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How emergency physicians use biomarkers: insights from a qualitative assessment of script concordance tests
  1. Yann-Erick Claessens1,2,
  2. Sophie Wannepain2,
  3. Stéphanie Gestin2,
  4. Xavier Magdelein1,
  5. Elsa Ferretti1,
  6. Marine Guilly2,
  7. Bernard Charlin3,
  8. Thierry Pelaccia4
  1. 1Department of Emergency Medicine, Centre Hospitalier Princesse Grace, Principalty of Monaco, Monaco
  2. 2Department of Emergency Medicine, Hôpital Cochin 27 rue du Faubourg Saint-Jacques, Paris, France
  3. 3Department of Surgery, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
  4. 4CESU, Hôpitaux Universitaires Faculté de Médecine, Strasbourg, France
  1. Correspondence to Professor Yann-Erick Claessens, Department of Emergency Medicine, Centre Hospitalier Princesse Grace, 1 avenue Pasteur BP489, Principalty of Monaco MC-98012, Monaco; yann-erick.claessens{at}chpg.mc

Abstract

Objectives Biomarkers have been developed in emergency medicine to improve decision at bedside using Bayesian approach. We intend to determine the cognitive process actually utilised by emergency physicians to incorporate biomarkers in clinical reasoning.

Design We invited eight emergency physicians to answer eight script concordance tests. Interviews were tape-recorded and qualitatively analysed using predetermined categories until saturation.

Results Emergency physicians mainly mobilised intuition and non-Bayesian reasoning to incorporate biomarkers for diagnosis or treatment strategies.

Conclusions Although biomarkers have been developed to be used in a Bayesian approach, emergency physicians mainly use other analytical and non-analytical cognitive processes to introduce these tools in their clinical reasoning.

  • cardiac care, diagnosis
  • infectious diseases, bacterial

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