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Table 5 Estimated effects of the intervention on clinical practice outcomes

From: Evaluation of a targeted, theory-informed implementation intervention designed to increase uptake of emergency management recommendations regarding adult patients with mild traumatic brain injury: results of the NET cluster randomised trial

  NET control1 NET intervention2
No. of patients No. of (%) No. of patients No. of (%) Adj. ORs**§§ 95%CI p value Adj. ARD %^ 95%CI
Outcomes measuring the implementation of single clinical recommendations
 Appropriate post-traumatic amnesia screening (PTA)* 1050 12 (1.1) 893 117 (13) 20.1 (6.8, 59.3) < 0.001 14 (8, 19)
 PTA screening-tool 1050 15 (1.4) 893 152 (17) 19.7 (6.6, 58.1) < 0.001 17 (11, 23)
 Memory-clinical assessment 1050 272 (26) 893 303 (34) 1.6 (1.2, 2.1) 0.001 9.5 (4.0, 15.1)
 CT scan-clinical criteria (CT)§ 494 337 (68) 491 352 (72) 1.2 (0.8, 1.6) 0.375 3.2 (− 3.7, 10.0)
 CT scan (all) 1050 458 (44) 893 446 (50) 1.2 (0.9, 1.6) 0.142 4.5 (− 1.5, 10.5)
 Provision of written patient information (INFO) 944 175 (19) 785 160 (20) 1.2 (0.8, 1.8) 0.302 3.1 (− 3.0, 9.3)
Outcomes measuring the implementation of composite recommendations
 Safe discharge based on PTA and INFO 944 2 (0.2) 785 45 (6) 27.6 (6.9, 110.5) < 0.001 5.8 (2.7, 8.9)
 Safe discharge based on PTA, CT, and INFO§§§ 413 0 (0) 402 14 (3.5) 1.8 (1.1, 3.0) 0.022 3.5 (1.0, 6.0)
  1. 1Number of clusters = 17
  2. 2Number of clusters = 14
  3. ORs = odds ratios
  4. *Primary outcome
  5. §Criteria that justify a scan are age 65 or older; GCS < 15, amnesia, suspected skull fracture, vomiting and coagulopathy. Only the subset of patients who have these symptoms noted in the medical records are included in the analysis
  6. **Adjusted odds ratios estimated from marginal logistic regression models using generalised estimating equations with an exchangeable correlation structure (unless otherwise noted) and robust variance estimation to allow for clustering of responses within EDs
  7. §§All models (unless otherwise noted) adjusted for the minimisation factors and pre-specified confounders (see ‘Effectiveness analyses’ section)
  8. §§§For this outcome, because there were no safe discharges in the control group, a cluster-level analysis was undertaken resulting in a ratio of geometric mean proportions. Details available in Additional file 2
  9. ^ARD calculated from marginal probabilities [75]. Confidence intervals for the metric were obtained by a pairwise comparison of margins after fitting a GEE model using Stata [43] allowing for clustering of observations within EDs