| A Survey of Emergency Physicians' Fear of Malpractice and Its Association With the Decision to Order Computed Tomography Scans for Children With Minor Head Trauma. | |
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MedLine Citation:
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PMID: 21346679 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE:: The objective of the study was to determine whether fear of malpractice is associated with emergency physicians' decision to order head computed tomography (CT) in 3 age-specific scenarios of pediatric minor head trauma. We hypothesized that physicians with higher fear of malpractice scores will be more likely to order head CT scans. METHODS:: Board-eligible/board-certified members of the Michigan College of Emergency Physicians were sent a 2-part survey consisting of case scenarios and demographic questions. Effect of fear of malpractice on the decision to order a CT scan was evaluated using a cumulative logit model. RESULTS:: Two hundred forty-six members (36.5%) completed the surveys. In scenario 1 (infant), being a male and working in a university setting were associated with reduced odds of ordering a CT scan (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.18-0.88; and OR, 0.35; 95% CI, 0.13-0.96, respectively). In scenario 2 (toddler), working for 15 years or more, at multiple hospitals, and for a private group were associated with reduced odds of ordering a CT scan (OR, 0.46; 95% CI, 0.26-0.79; OR, 0.36; 95% CI, 0.16-0.80; and OR, 0.51; 95% CI, 0.27-0.94, respectively). No demographic variables were significantly associated with ordering a CT scan in scenario 3 (teen). Overall, the fear of malpractice was not significantly associated with ordering a CT scan (OR, 1.28; 95% CI, 0.73-2.26; and OR, 1.70; 95% CI, 0.97-3.0). Only in scenario 2 was high fear significantly associated with increased odds of ordering a CT scan (OR, 2.09; 95% CI, 1.08-4.05). CONCLUSIONS:: Members of Michigan College of Emergency Physicians with a higher fear of malpractice score tended to order more head CT scans in pediatric minor head trauma. However, this trend was shown to be statistically significant only in 1 case and not overall. |
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Authors:
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Andrew C Wong; Terry Kowalenko; Stephanie Roahen-Harrison; Barbara Smith; Ronald F Maio; Rachel M Stanley |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-19 |
Journal Detail:
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Title: Pediatric emergency care Volume: - ISSN: 1535-1815 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8507560 Medline TA: Pediatr Emerg Care Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Department of Emergency Medicine, University of Michigan, Ann Arbor, MI. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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