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Third-party-funded project

Title:
Development and evaluation of a systematically graded social medical decision making tool (Project C-5)

Project management at the University of Würzburg:

• Dr. Heiner Vogel

Participating scientists:

• Dr. Anton Holderied , Landesversicherungsanstalt Unterfranken
• Dipl.-Psych. Susanne Frank , Arbeitsbereich Rehabilitationswissenschaften, Institut für Psychotherapie und Medizinische Psychologie der Universität Würzburg, Marcusstraße 9-11, 97070 Würzburg
• Mag. rer. nat. Julia Zdrahal-Urbanek , Arbeitsbereich Rehabilitationswissenschaften, Institut für Psychotherapie und Medizinische Psychologie der Universität Würzburg, Marcusstraße 9-11, 97070 Würzburg,Tel: +49-931-31-2072,Fax: +49-931-31-2078,Mail: j.zdrahal@mail.uni-wuerzburg.de
• Dr. Horst Eilmes , Sozialmedizinischer Dienst der LVA Ober- und Mittelfranken
• Dr. Bernd Keßler , Sozialmedizinischer Dienst der LVA Schwaben
• Dr. Reinhard Legner , Sozialmedizinischer Dienst der LVA Niederbayern-Oberpfalz
• Dr. Dieter Schmidt , Sozialmedizinischer Dienst der LVA Oberbayern

Abstract:


Background

In social medical assessment, where there is still a lack of evidence based decision making tools, all problems and biases known from diagnostic judgement examinations, especially those known from physical diagnostics, can occur. A particular difficulty in social medical decision making results from the discretionary powers of the relatively abstract formulated decision criteria. Furthermore, information processing is due to the fact that various sources of information exist, which partly supply redundant and inconsistent information, extraordinarily complex. To implement social medical assessment of high quality, the development of a systematised and standardised two-step decision tool is suggested. For that, results from project C-2, which took part during the first phase of RFBs’ supported research projects, and expert discussions will be applied.



Aims

The project consists of the following two steps: First, algorithms are developed on the basis of the results of project C-2 and expert discussions. These algorithms are to be used to judge whether there is need for rehabilitation or not and whether additional social medical assessments are necessary. Second, these algorithms have to be evaluated concerning their ability to reduce error rates in judging whether a patient has need for rehabilitation or not compared to the previous decision strategy.



Method

A controlled, prospective and longitudinal study design is planned during which the newly developed decision tools are compared with the current assessment procedure. The correlation of both procedures with the external criteria (IRES-questionnaire and additional medical assessment by rehabilitation clinicians) represents the principal purpose of the comparison.

Key words:
    medical rehabilitation
    social medical assessment
    medical judgement and decision making
    evidence based medicine
    need for rehabilitation
    experimental design

Projekt period: from 04.2002 to 03.2005

Funding institution:
Sonstige öffentliche Mittel ( VDR ) ,Granting date: 22.03.2002

Preceding project:
Projekt C-2

Publications:

• Zdrahal-Urbanek, J., Frank, S., Vogel, H. & Holderied, A.. ((under review)). Merkmale des Rehabilitationsbedarfs – Unterschiedliche Systeme der sozialmedizinischen Begutachtung im Vergleich mit der Würzburger Checkliste zur Prüfung des Reha-Bedarfs.. (monograph)

Links:
RFB-Homepage