L'étude WikiDécisionTDM: adaptation d'un outil d'aide à la décision partagée sur la décision de faire une tomodensitométrie (TDM) cérébrale chez les victimes d'un traumatistme craniocérébral léger (TCCL) et développement d'une formation pour les professionnels de la santé: prototypage rapide supporté par un wiki

 

Patrick Archambault

Centre de recherche du Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis (CHAU)

 

Domaine : Services de santé

Programme Consortium pour le développement de la recherche en traumatologie - Volet 3

Concours 2016-2017

Trauma victims do not always receive the recommended care because doctors may not always apply the latest knowledge in trauma care. This leads to the underuse, misuse and overuse of certain diagnostic procedures. One in particular, computed tomography (CT) is used for victims of mild traumatic brain injury (mTBI). In Canada, 10-35% of CT scans for mTBIs are carried out unnecessarily and some medical centers use them by as much as four times more than centers using them the least. A brain CT scan performed on a patient who does not show signs or symptoms of serious injuries is unnecessarily exposed to ionizing radiation that may increase the risk of developing cancer during his or her lifetime. Patients asking for tests has been identified as a reason why such tests are overused. Several studies have shown that a shared decision making process (SDM) may lower this overuse.

During this project, we will (phase 1) translate two American decision aids (child and adult) and change them to reflect the Québec context using a method called rapid prototyping based in a wiki which is a website which several people can access and modify at the same time. We will (phase 2) develop training for doctors and nurses to learn how to use these aids. Finally, we will (phase 3) put in place the new decision aids with training in three emergency departments in Québec. We will also measure if this process improves the proper use of head CTs for mTBI patients. This project is needed because it studies the how to of Shared Decision Making in trauma care. SDM is a recognized method for improving the use of new scientific knowledge and has been rarely studied in trauma. It will also train healthcare professionals working in the field of trauma on SDM.