Measuring Acceptability of Clinical Decision Rules: Validation of the Ottawa Acceptability of Decision Rules Instrument (OADRI) in Four Countries

Jamie C. Brehaut, Ian D. Graham, Timothy J. Wood, Monica Taljaard, Debra Eagles, Alison Lott, Catherine Clement, Anne-Maree Kelly, Suzanne Mason, Arthur Kellerman and Ian G. Stiell
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Jamie C. Brehaut: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada, jbrehaut@ohri.ca, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
Ian D. Graham: School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada, Knowledge Translation Portfolio, Canadian Institutes of Health Research, Ottawa, ON, Canada
Timothy J. Wood: Medical Council of Canada, Ottawa, ON, Canada
Monica Taljaard: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada
Debra Eagles: Department of Emergency Medicine, University of Ottawa, ON, Canada
Alison Lott: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
Catherine Clement: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
Anne-Maree Kelly: School of Health and Related Research, University of Sheffield, Sheffield, UK
Suzanne Mason: Joseph Epstein Centre for Emergency Medicine Research at Western Health and the University of Melbourne, Melbourne, Australia
Arthur Kellerman: Department of Emergency Medicine, Emory University, Atlanta, GA
Ian G. Stiell: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada, Department of Emergency Medicine, Emory University, Atlanta, GA, Department of Emergency Medicine, University of Ottawa, ON, Canada

Medical Decision Making, 2010, vol. 30, issue 3, 398-408

Abstract: Background. Clinical decision rules can benefit clinicians, patients, and health systems, but they involve considerable up-front development costs and must be acceptable to the target audience. No existing instrument measures the acceptability of a rule. The current study validated such an instrument. Methods. The authors administered the Ottawa Acceptability of Decision Rules Instrument (OADRI) via postal survey to emergency physicians from 4 regions (Australasia, Canada, United Kingdom, and United States), in the context of 2 recently developed rules, the Canadian C-Spine Rule (C-Spine) and the Canadian CT Head Rule (CT-Head). Construct validity of the 12-item instrument was evaluated by hypothesis testing. Results. As predicted by a priori hypotheses, OADRI scores were 1) higher among rule users than nonusers, 2) higher among those using the rule ‘‘all of the time’’ v. ‘‘most of the time’’ v. ‘‘some of the time,’’ and 3) higher among rule nonusers who would consider using a rule v. those who would not. We also examined explicit reasons given by respondents who said they would not use these rules. Items in the OADRI accounted for 85.5% (C- Spine) and 90.2% (CT-Head) of the reasons given for not considering a rule acceptable. Conclusions. The OADRI is a simple, 12-item instrument that evaluates rule acceptability among clinicians. Potential uses include comparing multiple ‘‘protorules’’ during development, examining acceptability of a rule to a new audience prior to implementation, indicating barriers to rule use addressable by knowledge translation interventions, and potentially serving as a proxy measure for future rule use.

Keywords: acceptability; clinical decision rules; validation; survey. (search for similar items in EconPapers)
Date: 2010
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:30:y:2010:i:3:p:398-408

DOI: 10.1177/0272989X09344747

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