Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the Cape Town metropole
Introduction Reduction of forearm and wrist fractures is a common practice in the Emergency Centre (EC). EC doctors must be familiar with the appropriate management thereof. The standard treatment of a fracture involves reduction and immobilization. This study aims to describe the diagnostic and man...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Division of General Surgery
2021
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867614233484591104 |
|---|---|
| access_status_str | Open Access |
| author | Goncalves, Melisanda |
| author2 | Cloete, Philip G |
| author_browse | Cloete, Philip G Goncalves, Melisanda |
| author_facet | Cloete, Philip G Goncalves, Melisanda |
| author_sort | Goncalves, Melisanda |
| collection | Thesis |
| description | Introduction Reduction of forearm and wrist fractures is a common practice in the Emergency Centre (EC). EC doctors must be familiar with the appropriate management thereof. The standard treatment of a fracture involves reduction and immobilization. This study aims to describe the diagnostic and management accuracy of EC clinicians using validated vignettes (also used as the reference standard) of adult patients with closed fractures of the forearm or wrist. Methods This is a prospective, cross-sectional study in the form of an electronic questionnaire to address the study aim. A set of vignettes were created and then validated to serve as the control for the study participants. The study was open to emergency medicine consultants, emergency medicine trainees/registrars, medical officers, and community service medical officers employed at a secondary-level public hospital EC in the Cape Town metropole. Comparison is made by the number and proportions of correct and incorrect answers using the vignette reference standard. Data were analysed using ChiSquare (X2). Results For the diagnosis of forearm and wrist fractures, EC clinicians present 86,8% (1309/1508) correct responses (p=0.68) and, for the course of action, 78% (278/354) correct responses (p=0.09). For the overall management of the fractures (diagnostic and course of action), EC clinicians answered correctly to 84,9% (1585/1866) and incorrectly to 15,1% (281/1866), although the difference by each EC clinician group.was not significant (p=0.72). Conclusion In Western Cape, EC doctors appear to fare better than reported in the literature. However, this can not be shown definitively with this dataset. Regular training is necessary for all clinicians working in EC to improve their skills in managing forearm and wrist fractures, including the interpretation of X-ray imaging. Clear and good notes in the patient folder, top-quality X-ray images, good EC work environment, and improvement between doctors communication are other sets of requirements important to help to avoid errors in fracture management. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/34035 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:48:47.429Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | Division of General Surgery |
| publisherStr | Division of General Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/34035 Evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the Cape Town metropole Goncalves, Melisanda Cloete, Philip G Bruijns, Stevan R Emergency Medicine Introduction Reduction of forearm and wrist fractures is a common practice in the Emergency Centre (EC). EC doctors must be familiar with the appropriate management thereof. The standard treatment of a fracture involves reduction and immobilization. This study aims to describe the diagnostic and management accuracy of EC clinicians using validated vignettes (also used as the reference standard) of adult patients with closed fractures of the forearm or wrist. Methods This is a prospective, cross-sectional study in the form of an electronic questionnaire to address the study aim. A set of vignettes were created and then validated to serve as the control for the study participants. The study was open to emergency medicine consultants, emergency medicine trainees/registrars, medical officers, and community service medical officers employed at a secondary-level public hospital EC in the Cape Town metropole. Comparison is made by the number and proportions of correct and incorrect answers using the vignette reference standard. Data were analysed using ChiSquare (X2). Results For the diagnosis of forearm and wrist fractures, EC clinicians present 86,8% (1309/1508) correct responses (p=0.68) and, for the course of action, 78% (278/354) correct responses (p=0.09). For the overall management of the fractures (diagnostic and course of action), EC clinicians answered correctly to 84,9% (1585/1866) and incorrectly to 15,1% (281/1866), although the difference by each EC clinician group.was not significant (p=0.72). Conclusion In Western Cape, EC doctors appear to fare better than reported in the literature. However, this can not be shown definitively with this dataset. Regular training is necessary for all clinicians working in EC to improve their skills in managing forearm and wrist fractures, including the interpretation of X-ray imaging. Clear and good notes in the patient folder, top-quality X-ray images, good EC work environment, and improvement between doctors communication are other sets of requirements important to help to avoid errors in fracture management. 2021-10-01T09:14:15Z 2021-10-01T09:14:15Z 2020 2021-09-16T09:58:48Z Master Thesis Masters MPhil http://hdl.handle.net/11427/34035 eng application/pdf Division of General Surgery Faculty of Health Sciences |
| spellingShingle | Emergency Medicine Goncalves, Melisanda Evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the Cape Town metropole |
| thesis_degree_str | Master's |
| title | Evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the Cape Town metropole |
| title_full | Evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the Cape Town metropole |
| title_fullStr | Evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the Cape Town metropole |
| title_full_unstemmed | Evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the Cape Town metropole |
| title_short | Evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the Cape Town metropole |
| title_sort | evaluation of the diagnostic and management accuracy of closed fractures of forearm and wrist using validated vignettes as a reference standard by emergency centre clinicians in the cape town metropole |
| topic | Emergency Medicine |
| url | http://hdl.handle.net/11427/34035 |
| work_keys_str_mv | AT goncalvesmelisanda evaluationofthediagnosticandmanagementaccuracyofclosedfracturesofforearmandwristusingvalidatedvignettesasareferencestandardbyemergencycentrecliniciansinthecapetownmetropole |