Decision Support Tools in Medicine: Evidence-Based Medicine Approach in Tamale Teaching Hospital

Abstract

Objective: To determine whether laboratory results match the preliminary diagnosis, using a model of malaria diagnosis by clinical staff at Tamale Teaching Hospital (TTH), Ghana.
Methods: Data of outpatients diagnosed with malaria in 2012 were collected retrospectively from clinical notes. Data of the clinicians who provided the preliminary diagnoses were collected by self-reporting questionnaire. Statistical analyses were performed with Epi-Info and SPSS software.
Results: A total of 344 patients were diagnosed with malaria in 2012, consisting of 186 females and 158 males. The age ranges between one month and 80 years. Forty-four clinicians responded to the questionnaire, consisting of 12 females and 32 males with mean ± SD age of 40.2±10.0 years. Respondents included consultants, medical officers, house officers, physician assistants, physician specialists and senior nurses, with mean ± SD years since qualification of 11.6±9.8 (range: 1-40 years). Nearly one-half (49%) of the clinicians reported not normally requesting laboratory investigations for suspected cases of malaria, thus not following an evidence-based approach for preliminary diagnosis. Slightly over onehalf (51%) of the preliminary diagnoses of malaria in suspected cases were incorrect. However, statistical assessment of the clinician’s preliminary diagnosis and the results from laboratory tests for malaria parasites showed a correlation (p=0.6548 at 95% CI).
Conclusion: Practice of evidence-based medicine and establishment of a technology-based healthcare system can lead to decrease incorrect diagnoses and inappropriate health care management