Search

Your search keyword '"Boutis, Kathy"' showing total 478 results
Start Over Author "Boutis, Kathy"
478 results on '"Boutis, Kathy"'

5. A Think-Aloud Study to Inform the Design of Radiograph Interpretation Practice

Author

Yoon, Jong-Sung, Boutis, Kathy, Pecaric, Martin R., Fefferman, Nancy R., Ericsson, K. Anders, and Pusic, Martin V.

Abstract

Models for diagnostic reasoning in radiology have been based on the observed behaviors of experienced radiologists but have not directly focused on the thought processes of novices as they improve their accuracy of image interpretation. By collecting think-aloud verbal reports, the current study was designed to investigate differences in specific thought processes between medical students (novices) as they learn and radiologists (experts), so that we can better design future instructional environments. Seven medical students and four physicians with radiology training were asked to interpret and diagnose pediatric elbow radiographs where fracture is suspected. After reporting their diagnosis of a case, they were given immediate feedback. Participants were asked to verbalize their thoughts while completing the diagnosis and while they reflected on the provided feedback. The protocol analysis of their verbalizations showed that participants used some combination of four processes to interpret the case: "gestalt interpretation," "purposeful search," "rule application," and "reasoning from a prior case." All types of processes except reasoning from a prior case were applied significantly more frequently by experts. Further, gestalt interpretation was used with higher frequency in abnormal cases while purposeful search was used more often for normal cases. Our assessment of processes could help guide the design of instructional environments with well-curated image banks and analytics to facilitate the novice's journey to expertise in image interpretation.

Published
2020
Full Text
View/download PDF

6. Computed Tomography Risk Disclosure in the Emergency Department: A Survey of Pediatric Emergency Medicine Fellowship Program Leaders

Author

Marin, Jennifer R., Thomas, Karen E., Mills, Angela M., and Boutis, Kathy

Subjects
Radiation risk, consent, disclosure, computed tomography, emergency department
Abstract

Introduction: Given the potential malignancy risks associated with computed tomography (CT), some physicians are increasingly advocating for risk disclosure to patients/families.Objective: Our goal was to evaluate the practices and attitudes of pediatric emergency medicine (PEM) fellowship program leaders’ regarding CT radiation-risk disclosure.Methods: We conducted a cross-sectional survey study of U.S. and Canadian PEM fellowship directors and associate/assistant directors. We developed a web-based survey using a modified Dillman technique. Primary outcome was the proportion who “almost always” or “most of the time” discussed potential malignancy risks from CT prior to ordering this test.Results: Of 128 physicians who received the survey, 108 (86%) responded. Of those respondents, 73%, 95% confidence interval (CI) [64-81] reported “almost always” or “most of the time” discussing potential malignancy risks when ordering a CT for infants; proportions for toddlers, school-age children, and teenagers were 72% (95% CI [63-80]), 66% (95% CI [56-75]), and 58% (95% CI [48-67]), respectively (test for trend, p=0.008). Eighty percent reported being “extremely” or “very” comfortable discussing radiation risks. Factors of “high” or “very high” importance in disclosing risks included parent request for a CT not deemed clinically indicated for 94% of respondents, and parent-initiated queries about radiation risks for 79%. If risk disclosure became mandatory, 82% favored verbal discussion over written informed consent.Conclusion: PEM fellowship program leaders report frequently disclosing potential malignancy risks from CT, with the frequency varying inversely with patient age. Motivating factors for discussions included parental request for a CT deemed clinically unnecessary and parental inquiry about risks.

Published
2018

15. A Primer on the Statistical Modelling of Learning Curves in Health Professions Education

Author

Pusic, Martin V., Boutis, Kathy, Pecaric, Martin R., Savenkov, Oleksander, Beckstead, Jason W., and Jaber, Mohamad Y.

Abstract

Learning curves are a useful way of representing the rate of learning over time. Features include an index of baseline performance (y-intercept), the efficiency of learning over time (slope parameter) and the maximal theoretical performance achievable (upper asymptote). Each of these parameters can be statistically modelled on an individual and group basis with the resulting estimates being useful to both learners and educators for feedback and educational quality improvement. In this primer, we review various descriptive and modelling techniques appropriate to learning curves including smoothing, regression modelling and application of the Thurstone model. Using an example dataset we demonstrate each technique as it specifically applies to learning curves and point out limitations.

Published
2017
Full Text
View/download PDF

16. Sequential Dependencies in Categorical Judgments of Radiographic Images

Author

Beckstead, Jason W., Boutis, Kathy, Pecaric, Martin, and Pusic, Martin V.

Abstract

Sequential context effects, the psychological interactions occurring between the events of successive trials when a sequence of similar stimuli are judged, have interested psychologists for decades. It has been well established that individuals exhibit sequential context effects in psychophysical experiments involving unidimensional stimuli. Recent evidence shows that these effects generalize to quantitative judgments of more complex multidimensional stimuli such as images of faces, chairs, and shoes. In this article, we test for the presence of sequential context effects by re-examining previously published data on categorical judgments of 234 complex radiographic images made by 20 experienced physicians and 20 medical students engaged in an online training task. We found that medical students, but not experienced physicians, displayed evidence of sequential context effects. We also found evidence suggesting that as the students learned over blocks of trials, they tended to shift from relative comparisons between consecutive images toward more independent comparisons of each image against (strengthening) internalized standards.

Published
2017
Full Text
View/download PDF

17. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research

Author

Adams, Hadie, Agnoletti, Vanni, Allanson, Judith, Amrein, Krisztina, Andaluz, Norberto, Anke, Audny, Antoni, Anna, van As, Arjan Bastiaan, Audibert, Gérard, Azaševac, Antun, Azouvi, Philippe, Azzolini, Maria Luisa, Baciu, Camelia, Badenes, Rafael, Barlow, Karen M, Bartels, Ronald, Bauerfeind, Ursula, Beauchamp, Miriam, Beer, Darcy, Beer, Ronny, Belda, Francisco Javier, Bellander, Bo-Michael, Bellier, Rémy, Benali, Habib, Benard, Thierry, Beqiri, Valzerda, Beretta, Luigi, Bernard, Francis, Bertolini, Guido, Bilotta, Federico, Blaabjerg, Morten, den Boogert, Hugo, Boutis, Kathy, Bouzat, Pierre, Brooks, Brian, Brorsson, Camilla, Bullinger, Monika, Burns, Emma, Calappi, Emiliana, Cameron, Peter, Carise, Elsa, Castaño-León, Ana M, Causin, Francesco, Chevallard, Giorgio, Chieregato, Arturo, Christie, Brian, Cnossen, Maryse, Coles, Jonathan, Collett, Johnny, Della Corte, Francesco, Craig, William, Csato, Gabor, Csomos, Akos, Curry, Nicola, Dahyot-Fizelier, Claire, Dawes, Helen, DeMatteo, Carol, Depreitere, Bart, Dewey, Deborah, van Dijck, Jeroen, Đilvesi, Đula, Dippel, Diederik, Dizdarevic, Kemal, Donoghue, Emma, Duek, Or, Dulière, Guy-Loup, Dzeko, Adelaida, Eapen, George, Emery, Carolyn A, English, Shane, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feng, Junfeng, Fergusson, Dean, Figaji, Anthony, Fleming, Joanne, Foks, Kelly, Francony, Gilles, Freedman, Stephen, Freo, Ulderico, Frisvold, Shirin K, Gagnon, Isabelle, Galanaud, Damien, Gantner, Dashiell, Giraud, Benoit, Glocker, Ben, Golubovic, Jagoš, Gómez López, Pedro A, Gordon, Wayne A, Gradisek, Primoz, Gravel, Jocelyn, Griesdale, Donald, Grossi, Francesca, Haagsma, Juanita A, Håberg, Asta Kristine, Haitsma, Iain, Van Hecke, Wim, Helbok, Raimund, Helseth, Eirik, van Heugten, Caroline, Hoedemaekers, Cornelia, Höfer, Stefan, Horton, Lindsay, Hui, Jiyuan, Huijben, Jilske Antonia, Hutchinson, Peter J, Jacobs, Bram, van der Jagt, Mathieu, Jankowski, Stefan, Janssens, Koen, Jelaca, Bojan, Jones, Kelly M, Kamnitsas, Konstantinos, Kaps, Rafael, Karan, Mladen, Katila, Ari, Kaukonen, Kirsi-Maija, De Keyser, Véronique, Kivisaari, Riku, Kolias, Angelos G, Kolumbán, Bálint, Kolundžija, Ksenija, Kondziella, Daniel, Koskinen, Lars-Owe, Kovács, Noémi, Kramer, Andreas, Kutsogiannis, Demitri, Kyprianou, Theodoros, Lagares, Alfonso, Lamontagne, François, Latini, Roberto, Lauzier, François, Lazar, Isaac, Ledig, Christian, Lefering, Rolf, Legrand, Valerie, Levi, Leon, Lightfoot, Roger, Lozano, Angels, MacDonald, Stephen, Major, Sebastian, Manara, Alex, Manhes, Pauline, Maréchal, Hugues, Martino, Costanza, Masala, Alessandro, Masson, Serge, Mattern, Julia, McFadyen, Bradford, McMahon, Catherine, Meade, Maureen, Melegh, Béla, Menovsky, Tomas, Moore, Lynne, Morgado Correia, Marta, Morganti-Kossmann, Maria Cristina, Muehlan, Holger, Mukherjee, Pratik, Murray, Lynnette, van der Naalt, Joukje, Negru, Ancuta, Nelson, David, Nieboer, Daan, Noirhomme, Quentin, Nyirádi, József, Oddo, Mauro, Okonkwo, David O, Oldenbeuving, Annemarie W, Ortolano, Fabrizio, Osmond, Martin, Payen, Jean-François, Perlbarg, Vincent, Persona, Paolo, Pichon, Nicolas, Piippo-Karjalainen, Anna, Pili-Floury, Sébastien, Pirinen, Matti, Ple, Horia, Poca, Maria Antonia, Posti, Jussi, Van Praag, Dominique, Ptito, Alain, Radoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Real, Ruben G L, Reed, Nick, Rhodes, Jonathan, Robertson, Claudia, Rocka, Saulius, Røe, Cecilie, Røise, Olav, Roks, Gerwin, Rosand, Jonathan, Rosenfeld, Jeffrey V, Rosenlund, Christina, Rosenthal, Guy, Rossi, Sandra, Rueckert, Daniel, de Ruiter, Godard C W, Sacchi, Marco, Sahakian, Barbara J, Sahuquillo, Juan, Sakowitz, Oliver, Salvato, Gerardo, Sánchez-Porras, Renán, Sándor, János, Sangha, Grinder, Schäfer, Nadine, Schmidt, Silke, Schneider, Kathryn J, Schnyer, David, Schöhl, Herbert, Schoonman, Guus G, Schou, Rico Frederik, Sir, Özcan, Skandsen, Toril, Smeets, Dirk, Sorinola, Abayomi, Stamatakis, Emmanuel, Stevanovic, Ana, Stevens, Robert D, Sundström, Nina, Taccone, Fabio Silvio, Takala, Riikka, Tanskanen, Päivi, Taylor, Mark Steven, Telgmann, Ralph, Temkin, Nancy, Teodorani, Guido, Thomas, Matt, Tolias, Christos M, Trapani, Tony, Turgeon, Alexis, Vajkoczy, Peter, Valadka, Alex B, Valeinis, Egils, Vallance, Shirley, Vámos, Zoltán, Vargiolu, Alessia, Vega, Emmanuel, Verheyden, Jan, Vik, Anne, Vilcinis, Rimantas, Vleggeert-Lankamp, Carmen, Vogt, Lidia, Volovici, Victor, Voormolen, Daphne C, Vulekovic, Peter, Vande Vyvere, Thijs, Van Waesberghe, Julia, Wessels, Lars, Wildschut, Eno, Williams, Guy, Winkler, Maren K L, Wolf, Stefan, Wood, Gordon, Xirouchaki, Nektaria, Younsi, Alexander, Zaaroor, Menashe, Zelinkova, Veronika, Zemek, Roger, Zumbo, Fabrizio, Maas, Andrew I R, Menon, David K, Adelson, P David, Andelic, Nada, Bell, Michael J, Belli, Antonio, Bragge, Peter, Brazinova, Alexandra, Büki, András, Chesnut, Randall M, Citerio, Giuseppe, Coburn, Mark, Cooper, D Jamie, Crowder, A Tamara, Czeiter, Endre, Czosnyka, Marek, Diaz-Arrastia, Ramon, Dreier, Jens P, Duhaime, Ann-Christine, Ercole, Ari, van Essen, Thomas A, Feigin, Valery L, Gao, Guoyi, Giacino, Joseph, Gonzalez-Lara, Laura E, Gruen, Russell L, Gupta, Deepak, Hartings, Jed A, Hill, Sean, Jiang, Ji-yao, Ketharanathan, Naomi, Kompanje, Erwin J O, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Levin, Harvey, Lingsma, Hester F, Maegele, Marc, Majdan, Marek, Manley, Geoffrey, Marsteller, Jill, Mascia, Luciana, McFadyen, Charles, Mondello, Stefania, Newcombe, Virginia, Palotie, Aarno, Parizel, Paul M, Peul, Wilco, Piercy, James, Polinder, Suzanne, Puybasset, Louis, Rasmussen, Todd E, Rossaint, Rolf, Smielewski, Peter, Söderberg, Jeannette, Stanworth, Simon J, Stein, Murray B, von Steinbüchel, Nicole, Stewart, William, Steyerberg, Ewout W, Stocchetti, Nino, Synnot, Anneliese, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Tibboel, Dick, Videtta, Walter, Wang, Kevin K W, Williams, W Huw, Wilson, Lindsay, and Yaffe, Kristine

Published
2017
Full Text
View/download PDF

18. A Performance-Based Competency Assessment of Pediatric Chest Radiograph Interpretation Among Practicing Physicians.

Author

Bregman, Stacey, Thau, Elana, Pusic, Martin, Perez, Manuela, and Boutis, Kathy

Subjects
NATIONAL competency-based educational tests, COMPUTERS in medicine, KRUSKAL-Wallis Test, STATISTICS, CHEST X rays, CONFIDENCE intervals, PEDIATRICS, DIAGNOSTIC imaging, BENCHMARKING (Management), CLINICAL competence, OUTCOME-based education, DESCRIPTIVE statistics, SENSITIVITY & specificity (Statistics), DATA analysis software, DATA analysis, DIAGNOSTIC errors, PSYCHOLOGY of physicians, LONGITUDINAL method, MEDICAL education
Abstract

Introduction: There is limited knowledge on pediatric chest radiograph (pCXR) interpretation skill among practicing physicians. We systematically determined baseline interpretation skill, the number of pCXR cases physicians required complete to achieve a performance benchmark, and which diagnoses posed the greatest diagnostic challenge. Methods: Physicians interpreted 434 pCXR cases via a web-based platform until they achieved a performance benchmark of 85% accuracy, sensitivity, and specificity. Interpretation difficulty scores for each case were derived by applying one-parameter item response theory to participant data. We compared interpretation difficulty scores across diagnostic categories and described the diagnoses of the 30% most difficult-to-interpret cases. Results: 240 physicians who practice in one of three geographic areas interpreted cases, yielding 56,833 pCXR case interpretations. The initial diagnostic performance (first 50 cases) of our participants demonstrated an accuracy of 68.9%, sensitivity of 69.4%, and a specificity of 68.4%. The median number of cases completed to achieve the performance benchmark was 102 (interquartile range 69, 176; min, max, 54, 431). Among the 30% most difficult-to-interpret cases, 39.2% were normal pCXR and 32.3% were cases of lobar pneumonia. Cases with a single trauma-related imaging finding, cardiac, hilar, and diaphragmatic pathologies were also among the most challenging. Discussion: At baseline, practicing physicians misdiagnosed about one-third of pCXR and there was up to an eight-fold difference between participants in number of cases completed to achieve the standardized performance benchmark. We also identified the diagnoses with the greatest potential for educational intervention. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

25. Validation and refinement of a clinical decision rule for the use of computed tomography in children with minor head injury in the emergency department

Author

Osmond, Martin H., Klassen, Terry P., Wells, George A., Davidson, Jennifer, Correll, Rhonda, Boutis, Kathy, Joubert, Gary, Gouin, Serge, Khangura, Simi, Turner, Troy, Belanger, Francois, Silver, Norm, Taylor, Brett, PhD, Janet Curran, and Stiell, Ian G.

Subjects
Pediatric injuries -- Diagnosis, Head injuries -- Diagnosis, Emergency medicine -- Standards, Pediatric emergencies -- Diagnosis, CAT scans -- Standards, Health
Abstract

BACKGROUND: There is uncertainty about which children with minor head injury need to undergo computed tomography (CT). We sought to prospectively validate the accuracy and potential for refinement of a previously derived decision rule, Canadian Assessment of Tomography for Childhood Head injury (CATCH), to guide CT use in children with minor head injury. METHODS: This multicentre cohort study in 9 Canadian pediatric emergency departments prospectively enrolled children with blunt head trauma presenting with a Glasgow Coma Scale score of 13-15 and loss of consciousness, amnesia, disorientation, persistent vomiting or irritability. Physicians completed standardized assessment forms before CT, including clinical predictors of the rule. The primary outcome was neurosurgical intervention and the secondary outcome was brain injury on CT. We calculated test characteristics of the rule and used recursive partitioning to further refine the rule. RESULTS: Of 4060 enrolled patients, 23 (0.6%) underwent neurosurgical intervention, and 197 (4.9%) had brain injury on CT. The original 7-item rule (CATCH) had sensitivities of 91.3% (95% confidence interval [CI] 72.0%-98.9%) for neurosurgical intervention and 97.5% (95% CI 94.2%-99.2%) for predicting brain injury. Adding '[greater than or equal to] 4 episodes of vomiting' resulted in a refined 8-item rule (CATCH2) with 100% (95% CI 85.2%100%) sensitivity for neurosurgical intervention and 99.5% (95% CI 97.2%-100%) sensitivity for brain injury. INTERPRETATION: Among children presenting to the emergency department with minor head injury, the CATCH2 rule was highly sensitive for identifying those children requiring neurosurgical intervention and those with any brain injury on CT. The CATCH2 rule should be further validated in an implementation study designed to assess its clinical impact., Pediatric head injury accounts for more than 500 000 emergency department visits annually in the United States. (1) Most head injuries are mild and do not require neurosurgical management. However, [...]

Published
2018
Full Text
View/download PDF

28. How safe are paediatric emergency departments? A national prospective cohort study

Author

Plint, Amy C, primary, Newton, Amanda S, additional, Stang, Antonia, additional, Cantor, Zach, additional, Hayawi, Lamia, additional, Barrowman, Nick, additional, Boutis, Kathy, additional, Gouin, Serge, additional, Doan, Quynh, additional, Dixon, Andrew, additional, Porter, Robert, additional, Joubert, Gary, additional, Sawyer, Scott, additional, Crawford, Tyrus, additional, Gravel, Jocelyn, additional, Bhatt, Maala, additional, Weldon, Patrick, additional, Millar, Kelly, additional, Tse, Sandy, additional, Neto, Gina, additional, Grewal, Simran, additional, Chan, Melissa, additional, Chan, Kevin, additional, Yung, Grant, additional, Kilgar, Jennifer, additional, Lynch, Tim, additional, Aglipay, Mary, additional, Dalgleish, Dale, additional, Farion, Ken, additional, Klassen, Terry P, additional, Johnson, David W, additional, and Calder, Lisa A, additional

Published
2022
Full Text
View/download PDF

30. Using Signal Detection Theory to Model Changes in Serial Learning of Radiological Image Interpretation

Author

Boutis, Kathy, Pecaric, Martin, and Seeto, Brian

Abstract

Signal detection theory (SDT) parameters can describe a learner's ability to discriminate (d[prime symbol]) normal from abnormal and the learner's criterion ([lambda]) to under or overcall abnormalities. To examine the serial changes in SDT parameters with serial exposure to radiological cases. 46 participants were recruited for this study: 20 medical students (MED), 6 residents (RES), 12 fellows (FEL), 5 staff pediatric emergency physicians (PEM), and 3 staff radiologists (RAD). Each participant was presented with 234 randomly assigned ankle radiographs using a web-based application. Participants were given a clinical scenario and considered 3 views of the ankle. They classified each case as normal or abnormal. For abnormal cases, they specified the location of the abnormality. Immediate feedback included highlighting on the images and the official radiologist's report. The low experience group (MED, RES, FEL) showed steady improvement in discrimination ability with each case, while the high experience group (PEM, RAD) had higher and stable discrimination ability throughout the exercise. There was also a difference in the way the high and low experience groups balanced sensitivity and specificity ([lambda]) with the low experience group tending to make more errors calling positive radiographs negative. This tendency was progressively less evident with each increase in expertise level. SDT metrics provide valuable insight on changes associated with learning radiograph interpretation, and may be used to design more effective instructional strategies for a given learner group. (Contains 2 tables and 6 figures.)

Published
2010
Full Text
View/download PDF

36. Paediatric post-concussive symptoms: symptom clusters and clinical phenotypes

Author

Lyons, Todd W, primary, Mannix, Rebekah, additional, Tang, Ken, additional, Yeates, Keith Owen, additional, Sangha, Gurinder, additional, Burns, Emma CM, additional, Beer, Darcy, additional, Dubrovsky, Alexander S, additional, Gagnon, Isabelle, additional, Gravel, Jocelyn, additional, Freedman, Stephen B, additional, Craig, William, additional, Boutis, Kathy, additional, Osmond, Martin H, additional, Gioia, Gerard, additional, and Zemek, Roger, additional

Published
2022
Full Text
View/download PDF

40. Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED

Author

Zemek, Roger, Barrowman, Nick, Freedman, Stephen B., Gravel, Jocelyn, Gagnon, Isabelle, McGahern, Candice, Aglipay, Mary, Sangha, Gurinder, Boutis, Kathy, Beer, Darcy, Craig, William, Burns, Emma, Farion, Ken J., Mikrogianakis, Angelo, Barlow, Karen, Dubrovsky, Alexander S., Meeuwisse, Willem, Gioia, Gerard, Meehan, William P., III, Beauchamp, Miriam H., Kamil, Yael, Grool, Anne M., Hoshizaki, Blaine, Anderson, Peter, Brooks, Brian L., Yeates, Keith Owen, Vassilyadi, Michael, Klassen, Terry, Keightley, Michelle, Richer, Lawrence, DeMatteo, Carol, and Osmond, Martin H.

Published
2016
Full Text
View/download PDF

47. Delayed identification of pediatric abuse-related fractures

Author

Ravichandiran, Nisanthini, Schuh, Suzanne, Bejuk, Marta, Al-Harthy, Nesrin, Shouldice, Michelle, Au, Hosanna, and Boutis, Kathy

Subjects
Child abuse -- Evaluation, Physicians -- Powers and duties, Children -- Injuries, Children -- Diagnosis
Published
2010

48. Learning Pediatric Point-of-Care Ultrasound

Author

Kwan, Charisse, primary, Weerdenburg, Kirstin, additional, Pusic, Martin, additional, Constantine, Erika, additional, Chen, Aaron, additional, Rempell, Rachel, additional, Herman, Joshua E., additional, and Boutis, Kathy, additional

Published
2021
Full Text
View/download PDF

49. Interleukin-8 Predicts Fatigue at 12 Months Post-Injury in Children with Traumatic Brain Injury

Author

Crichton, Alison, primary, Ignjatovic, Vera, additional, Babl, Franz E., additional, Oakley, Ed, additional, Greenham, Mardee, additional, Hearps, Stephen, additional, Delzoppo, Carmel, additional, Beauchamp, Miriam H., additional, Guerguerian, Anne-Marie, additional, Boutis, Kathy, additional, Hubara, Evyatar, additional, Hutchison, Jamie, additional, and Anderson, Vicki, additional

Published
2021
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results