International survey of emergency physicians' priorities for clinical decision rules.
OBJECTIVE
One of the first stages in the development of new clinical decision rules (CDRs) is determination of need. This study examined the clinical priorities of emergency physicians (EPs) working in Australasia, Canada, the United Kingdom, and the United States for the development of future CDRs.


METHODS
The authors administered an e-mail and postal survey to members of the national emergency medicine (EM) associations in Australasia, Canada, the United Kingdom, and the United States. Results were analyzed via frequency distributions.


RESULTS
The total response rate was 54.8% (1,150/2,100). The respondents were primarily male (74%), with a mean age of 42.5 years (SD +/- 8), and a mean of 12 years of experience (SD +/- 7). The top 10 clinical priorities (% selected) were: 1) investigation of febrile child < 36 months (62%); 2) identification of central or serious vertigo (42%); 3) lumbar puncture or admission of febrile child < 3 months (41%); 4) imaging for suspected transient ischemic attack (39%); 5) admission for anterior chest pain (37%); 6) computed tomography (CT) angiography for pulmonary embolus (30%); 7) admission for suicide risk (29%); 8) ultrasound for pain or bleeding in the first trimester of pregnancy (28%); 9) nonspecific weakness in elders (26%); and 10) CT for abdominal pain (25%). Between study countries, there was consistency in identification of clinical problems, but variation in prioritization.


CONCLUSIONS
This international survey identified the sampled EPs' priorities for the future development of CDRs. The top priority overall was investigation of the febrile child < 36 months. These results will be valuable to researchers for future development of CDRs in EM that are relevant internationally.
Eagles
Debra
D
Department of Emergency Medicine, Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ontario, Canada.
Stiell
Ian G
IG
Clement
Catherine M
CM
Brehaut
Jamie
J
Kelly
Anne-Maree
AM
Mason
Suzanne
S
Kellermann
Arthur
A
Perry
Jeffrey J
JJ
D000328:Adult; D002983:Clinical Competence; D002985:Clinical Protocols; D003657:Decision Making; D003661:Decision Support Techniques; D003695:Delivery of Health Care; D004635:Emergency Medicine / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006292:Health Priorities; D006301:Health Services Needs and Demand; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged