Developing a Physiotherapy-Specific Preliminary Clinical Decision-Making Tool for Oxygen Titration: A Modified Delphi Study

Introduction For many patients, audio-visual appointments have provided a timely and efficient way of seeking advice, assessment and treatment for their hand injuries during the NHS response to COVID-19. This study aimed to explore the experience of hand units across the UK in determining the safe and judicious use of audio-visual outpatient care for the management of acute upper limb trauma. Methods An online cross-sectional survey was sent to the therapy leads of hand units across the UK. Questions focused on the experience of using audio-visual technology in the management of upper limb trauma, and the relevant factors in determining its appropriate use. A deductive mixed methods analysis was used to identify both common themes and capture community experience and characteristics. Results A total of 51 out of 76 hand therapy units completed the survey; a response rate of 67%. Of these, 82% (42/51) reported using audio-visual technology to manage upper limb trauma during the UK COVID-19 lockdown. When determining patient suitability for audio-visual consultations, 73% (37/51) of respondents reported the use of COVID-19 guidelines, but only 35% (18/51) reported the use of a clinical decision-making tool. In agreement with our experience at Salisbury Hospital Foundation Trust, 92% (47/51) had concerns relating to the use of audio-visual care. Conclusion The choice of safely managed remote care or in-person consultation has, to date, largely relied on the discretion of the clinician. A carefully designed clinical decision-making tool for the management of upper limb trauma is needed for use both in clinical practice and in future service planning.

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The pediatric intermed: A new clinical -decision making tool for proactive evaluation of psychosocial stress in children with IBD

Inflammatory Bowel Diseases ◽

10.1097/00054725-201112002-00192 ◽

2011 ◽

Vol 17 ◽

pp. S60

Author(s):

Janice Cohen ◽

David Mack ◽

John Lyons ◽

Eric Benchimol

Keyword(s):

Decision Making ◽

Psychosocial Stress ◽

Clinical Decision Making ◽

Clinical Decision ◽

Decision Making Tool

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Prediction of Intravesical Recurrence After Radical Nephroureterectomy: Development of a Clinical Decision-making Tool

European Urology ◽

10.1016/j.eururo.2013.09.003 ◽

2014 ◽

Vol 65 (3) ◽

pp. 650-658 ◽

Cited By ~ 71

Author(s):

Evanguelos Xylinas ◽

Luis Kluth ◽

Niccolo Passoni ◽

Quoc-Dien Trinh ◽

Malte Rieken ◽

...

Keyword(s):

Decision Making ◽

Clinical Decision Making ◽

Clinical Decision ◽

Radical Nephroureterectomy ◽

Decision Making Tool

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Operationalization of the learned non-use phenomenon - A Delphi study

10.1101/2020.03.18.20037374 ◽

2020 ◽

Author(s):

Theresa Hirsch ◽

Maria Barthel ◽

Pauline Aarts ◽

Yi-An Chen ◽

Susanna Freivogel ◽

...

Keyword(s):

Decision Making ◽

Clinical Practice ◽

Delphi Study ◽

Clinical Decision Making ◽

Negative Reinforcement ◽

Brain Lesion ◽

Clinical Decision ◽

Diagnostic Process ◽

Sources Of Information ◽

Wide Range

AbstractThe discrepancy between residual functional capacity and reduced use of the contralesional hand, frequently observed after a brain lesion, has been termed Learned Non-Use (LNU) and is thought to depend on the interaction of neuronal mechanisms during recovery and learning-dependent mechanisms such as negative reinforcement. Despite the generally accepted existence of the LNU phenomenon among clinicians and researchers, no unequivocal and transdisciplinary definition exists to date. Furthermore, although therapeutic approaches are implemented in clinical practice to explicitly target LNU, no standardized diagnostic routine is described in the current literature.Based on a structured group communication following the Delphi method among clinical and scientific experts in the field of LNU, knowledge from both, the work with patient populations and with animal models, was synthesized and integrated to reach consensus regarding a transdisciplinary definition of the LNU phenomenon. Furthermore, the mode and strategy of the diagnostic process, as well as the sources of information and outcome parameters relevant for the clinical decision making, were described with a wide range showing the current lack of a consistent universal diagnostic approach. Building on these results, the need for the development of a structured diagnostic procedure and its implementation into clinical practice is emphasized. Moreover, it exists a striking gap between the prevailing hypotheses regarding the mechanisms underlying the LNU phenomenon and the actual evidence. Therefore, basic research is needed to bridge between bedside and bench and eventually improve clinical decision making and further development of interventional strategies beyond the field of stroke rehabilitation.

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Consensus for a primary care clinical decision-making tool for assessing, diagnosing, and managing shoulder pain in Alberta, Canada

BMC Family Practice ◽

10.1186/s12875-021-01544-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Breda H. F. Eubank ◽

Sebastian W. Lackey ◽

Mel Slomp ◽

Jason R. Werle ◽

Colleen Kuntze ◽

...

Keyword(s):

Primary Care ◽

Decision Making ◽

Shoulder Pain ◽

Clinical Decision Making ◽

Clinical Decision ◽

Primary Care Providers ◽

Rapid Review ◽

Diagnosis And Management ◽

Joint Health ◽

Decision Making Tool

Abstract Background Shoulder pain is a highly prevalent condition and a significant cause of morbidity and functional disability. Current data suggests that many patients presenting with shoulder pain at the primary care level are not receiving high quality care. Primary care decision-making is complex and has the potential to influence the quality of care provided and patient outcomes. The aim of this study was to develop a clinical decision-making tool that standardizes care and minimizes uncertainty in assessment, diagnosis, and management. Methods First a rapid review was conducted to identify existing tools and evidence that could support a comprehensive clinical decision-making tool for shoulder pain. Secondly, provincial consensus was established for the assessment, diagnosis, and management of patients presenting to primary care with shoulder pain in Alberta, Canada using a three-step modified Delphi approach. This project was a highly collaborative effort between Alberta Health Services’ Bone and Joint Health Strategic Clinical Network (BJH SCN) and the Alberta Bone and Joint Health Institute (ABJHI). Results A clinical decision-making tool for shoulder pain was developed and reached consensus by a province-wide expert panel representing various health disciplines and geographical regions. This tool consists of a clinical examination algorithm for assessing, diagnosis, and managing shoulder pain; recommendations for history-taking and identification of red flags or additional concerns; recommendations for physical examination and neurological screening; recommendations for the differential diagnosis; and care pathways for managing patients presenting with rotator cuff disease, biceps pathology, superior labral tear, adhesive capsulitis, osteoarthritis, and instability. Conclusions This clinical decision-making tool will help to standardize care, provide guidance on the diagnosis and management of shoulder pain, and assist in clinical decision-making for primary care providers in both public and private sectors.

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Prediction of progression to MIBC for pT1 bladder cancer: Development of a clinical decision-making tool

European Urology Supplements ◽

10.1016/s1569-9056(17)32074-2 ◽

2017 ◽

Vol 16 (11) ◽

pp. e2937

Author(s):

M. Abufaraj ◽

D. D’Andrea ◽

R. Ristl ◽

B. Foerster ◽

C. Seitz ◽

...

Keyword(s):

Decision Making ◽

Bladder Cancer ◽

Clinical Decision Making ◽

Clinical Decision ◽

Cancer Development ◽

Decision Making Tool

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Spontaneous Acute Subdural Hematoma: Beware of the Aneurysm

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0039-1697770 ◽

2019 ◽

Vol 10 (03) ◽

pp. 537-541

Author(s):

Nathan Beucler ◽

Christelle Haikal ◽

David Hibbert ◽

Aurore Sellier ◽

Christophe Joubert ◽

...

Keyword(s):

Decision Making ◽

Subdural Hematoma ◽

Clinical Decision Making ◽

Clinical Decision ◽

Clinical Suspicion ◽

Ruptured Aneurysm ◽

Acute Subdural Hematoma ◽

Common Etiology ◽

Underlying Pathology ◽

Decision Making Tool

AbstractSpontaneous acute subdural hematoma should raise clinical suspicion for underlying pathology, the most common etiology being a ruptured aneurysm. Through this case report, our team developed a clinical decision-making tool to help physicians decide when it is necessary to order an acute subdural hematoma to assess for ruptured aneurysm.

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