Australian and US responses to electroconvulsive therapy dosage selection.
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.
Little
John D
JD
Grampians Psychiatric Services, Ballarat, Victoria, Australia. johnl@bhs.grampianshealth.org.au
McFarlane
Jo
J
Barton
David
D
Varma
Shashjit L
SL
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