2017
Patient-Centered Decision Support: Formative Usability Evaluation of Integrated Clinical Decision Support With a Patient Decision Aid for Minor Head Injury in the Emergency Department
Melnick ER, Hess EP, Guo G, Breslin M, Lopez K, Pavlo AJ, Abujarad F, Powsner SM, Post LA. Patient-Centered Decision Support: Formative Usability Evaluation of Integrated Clinical Decision Support With a Patient Decision Aid for Minor Head Injury in the Emergency Department. Journal Of Medical Internet Research 2017, 19: e174. PMID: 28526667, PMCID: PMC5457532, DOI: 10.2196/jmir.7846.Peer-Reviewed Original ResearchConceptsMinor head injuryCanadian CT Head RuleClinician-patient relationshipPatient-specific riskHead injuryPatient decision aidClinical decision supportDecision supportCT useEmergency departmentPatient concernsCanadian Computed Tomography Head RuleUser interface developmentMinor head injury patientsFormative usability evaluationPatient-centered decision supportEmergency care cliniciansUser-centered designHead injury patientsClinical decision rulePatients' specific concernsIntegrated clinical decision supportTomography Head RuleInitial prototype developmentHealth information technology
2015
Understanding Overuse of Computed Tomography for Minor Head Injury in the Emergency Department: A Triangulated Qualitative Study
Melnick ER, Shafer K, Rodulfo N, Shi J, Hess EP, Wears RL, Qureshi RA, Post LA. Understanding Overuse of Computed Tomography for Minor Head Injury in the Emergency Department: A Triangulated Qualitative Study. Academic Emergency Medicine 2015, 22: 1474-1483. PMID: 26568523, DOI: 10.1111/acem.12824.Peer-Reviewed Original ResearchConceptsMinor head injuryCanadian CT Head RuleEmergency departmentHead injuryComputed tomographyPatient expectationsUrban academic emergency departmentUse of CTCommunity emergency departmentsClinical decision ruleHigh-quality evidenceAcademic emergency departmentHealth care providersFocus groupsPatient anxietyCT useED practiceCT scanCare providersProvider confidenceED contextPatient engagementQualitative studyTriangulated qualitative studyMultidisciplinary teamRedefining Overuse to Include Costs: A Decision Analysis for Computed Tomography in Minor Head Injury
Melnick ER, Keegan J, Taylor RA. Redefining Overuse to Include Costs: A Decision Analysis for Computed Tomography in Minor Head Injury. The Joint Commission Journal On Quality And Patient Safety 2015, 41: 313-ap2. PMID: 26108124, DOI: 10.1016/s1553-7250(15)41041-4.Peer-Reviewed Original ResearchConceptsNet monetary benefitCurrent clinical decision rulesMonetary benefitsInclusion of costsCosts outweigh benefitsDecision analysisDecision analytic modelTwo-way sensitivity analysesDecision rulesProbability of lesionCanadian CT Head RuleMain driversOnly effectivenessCostSignificant impactSensitivity analysisCost of CT
2012
CT Overuse for Mild Traumatic Brain Injury
Melnick ER, Szlezak CM, Bentley SK, Dziura JD, Kotlyar S, Post LA. CT Overuse for Mild Traumatic Brain Injury. The Joint Commission Journal On Quality And Patient Safety 2012, 38: 483-489. PMID: 23173394, DOI: 10.1016/s1553-7250(12)38064-1.Peer-Reviewed Original ResearchConceptsMild traumatic brain injuryCanadian CT Head RuleNew Orleans CriteriaTraumatic brain injuryProportion of casesComputed tomographyEmergency departmentBrain injuryCT useEmergency Physicians Clinical PolicyLevel I emergency departmentImportant brain injuryClinical Excellence (NICE) guidelinesMinor head injuryProspective observational studyCurrent guideline recommendationsHead CT findingsEvidence-based guidelinesHealth care costsRadiation-induced cancerCT overuseAdult patientsExcellence guidelinesCT findingsGuideline recommendations