Trauma victims do not always receive the best care possible for their injuries. Certain procedures used to help diagnose trauma injuries are often used inappropriately. A computed tomography (CT) head scan is an important diagnostic test used to help determine if a patient has a brain injury. However, CT scans also expose patients to ionizing radiation and may increase the risk of the patient developing cancer during his or her lifetime. Therefore, it is important that patients who do not show signs or symptoms of serious injuries do not receive CT scans. In Canada, many patients with mild traumatic brain injury (mTBI) receive unnecessary head CT scans. One reason why CT scans are overused is that patients ask for the scans. However, patients and doctors make better decisions about the patients’ health when they share decision making. Patient decision aids are paper or Internet-based tools that help patients become involved in decision making about their health care. Patient decision aids clearly explain the health care decision that needs to be made, provide information about the options and outcomes, and by help patients express their personal values.
There exist two American patient decision aids to help adults with mTBI and parents of children with mTBI to decide if they want CT scans. However, there are no Canadian patient decision aids on the same subject. The goal of our project is to involve Canadian experts to help us adapt the American decision aids to a Canadian context. The adapted decision aids will reflect the values and health issues of Canadian mTBI patients. We will invite 25 Canadian emergency room doctors, researchers, decision makers and patient representatives to help us create patient decision aids for adults and children about head CT scans. These experts will meet for one day in Quebec City in January 2017 to decide what information should be put into the Canadian decision aids. After the meeting, eight Canadian experts will join a scientific committee which will meet regularly over video conferencing. The experts on the scientific committee will offer their advice to help improve the decision aids as they are tested with patients.
This project is important because it will help Canadian patients with mTBI and their doctors make better decisions about head CT scans. We hope that our project will help reduce the number of Canadian patients with mTBI that receive unnecessary CT scans. By involving Canadian experts in the preparation and testing of the decision aids in Canadian contexts, we will create improved decision aids that are adapted to Canadian values and health issues.
Patrick Archambault (Université Laval et CISSS de Chaudière-Appalaches)
Louise Sauvé; Patrick Plante; Isabelle Gagnon (Hôpital de Montréal pour enfants); Rob Green (Dalhousie University); Roger Zemek (Children's hospital of Eastern Ontario); Janet Curran (IWK Health Center - Nova Scotia); Marie-Pierre Gagnon (CHU de Québec - Hôpital St-François d'Assise); Jocelyn Gravel CHU Ste-Justine); France Légaré (Université Laval); Marie-Christine Ouellet (CIRRIS-IRDPQ); Annie Leblanc (CHU de Québec - Hôpital St-François d'Assise); Nathalie Le Sage (CHU de Québec - Hôpital de l'Enfant-Jésus); Eddy Lang (Rockyview General Hospital - Calgary); Holly Witteman (Université Laval); Richard Riopelle (McGill)
Canadian Traumatic Brain Injury Research Consortium (CTRC)
Project Grant Competition
2016 - 2018
45 277,00 $