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When do patients need certain tests? Made-in-Ottawa rules adopted in U.S.

When do patients need certain tests? Made-in-Ottawa rules adopted in U.S.

Dr. Ian Stiell and other physician-scientists at The Ottawa Hospital have developed easy-to-follow rules for deciding when patients need certain diagnostic tests – and some American doctors are taking notice.

Patients in some U.S. emergency rooms will be spared from unnecessary and often uncomfortable diagnostic procedures, as doctors look north to Ottawa for help determining when diagnostic tests are needed.

A list of the top five ways to reduce unnecessary procedures was recently published in the prestigious JAMA Internal Medicine, and three of those ways are based on work by physician-scientists at The Ottawa Hospital.

As in most developed countries, the cost of medical care in the U.S. – particularly in emergency departments – is growing. Between 2003 and 2011, the average cost to treat a person in a U.S. emergency room rose 240 percent, to $1,354 from $560, according to a study by the U.S. Agency for Healthcare Research and Quality.

Physician-scientists at The Ottawa Hospital have gained a worldwide reputation for developing easy-to-follow clinical decision rules to determine whether diagnostic tests for particular ailments are needed. These rules, which have proven to be remarkably accurate, are now being recommended to U.S. emergency room doctors as a way to save time and money, and to spare patients from unnecessary tests.

“Having a group of U.S. researchers independently recommend our work in a high-profile journal such as JAMA Internal Medicine is tremendous validation, and a good indication that these evidence-based clinical decision tools are reliable,” said Dr. Ian Stiell, a senior scientist at the Ottawa Hospital Research Institute and emergency physician at The Ottawa Hospital.

The made-in-Ottawa clinical decision rules on the list include:

  • Canadian C-Spine Rule, used to determine if a patient needs a cervical spine CT scan (developed by Dr. Stiell)
  • Canadian CT Head Rule, used to determine if a patient needs a head CT scan after a mild trauma (developed by Dr. Stiell)
  • Wells Rule, used to determine the likelihood a person has blood clots in the lung (pulmonary embolisms) (developed by Dr. Phillip Wells)

Many of the clinical decision rules pioneered in Ottawa are now being used throughout Europe and Asia, including the world-renowned Ottawa Ankle Rules, also developed by Dr. Stiell.

“These made-in-Canada tools clearly have a positive impact on patients globally, which is wonderful,” said Dr. Jack Kitts, President and CEO of The Ottawa Hospital. “World-class research is being translated into world-class medical care right here in Ottawa.”


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