Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 19334,
    "title": "The Ottawa Knee Rule: Examining Use in an Academic Emergency Department",
    "subtitle": null,
    "abstract": "Introduction: The Ottawa Knee Rule is a validated clinical decision rule for determining whether knee radiographs should be obtained in the setting of acute knee trauma. The objectives of this study were to assess physician knowledge of, barriers to implementation of, and compliance with the Ottawa Knee Rule in academic emergency departments (EDs), and evaluate whether patient characteristics predict guideline noncompliance.\nMethods: A 10 question online survey was distributed to all attending ED physicians working at three affiliated academic EDs to assess knowledge, attitudes and self-reported practice behaviors relatedto the Ottawa Knee Rule. We also performed a retrospective ED record review of patients 13 years of age and older who presented with acute knee trauma to the 3 study EDs during the 2009 calendar year, and we analyzed ED records for 19 variables.\nResults: ED physicians (n = 47) correctly answered 73.2% of questions assessing knowledge of the Ottawa Knee Rule. The most commonly cited barriers to implementation were “patient expectations” and system issues, such as “orthopedics referral requirement.” We retrospectively reviewed 838 records, with 260 eligible for study inclusion. The rate of Ottawa Knee Rule compliance was retrospectively determined to be 63.1%. We observed a statistically significant correlation betweenOttawa Knee Rule compliance and patient age, but not gender, insurance status, or provider type, among others.\nConclusion: Compliance with the Ottawa Knee Rule among academic ED healthcare providers is poor, which was predicted by patient age and not other physician or patient variables. Improving compliance will require comprehensive educational and systemic interventions. [West J Emerg Med. 2012;13(4):366-373.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "Clinical decision guidelines"
        },
        {
            "word": "knee"
        },
        {
            "word": "Trauma"
        },
        {
            "word": "radiograph"
        },
        {
            "word": "Compliance"
        },
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "Orthopedics"
        },
        {
            "word": "radiology"
        }
    ],
    "section": "Clinical Practice",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3t22x2z8",
    "frozenauthors": [
        {
            "first_name": "Bryan",
            "middle_name": "G.",
            "last_name": "Beutel",
            "name_suffix": "",
            "institution": "Injury Prevention Center at Rhode Island Hospital, Providence, Rhode Island",
            "department": "None"
        },
        {
            "first_name": "Samir",
            "middle_name": "K.",
            "last_name": "Trehan",
            "name_suffix": "",
            "institution": "Injury Prevention Center at Rhode Island Hospital, Providence, Rhode Island",
            "department": "None"
        },
        {
            "first_name": "Robert",
            "middle_name": "M.",
            "last_name": "Shalvoy",
            "name_suffix": "",
            "institution": "Department of Orthopedics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "J",
            "last_name": "Mello",
            "name_suffix": "",
            "institution": "Injury Prevention Center at Rhode Island Hospital, Providence, Rhode Island; Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Community Health, The Warren Alpert Medical School of Brown University, Providence, Rhode Island",
            "department": "None"
        }
    ],
    "date_submitted": "2011-09-12T00:32:03Z",
    "date_accepted": "2011-09-12T00:32:03Z",
    "date_published": "2012-09-04T07:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/19334/galley/9563/download/"
        }
    ]
}