Impact of digitally acquired peer diagnostic input on diagnostic confidence in outpatient cases: A pragmatic randomized trial.
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ABSTRACT: Objective
The study sought to evaluate if peer input on outpatient cases impacted diagnostic confidence.Materials and methods
This randomized trial of a peer input intervention occurred among 28 clinicians with case-level randomization. Encounters with diagnostic uncertainty were entered onto a digital platform to collect input from ≥5 clinicians. The primary outcome was diagnostic confidence. We used mixed-effects logistic regression analyses to assess for intervention impact on diagnostic confidence.Results
Among the 509 cases (255 control; 254 intervention), the intervention did not impact confidence (odds ratio [OR], 1.46; 95% confidence interval [CI], 0.999-2.12), but after adjusting for clinician and case traits, the intervention was associated with higher confidence (OR, 1.53; 95% CI, 1.01-2.32). The intervention impact was greater in cases with high uncertainty (OR, 3.23; 95% CI, 1.09- 9.52).Conclusions
Peer input increased diagnostic confidence primarily in high-uncertainty cases, consistent with findings that clinicians desire input primarily in cases with continued uncertainty.
SUBMITTER: Khoong EC
PROVIDER: S-EPMC7936511 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Publications
Impact of digitally acquired peer diagnostic input on diagnostic confidence in outpatient cases: A pragmatic randomized trial.
Khoong Elaine C EC Fontil Valy V Rivadeneira Natalie A NA Hoskote Mekhala M Nundy Shantanu S Lyles Courtney R CR Sarkar Urmimala U
Journal of the American Medical Informatics Association : JAMIA 20210301 3
<h4>Objective</h4>The study sought to evaluate if peer input on outpatient cases impacted diagnostic confidence.<h4>Materials and methods</h4>This randomized trial of a peer input intervention occurred among 28 clinicians with case-level randomization. Encounters with diagnostic uncertainty were entered onto a digital platform to collect input from ≥5 clinicians. The primary outcome was diagnostic confidence. We used mixed-effects logistic regression analyses to assess for intervention impact on ...[more]
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