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Flow diagram or prose: does the format of practice guidelines matter?
R D Hardern1, L C Hodgson, D W Hamer
1General Infirmary, Leeds, UK.
Summary
Comparing guideline formats for paracetamol poisoning management, this study found no significant performance difference between prose and flow diagrams. However, access to either guideline format improved correct management compared to no access.
Area of Science:
- Toxicology
- Medical Education
- Emergency Medicine
Background:
- Effective management of paracetamol poisoning relies on accessible and understandable clinical guidelines.
- Previous research has not definitively established the optimal format for presenting these guidelines.
Purpose of the Study:
- To compare the performance of prose versus flow diagram formats for paracetamol poisoning management guidelines.
- To evaluate the impact of guideline accessibility on the accuracy of management decisions.
Main Methods:
- A prospective questionnaire study involving senior house officers.
- Seven hypothetical cases of paracetamol ingestion were presented.
- Management accuracy and time were assessed for groups with flow diagrams, prose guidelines, or no guidelines.
Main Results:
- No statistically significant difference in correct answer proportions between the flow diagram (37%) and prose (31%) guideline groups.
- The group without access to guidelines showed significantly lower correct answer rates (19%).
- No significant variation in time taken to answer questions across groups.
Conclusions:
- Neither prose nor flow diagram formats demonstrated superior performance for paracetamol poisoning guidelines.
- Access to clinical guidelines, regardless of format, is crucial for improving the accuracy of poisoning management.
- Further research may explore combined or interactive guideline formats.