training and practice.


2019 ◽  
Vol 8 (4) ◽  
pp. 207
Author(s):  
Alireza Baratloo ◽  
Shahram Bagheri-Hariri ◽  
Maryam Bahreini ◽  
Pezhman Farshidmehr ◽  
Somayeh Barazandeh ◽  
...  

1977 ◽  
Vol 20 (2) ◽  
pp. 319-324
Author(s):  
Anita F. Johnson ◽  
Ralph L. Shelton ◽  
William B. Arndt ◽  
Montie L. Furr

This study was concerned with the correspondence between the classification of measures by clinical judgment and by factor analysis. Forty-six measures were selected to assess language, auditory processing, reading-spelling, maxillofacial structure, articulation, and other processes. These were applied to 98 misarticulating eight- and nine-year-old children. Factors derived from the analysis corresponded well with categories the measures were selected to represent.


2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.


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