NDLI: Emergency Physicians' Perceptions and Decision-making Processes Regarding Patients Presenting with Palpitations.

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Emergency Physicians' Perceptions and Decision-making Processes Regarding Patients Presenting with Palpitations.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Probst, Marc A. Kanzaria, Hemal K. Hoffman, Jerome R. Mower, William R. Moheimani, Roya S. Sun, Benjamin C. Quigley, Denise D.
Spatial Coverage	United States
Description	Author Affiliation: Probst MA ( Department of Emergency Medicine, School of Medicine, University of California, Los Angeles, Los Angeles, California); Kanzaria HK ( Department of Emergency Medicine, School of Medicine, University of California, Los Angeles, Los Angeles, California); Hoffman JR ( Department of Emergency Medicine, School of Medicine, University of California, Los Angeles, Los Angeles, California.); Mower WR ( Department of Emergency Medicine, School of Medicine, University of California, Los Angeles, Los Angeles, California.); Moheimani RS ( Department of Emergency Medicine, School of Medicine, University of California, Los Angeles, Los Angeles, California.); Sun BC ( Department of Emergency Medicine, Center for Policy Research-Emergency Medicine, Oregon Health & Science University, Portland, Oregon.); Quigley DD ( RAND Corporation, Santa Monica, California.)
Abstract	BACKGROUND: Palpitations are a common emergency department (ED) complaint, yet relatively little research exists on this topic from an emergency care perspective. OBJECTIVES: We sought to describe the perceptions and clinical decision-making processes of emergency physicians (EP) surrounding patients with palpitations. METHODS: We conducted 21 semistructured interviews with a convenience sample of EPs. We recruited participants from academic and community practice settings from four regions of the United States. The transcribed interviews were analyzed using a combination of structural coding and grounded theory approaches with ATLAS.ti, a qualitative data analysis software program (version 7; Atlas.ti Scientific Software Development GmbH, Berlin, Germany). RESULTS: EPs perceive palpitations to be a common but generally benign chief complaint. EPs' clinical approach to palpitations, with regards to testing, treatment, and ED management, can be classified as relating to one or more of the following themes: (1) risk stratification, (2) diagnostic categorization, (3) algorithmic management, and (4) case-specific gestalt. With regard to disposition decisions, four main themes emerged: (1) presence of a serious diagnosis, (2) perceived need for further cardiac testing/monitoring, (3) presence of key associated symptoms, (4) request of other physician or patient desire. The interrater reliability exercise yielded a Fleiss' kappa measure of 0.69, indicating substantial agreement between coders. CONCLUSION: EPs perceive palpitations to be a common but generally benign chief complaint. EPs rely on one or more of four main clinical approaches to manage these patients. These findings could help guide future efforts at developing risk-stratification tools and clinical algorithms for patients with palpitations.
File Format	HTM / HTML
ISSN	07364679
DOI	10.1016/j.jemermed.2015.02.013
Journal	The Journal of Emergency Medicine
Issue Number	2
Volume Number	49
Language	English
Publisher	Elsevier
Publisher Date	2015-08-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Emergency medicine Arrhythmias, Cardiac Diagnosis Attitude Of Health Personnel Clinical Decision-making Emergency Medicine Interviews As Topic Physician's Practice Patterns Statistics & Numerical Data Risk Assessment
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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