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dc.contributor.authorElahi, Cyrus
dc.contributor.authorWilliamson, Theresa
dc.contributor.authorSpears, Charis A.
dc.contributor.authorWilliams, Sarah
dc.contributor.authorNajjuma, Josephine Nambi
dc.contributor.authorStaton, Catherine A.
dc.contributor.authorVissoci, João Ricardo Nickenig
dc.contributor.authorFuller, Anthony
dc.contributor.authorKitya, David
dc.contributor.authorHaglund, Michael M.
dc.date.accessioned2022-01-20T13:55:51Z
dc.date.available2022-01-20T13:55:51Z
dc.date.issued2020
dc.identifier.citationElahi, C., Williamson, T., Spears, C. A., Williams, S., Najjuma, J. N., Staton, C. A., ... & Haglund, M. M. (2020). Estimating prognosis for traumatic brain injury patients in a low-resource setting: how do providers compare to the CRASH risk calculator?. Journal of neurosurgery, 134(4), 1285-1293.en_US
dc.identifier.urihttp://ir.must.ac.ug/xmlui/handle/123456789/1251
dc.description.abstractOBJECTIVE Traumatic brain injury (TBI), a burgeoning global health concern, is one condition that could benefit from prognostic modeling. Risk stratification of TBI patients on presentation to a health facility can support the prudent use of limited resources. The CRASH (Corticosteroid Randomisation: After Significant Head Injury) model is a well-established prognostic model developed to augment complex decision-making. The authors’ current study objective was to better understand in-hospital decision-making for TBI patients and determine whether data from the CRASH risk calculator influenced provider assessment of prognosis. METHODS The authors performed a choice experiment using a simulated TBI case. All participant doctors received the same case, which included a patient history, vitals, and physical examination findings. Half the participants also received the CRASH risk score. Participants were asked to estimate the patient prognosis and decide the best next treatment step. The authors recruited a convenience sample of 28 doctors involved in TBI care at both a regional and a national referral hospital in Uganda. RESULTS For the simulated case, the CRASH risk scores for 14-day mortality and an unfavorable outcome at 6 months were 51.4% (95% CI 42.8%, 59.8%) and 89.8% (95% CI 86.0%, 92.6%), respectively. Overall, participants were overoptimistic when estimating the patient prognosis. Risk estimates by doctors provided with the CRASH risk score were closer to that score than estimates made by doctors in the control group; this effect was more pronounced for inexperienced doctors. Surgery was selected as the best next step by 86% of respondents. CONCLUSIONS: This study was a novel assessment of a TBI prognostic model’s influence on provider estimation of risk in a low-resource setting. Exposure to CRASH risk score data reduced overoptimistic prognostication by doctors, particularly among inexperienced providers.en_US
dc.description.sponsorshipFogarty International Centeren_US
dc.language.isoen_USen_US
dc.publisherJournal of neurosurgeryen_US
dc.subjectTraumatic brain injuryen_US
dc.subjectDiscrete choice experimenten_US
dc.subjectNeurosurgeryen_US
dc.subjectClinical decision supporten_US
dc.subjectRisk calculatoren_US
dc.titleEstimating prognosis for traumatic brain injury patients in a low-resource setting: how do providers compare to the CRASH risk calculator?en_US
dc.typeArticleen_US


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