II. Indications
- Risk stratification for the evaluation and management of presentations with risk of poor outcome
- Limit testing that would otherwise risk adverse effects (e.g. radiation exposure)
- Standardize the approach to common conditions (esp. for those with less experience)
- Checklist documentation to prevent errors
III. Precautions: Pitfalls
- Clinical Decision Rules may be misapplied
- Use decision rules that have been prospectively validated, refined and used in clinical practice
- Decision rules should have high Test Sensitivity
- However, this is at the expense of Test Specificity with a high rate of False Positive tests
- Use clinical gestalt when interpreting the results of Clinical Decision Rules
- Many decision rules have a subjective component (e.g. Wells Score "PE more likely than alternatives")
- Avoid applying the decision tool to patients outside the population studied
- Be aware of the study inclusion and exclusion criteria
- Avoid mashing multiple decision tools together
- Use each decision tool individually, in the way it was validated
- Be cautious when applying 2 decision rules, each directing a different approach
IV. Examples
- Head and Neck
- Thoracic
- See Chest Pain Decision Rules
- Bosner Chest Pain Decision Rule
- Diamond and Forrester Chest Pain Prediction Rule
- Vancouver Chest Pain Rule
- Dual-Antiplatelet Therapy Decision Rule
- Chest Wall Pain Prediction Rule
- CHF Decision Rule for Predicting Mortality
- Diehr Rule to Diagnose Pneumonia
- Nexus Chest CT Decision Rule in Blunt Trauma
- San Francisco Syncope Rule
- Abdomen
- Hematology and Oncology
- Neurologic
- Musculoskeletal
- Miscellaneous
V. References
- Mason, Grock, Carmelli in Herbert (2018) 18(6): EM:Rap 12-3
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Definition (MSH) | Mathematical or statistical procedures used as aids in making a decision. They are frequently used in medical decision-making. |
Concepts | Intellectual Product (T170) |
MSH | D003661 |
English | Decision Support Technic, Decision Support Technics, Decision Support Technique, Decision Support Techniques, Technic, Decision Support, Technics, Decision Support, Technique, Decision Support, Techniques, Decision Support |
Swedish | Beslutsstödstekniker |
Finnish | Päätöksentukimenetelmät |
Russian | RESHENII PRINIATIIA TEKHNOLOGIIA, METODY PRINIATIIA RESHENII, PRINIATIE RESHENII, ANALIZ, RESHENII STATISTICHESKII ANALIZ, PRINIATIE RESHENII, TEKHNOLOGIIA, МЕТОДЫ ПРИНЯТИЯ РЕШЕНИЙ, ПРИНЯТИЕ РЕШЕНИЙ, АНАЛИЗ, ПРИНЯТИЕ РЕШЕНИЙ, ТЕХНОЛОГИЯ, РЕШЕНИЙ ПРИНЯТИЯ ТЕХНОЛОГИЯ, РЕШЕНИЙ СТАТИСТИЧЕСКИЙ АНАЛИЗ |
Japanese | 意思決定支援技法, ディシジョンモデリング, モデル-意思決定支援, 意思決定支援モデル, 意思決定分析, 決定分析 |
French | Techniques d'aide à la décision, Technologie d'aide à la prise de décision, Technologie d'aide à la décision, Techniques d'aide à la prise de décision |
Italian | Tecnica di supporto decisionale, Tecniche di supporto decisionale |
Croatian | ODLUČIVANJE, TEHNIKE POTPORE |
Polish | Modelowanie decyzyjne, Metody wsparcia decyzji, Metody wspomagania decyzji, Analiza decyzyjna |
Czech | rozhodování - techniky pomocné, metody pro podporu rozhodování, metody na podporu rozhodování |
Norwegian | Beslutningsstøtteteknikker |
Spanish | Técnicas de Apoyo a la Toma de Decisiones, Técnicas de Apoyo para la Decisión |
Portuguese | Técnicas de Apoio à Decisão, Modelos de Apoio à Decisão, Técnicas de Apoio para a Decisão |
German | Entscheidungsunterstützende Techniken |
Dutch | Beslissingsondersteunende techniek, Beslissingsondersteunende technieken |
Ontology: Decision Aids (C0086104)
Concepts | Intellectual Product (T170) |
MSH | D003661 |
English | Aid, Decision, Aids, Decision, Decision Aid, decision aids, decision aid, Decision Aids |
French | Supports à la décision, Aides à la décision |
Italian | Presa di decisione |
Norwegian | Beslutningshjelpemidler |
Ontology: Clinical Prediction Rule (C3179496)
Definition (MSH) | Use of a combination of multiple tests, both with positive and negative results, to arrive at a course of action. |
Concepts | Intellectual Product (T170) |
MSH | D003661 |
English | Prediction Rule, Clinical, Clinical Prediction Rule, Prediction Rules, Clinical, Rule, Clinical Prediction, Rules, Clinical Prediction, Clinical Prediction Rules |
Italian | Regola di predizione clinica |
Norwegian | Klinisk prediksjonsregel |