title: Survey of emergency physicians' requirements for a clinical decision rule for acute respiratory illnesses in three countries.
abstract: ABSTRACTObjective:There are currently no widely used guidelines to determine which older patients with acute respiratory conditions require hospital admission. This study assessed the need for clinical decision rules to help determine whether hospital admission is required for patients over 50 years for three common respiratory conditions: chronic obstructive pulmonary disease (COPD), heart failure (HF), and community-acquired pneumonia (CAP).
  
  
  METHODS
  Postal survey.
  
  
  METHODS
  Emergency physicians (EPs) from the United States, Canada, and Australasia.
  
  
  METHODS
  A random sample of EPs from the United States, Canada, and Australasia.
  
  
  METHODS
  A modified Dillman technique with a prenotification letter and up to three postal surveys.
  
  
  RESULTS
  EP opinions regarding the need for and willingness to use clinical decision rules for emergency department (ED) patients over 50 years with COPD, HF, or CAP to predict hospital admission. We assessed the required sensitivity of each rule for return ED visit or death within 14 days.
  
  
  RESULTS
  A total of 801 responses from 1,493 surveys were received, with response rates of 55%, 60%, and 46% for Australasia, Canada, and the United States, respectively. Over 90% of EPs reported that they would consider using clinical decision rules for HF, CAP, and COPD. The median required sensitivity for death within 14 days was 97 to 98% for all conditions.
  
  
  CONCLUSIONS
  EPs are likely to adopt highly sensitive clinical decision rules to predict the need for hospital admission for patients over 50 years with COPD, HF, or CAP.
authors.affiliation: Department of Emergency Medicine, Department of Epidemiology and Community Medicine, Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON. jperry@ohri.ca
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Perry
authors.forename: Reena
authors.initials: R
authors.lastname: Goindi
authors.forename: Cheryl
authors.initials: C
authors.lastname: Symington
authors.forename: Jamie
authors.initials: J
authors.lastname: Brehaut
authors.forename: Monica
authors.initials: M
authors.lastname: Taljaard
authors.forename: Sandra
authors.initials: S
authors.lastname: Schneider
authors.forename: Ian G
authors.initials: IG
authors.lastname: Stiell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044362:Australasia; D002170:Canada; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003661:Decision Support Techniques; D004636:Emergency Service, Hospital; D005260:Female; D019538:Health Care Surveys / Q000379:methods*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*; D012140:Respiratory Tract Diseases / Q000628:therapy*; D012189:Retrospective Studies; D014481:United States