Validity of Structured Cases to Study Clinical Judgment. Executive Summary and Final Report

摘要

The project examined the validity of using carefully structured clinical case vignettes as a method to study the clinical behavior of physicians. The validation measure was the test ordering behavior of family practice physicians in cases of urinary tract infection (UTI) and newly discovered cases of hypertension. A method was developed to determine the clinical cues or characteristics of the patient which affected test ordering. A regression equation was calculated from data obtained by chart review of patient cases. In general, the study showed a high correlation between predicted test ordering and actual test ordering on paper cases, at least for UTI, an acute disease. Paper cases therefore can be effectively used for the prediction of clinical performance.