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...

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Main Author:	Saad, Mohd Shukri Mat
Format:	Thesis
Language:	English
Published:	2017
Subjects:	R Medicine (General)
Online Access:	http://eprints.usm.my/44732/1/Dr.%20Mohd%20Shukri%20Mat%20Saad-24%20pages.pdf
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id	my-usm-ep.44732
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spelling	my-usm-ep.447322020-10-22T03:03:15Z Determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in Emergency Department 2017 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 http://eprints.usm.my/44732/ http://eprints.usm.my/44732/1/Dr.%20Mohd%20Shukri%20Mat%20Saad-24%20pages.pdf application/pdf en public masters Pusat Pengajian Sains Perubatan Universiti Sains Malaysia
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine (General)
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
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.
format	Thesis
qualification_level	Master's degree
author	Saad, Mohd Shukri Mat
author_facet	Saad, Mohd Shukri Mat
author_sort	Saad, Mohd Shukri Mat
title	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_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_sort	determining the content validity and reliability of twed matrix as a cognitive debiasing strategy in clinical decision making in emergency department
granting_institution	Pusat Pengajian Sains Perubatan
granting_department	Universiti Sains Malaysia
publishDate	2017
url	http://eprints.usm.my/44732/1/Dr.%20Mohd%20Shukri%20Mat%20Saad-24%20pages.pdf
_version_	1747821394636308480

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

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