Most fun study I have ever done:
We asked clinicians why they tested NH3, their pre-test prob of HE, and what they planned to do while they were blinded to the result
tl/dr: Clinicians are good at diagnosing HE in the ED, so no need for Nh3
doi.org/10.1016/j.cgh.…
#livertwitter
We asked clinicians why they tested NH3, their pre-test prob of HE, and what they planned to do while they were blinded to the result
tl/dr: Clinicians are good at diagnosing HE in the ED, so no need for Nh3
doi.org/10.1016/j.cgh.…
#livertwitter
We find that a clinicians' pre-test probability of HE is the same as the post-test probability. But! not only does Nh3 add nothing diagnostically, when high it leads to excess lactulose use even when tested in people without #cirrhosis
Now we need to design the QI intervention
Now we need to design the QI intervention
I have always wanted to do this study. Huge thanks to @juanjgonMD 4 doing it. Even if u dont care about Nh3, we are very proud of our design, which allowed us to assess the value of a test using the clinician's real-time reasons for testing and prior probability
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