Clinical Research Oriented Workshop (CROW) Meeting: July 14, 2010

Present: Amanda Kennedy, Rodger Kessler, Ben Littenberg, Carol McBride, Connie van Eeghen

1. Round Table: Pesto season is here, don’t forget the grape tomatoes and the chicken (if necessary); watch the prosciutto – it’s a bit salty

2. Ben’s Discussion: how to predict medical events successfully

a. A clinical diagnosis is the same as a prediction, a classification, and is usually accompanied by a prescription.
b. Ottawa ankle rule: if the patient can bear weight on the ankle and there is no pain at three other specific points on the foot, it is usually not a fracture and therefore it can be managed with conservative and speedy measures. Derived from clinical experience and has become an “official” prediction rule, this prediction is based on the probability of an ankle fracture given that there are no points on the Ottawa scale [P(AF|no points)]. (Note: the prescription is based on this prediction plus the costs/benefits of treatment or not, but that’s another lecture.)
c. How to come up with a rule:
i. Clinical experience – heuristics
ii. Random, uninformed decision making
iii. Logistical regression (predictors and outcomes)
iv. Neural networks
v. Classification and Regression Trees
d. Decision algorithms for prediction should be:
i. Low false negative rate
ii. Easy, simple, fast, and cheap
iii. Few predictors in number
iv. Easy to obtain
v. Reliably measurable
vi. Easily calculable – which the Ottawa rule accomplished by massive simplification of the regression equation

3. Next Fellows Meeting(s): Wednesday, 2:00 – 3:30 p.m., at Given Courtyard Level 4
a. July 21: Predictions, continued: Ben (no Matt through Aug 21, no Connie or Kairn)
b. July 28: Carol – data collection/analysis (no Connie, Matt)
c. Aug 4: Diantha Howard and Liz Chen: REDCap training (no Connie, Matt)
d. Aug 11: Connie’s qualitative study on quality – members will be asked to perform analysis; slides to be mailed out one week ahead (no Matt)
e. Future agenda to consider:
i. Rodger: Mixed methods article
ii. Future: Review of different types of journal articles (lit review, case study, original article, letter to editor…), when each is appropriate, tips on planning/writing (Abby)
iii. Future: Informed consent QI: Connie to follow up with Nancy Stalnaker, Alan Rubin will follow up with Alan Wortheimer or Rob McCauly
iv. Kairn will ask a librarian to join us for selected issues

4. Fellows document – nothing this time – to be reviewed after trialing Wednesday meeting times, which started May 5, 2010.

Recorder: Connie van Eeghen