Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department

Background: Cognitive biases always complicate clinical decision making in emergency department. TWED Matrix was invented as a tool for debiasing strategy to reduce diagnostic error caused by cognitive biases. It is in the form of mnemonic to encourage metacognition by doctors to reduce errors in...

Full description

Bibliographic Details
Main Author: Saad, Mohd Shukri Mat
Format: Thesis
Language:English
Published: 2017
Subjects:
Online Access:http://eprints.usm.my/44732/1/Dr.%20Mohd%20Shukri%20Mat%20Saad-24%20pages.pdf
_version_ 1825835022849933312
author Saad, Mohd Shukri Mat
author_facet Saad, Mohd Shukri Mat
author_sort Saad, Mohd Shukri Mat
collection USM
description Background: Cognitive biases always complicate clinical decision making in emergency department. TWED Matrix was invented as a tool for debiasing strategy to reduce diagnostic error caused by cognitive biases. It is in the form of mnemonic to encourage metacognition by doctors to reduce errors in clinical decision making in emergency department. As it is relatively new tool, a study was conducted to determine the content validity and reliability of TWED Matrix as cognitive debiasing strategy in clinical decision making in emergency medicine. Methodology: This study was divided into two stages; the developmental stage and the judgment stage. In the developmental stage, we narrowed down 50 cognitive biases into six classes, and total of four vital questions covering eight items were asked. Then, in the judgment stage, emergency physicians as expert judges were chosen to evaluate eight items in the form of Likert scale for their relevance and representativeness. For relevance, CVI and modified Kappa were assessed and for representativeness, CVI was calculated. Reliability was tested using Cronbach Alpha. Results: For relevancy, all of the items were scored of CVI more than 0.78. CVI average for relevancy was 0.89. Modified Kappa statistic was calculated to make adjustment for possibilities of chance agreement. For representativeness, all eight items produced CVI of more than 0.78 which is the minimum value for CVI acceptance. CVIaverage was 0.94. Alpha value for item relevancy was 0.767 which is within acceptable value. Reliability on item representativeness produced Cronbach’s Alpha of 0.737 which is still above acceptance value of 0.7. Conclusion: TWED Matrix showed significant validity and reliability in this study although further evaluation and assessment needed to strengthen the power of the study before it could safely and widely use as a cognitive debiasing strategy in clinical decision making in emergency department.
first_indexed 2024-03-06T15:31:29Z
format Thesis
id usm.eprints-44732
institution Universiti Sains Malaysia
language English
last_indexed 2024-03-06T15:31:29Z
publishDate 2017
record_format dspace
spelling usm.eprints-447322020-10-22T03:03:15Z http://eprints.usm.my/44732/ Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department Saad, Mohd Shukri Mat R Medicine (General) Background: Cognitive biases always complicate clinical decision making in emergency department. TWED Matrix was invented as a tool for debiasing strategy to reduce diagnostic error caused by cognitive biases. It is in the form of mnemonic to encourage metacognition by doctors to reduce errors in clinical decision making in emergency department. As it is relatively new tool, a study was conducted to determine the content validity and reliability of TWED Matrix as cognitive debiasing strategy in clinical decision making in emergency medicine. Methodology: This study was divided into two stages; the developmental stage and the judgment stage. In the developmental stage, we narrowed down 50 cognitive biases into six classes, and total of four vital questions covering eight items were asked. Then, in the judgment stage, emergency physicians as expert judges were chosen to evaluate eight items in the form of Likert scale for their relevance and representativeness. For relevance, CVI and modified Kappa were assessed and for representativeness, CVI was calculated. Reliability was tested using Cronbach Alpha. Results: For relevancy, all of the items were scored of CVI more than 0.78. CVI average for relevancy was 0.89. Modified Kappa statistic was calculated to make adjustment for possibilities of chance agreement. For representativeness, all eight items produced CVI of more than 0.78 which is the minimum value for CVI acceptance. CVIaverage was 0.94. Alpha value for item relevancy was 0.767 which is within acceptable value. Reliability on item representativeness produced Cronbach’s Alpha of 0.737 which is still above acceptance value of 0.7. Conclusion: TWED Matrix showed significant validity and reliability in this study although further evaluation and assessment needed to strengthen the power of the study before it could safely and widely use as a cognitive debiasing strategy in clinical decision making in emergency department. 2017 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/44732/1/Dr.%20Mohd%20Shukri%20Mat%20Saad-24%20pages.pdf Saad, Mohd Shukri Mat (2017) Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department. Masters thesis, Pusat Pengajian Sains Perubatan.
spellingShingle R Medicine (General)
Saad, Mohd Shukri Mat
Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department
title Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department
title_full Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department
title_fullStr Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department
title_full_unstemmed Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department
title_short Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department
title_sort determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in emergency department
topic R Medicine (General)
url http://eprints.usm.my/44732/1/Dr.%20Mohd%20Shukri%20Mat%20Saad-24%20pages.pdf
work_keys_str_mv AT saadmohdshukrimat determiningthecontentvalidityandreliabilityoftwedmatrixasacognitivedebiasingstrategyinclinicaldecisionmakinginemergencydepartment