title: Australian and US responses to electroconvulsive therapy dosage selection.
abstract: OBJECTIVE
  The practice of electroconvulsive therapy (ECT) varies considerably across sites with a lack of certainty as to what constitutes seizure adequacy. The aim of this study was to trial a method to explore decision making and to describe any differences between Australian and US practitioners.
  
  
  METHODS
  Two hundred and thirty-six consultant psychiatrists from Australia and US were asked what dosage of electrical energy they would prescribe after reading a standardized clinical vignette in which an unremarked upon change in seizure tracings followed the first two treatments.
  
  
  RESULTS
  Considerable variability in the dosage was found with 17.3% decreasing, 46.8% maintaining and 30% increasing charge. Involvement in administration of ECT was unrelated to this decision.
  
  
  CONCLUSIONS
  Standardized vignettes may be a useful method to assess clinicians' responses in dosage selection.
authors.affiliation: Grampians Psychiatric Services, Ballarat, Victoria, Australia. johnl@bhs.grampianshealth.org.au
authors.forename: John D
authors.initials: JD
authors.lastname: Little
authors.forename: Jo
authors.initials: J
authors.lastname: McFarlane
authors.forename: David
authors.initials: D
authors.lastname: Barton
authors.forename: Shashjit L
authors.initials: SL
authors.lastname: Varma
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires