title: An algorithm developed using the Brighton Collaboration case definitions is more efficient for determining diagnostic certainty.
abstract: The Brighton Collaboration is a global research network focused on vaccine safety. The Collaboration has created case definitions to determine diagnostic certainty for several adverse events. Currently nested within multi-page publications, these definitions can be cumbersome for use. We report the results of a randomized trial in which the case definition for anaphylaxis was converted into a user-friendly algorithm and compared the algorithm with the standard case definition. The primary outcomes were efficiency and accuracy. Forty medical students determined the Brighton Level of diagnostic certainty of a sample case of anaphylaxis using either the algorithm or the original case definition. Most participants in both groups selected the correct Brighton Level. Participants using the algorithm required significantly less time to review the case and determine the level of diagnostic certainty [mean difference=107 s (95% CI: 13-200; p=0.026)], supporting that the algorithm was more efficient without impacting accuracy.
authors.affiliation: Vanderbilt University Medical Center, Light Hall, 2215 Garland Avenue, Mailbox #43, Nashville, TN 37232, USA. Electronic address: deepa.s.joshi@vanderbilt.edu.
authors.forename: Deepa
authors.initials: D
authors.lastname: Joshi
authors.affiliation: Vanderbilt University Medical Center, Light Hall, 2215 Garland Avenue, Mailbox #43, Nashville, TN 37232, USA. Electronic address: ema2016@stanford.edu.
authors.forename: Emily
authors.initials: E
authors.lastname: Alsentzer
authors.affiliation: Vanderbilt University Medical Center, Light Hall, 2215 Garland Avenue, Mailbox #43, Nashville, TN 37232, USA. Electronic address: Kathryn.edwards@vanderbilt.edu.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Edwards
authors.affiliation: Vanderbilt University Medical Center, Light Hall, 2215 Garland Avenue, Mailbox #43, Nashville, TN 37232, USA. Electronic address: allison.norton@vanderbilt.edu.
authors.forename: Allison
authors.initials: A
authors.lastname: Norton
authors.affiliation: Vanderbilt University Medical Center, Light Hall, 2215 Garland Avenue, Mailbox #43, Nashville, TN 37232, USA. Electronic address: elizabeth.williams@vanderbilt.edu.
authors.forename: Sarah Elizabeth
authors.initials: SE
authors.lastname: Williams
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000465:Algorithms; D000707:Anaphylaxis / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D013337:Students, Medical; D013997:Time Factors; D014611:Vaccination / Q000009:adverse effects*; D055815:Young Adult
keywords: Adverse events following immunization; Brighton Collaboration; Vaccine safety monitoring