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ABCDE cognitive aid tool in patient assessment - development and validation in a multicenter pilot simulation study.

ABSTRACT: Background: The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The efficacy of using cognitive aids (CA) in resuscitation and peri-arrest situations remains an important knowledge gap. This work aims to develop an ABCDE CA tool (CAT) and study its potential benefits in patient condition assessment.

Methods: The development of the ABCDE CAT was done by 3 rounds of modified Delphi method performed by the members of the Advanced Life Support Science and Education Committee of the European Resuscitation Council. A pilot multicentre study on 48 paramedic students performing patient assessment in pre-post cohorts (without and with the ABCDA CAT) was made in order to validate and evaluate the impact of the tool in simulated clinical scenarios. The cumulative number and proper order of steps in clinical assessment in simulated scenarios were recorded and the time of the assessment was measured.

Results: The Delphi method resulted in the ABCDE CAT. The use of ABCDE CAT was associated with more performed assessment steps (804: 868; OR?=?1.17, 95% CI: 1.02 to 1.35, p?=?0.023) which were significantly more frequently performed in proper order (220: 338; OR?=?1.68, 95% CI: 1.40 to 2.02, p?
Conclusion: The cognitive aid for ABCDE assessment was developed. The use of this cognitive aid for ABCDE helps paramedics to perform more procedures, more frequently in the right order and did not prolong the patient assessment in advanced life support and peri-arrest care.

SUBMITTER: Peran D

PROVIDER: S-EPMC7718686 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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ABCDE cognitive aid tool in patient assessment - development and validation in a multicenter pilot simulation study.

Peran David D Kodet Jiri J Pekara Jaroslav J Mala Lucie L Truhlar Anatolij A Cmorej Patrik Christian PC Lauridsen Kasper Glerup KG Sari Ferenc F Sykora Roman R

BMC emergency medicine 20201204 1

<h4>Background</h4>The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The efficacy of using cognitive aids (CA) in resuscitation and peri-arrest situations remains an important knowledge gap. This work aims to develop an ABCDE CA tool (CAT) and study its potential benefits in patient condition assessment.<h4>Methods</h4>The development of the ABCDE CAT was done by 3 rounds of modified Delphi method performed by the members ...[more]

PMID: 33276731

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Project description:BackgroundMusculoskeletal conditions account for 16% of global disability, resulting in a negative effect on millions of patients and an increasing demand for health care use. Digital technologies to improve health care outcomes and efficiency are considered a priority; however, innovations are rarely tested with sufficient rigor in clinical trials, which is the gold standard for clinical proof of safety and efficacy. We have developed a new musculoskeletal digital assessment routing tool (DART) that allows users to self-assess and be directed to the right care. DART requires validation in a real-world setting before implementation.ObjectiveThis pilot study aims to assess the feasibility of a future trial by exploring the key aspects of trial methodology, assessing the procedures, and collecting exploratory data to inform the design of a definitive randomized crossover noninferiority trial to assess DART safety and effectiveness.MethodsWe will collect data from 76 adults with a musculoskeletal condition presenting to general practitioners within a National Health Service (NHS) in England. Participants will complete both a DART assessment and a physiotherapist-led triage, with the order determined by randomization. The primary analysis will involve an absolute agreement intraclass correlation (A,1) estimate with 95% CI between DART and the clinician for assessment outcomes signposting to condition management pathways. Data will be collected to allow the analysis of participant recruitment and retention, randomization, allocation concealment, blinding, data collection process, and bias. In addition, the impact of trial burden and potential barriers to intervention delivery will be considered. The DART user satisfaction will be measured using the system usability scale.ResultsA UK NHS ethics submission was done during June 2021 and is pending approval; recruitment will commence in early 2022, with data collection anticipated to last for 3 months. The results will be reported in a follow-up paper in 2022.ConclusionsThis study will inform the design of a randomized controlled crossover noninferiority study that will provide evidence concerning mobile health DART system clinical signposting in an NHS setting before real-world implementation. Success should produce evidence of a safe, effective system with good usability, potentially facilitating quicker and easier patient access to appropriate care while reducing the burden on primary and secondary care musculoskeletal services. This rigorous approach to mobile health system testing could be used as a guide for other developers of similar applications.Trial registrationClinicalTrials.gov NCT04904029; http://clinicaltrials.gov/ct2/show/NCT04904029.International registered report identifier (irrid)PRR1-10.2196/31541.

Dataset Information

ABCDE cognitive aid tool in patient assessment - development and validation in a multicenter pilot simulation study.

Publications

ABCDE cognitive aid tool in patient assessment - development and validation in a multicenter pilot simulation study.

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