Page 25 - JCTR-10-2

Journal of Clinical and Translational Research 2024; 10(2): 119-140

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

REVIEW ARTICLE

Identification of the essential and critical factors of decision-making for

COVID-19 patient management: a mixed-method study

Hamidreza Abtahi , Sharareh Rostam Niakan Kalhori , Amir Hossein Abooei , Moloud Taheriyan ,
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1
2,3
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Seyed Mohammad Ayyoubzadeh , Marsa Gholamzadeh *, Elham Sadat Mousavinasab , Shahideh Amini ,
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6
5
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Mojghan Mohajeri Iravani , Alireza Bahramnejad 8
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1 Department of Pulmonary and Critical Care, Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences,
Tehran, Iran, Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran,
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Iran, Department of Computer Science, Peter L. Reichertz Institute for Medical Informatics, Technical University of Braunschweig, Braunschweig,
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Germany, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy, Department of Health Information Management,
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School of Allied Medical Sciences, Kashan University of Medical Science, Kashan, Iran, Department of Clinical Pharmacy, Faculty of Pharmacy,
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Tehran University of Medical Sciences, Tehran, Iran, Department of Anesthesiology and Critical Care, Aja University of Medical Sciences, Tehran,
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Iran, Department of Emergency Medicine, Iran University of Medical Sciences, Tehran, Iran
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ARTICLE INFO Abstract
Article history: Background: Understanding the contributing factors for decision-making based on the disease stage
Received: December 21, 2022 is highly crucial to improving patient care.
Accepted: October 27, 2023 Aim: This study aimed to identify the critical and essential factors to enhance clinical decision-making
Published Online: March 20, 2024 for COVID-19 patients.
Methods: This mixed-method research was conducted in two phases. In the first phase, a systematic
Keywords: literature review was performed using defined search strategies across four databases, including
COVID-19 PubMed, Scopus, Web of Science, and IEEE. A total of 136 studies were obtained. Next, a
Coronavirus questionnaire-based survey was conducted to validate the findings from the review and to categorize
Decision-making the factors into essential and critical factors. The content validity ratio was used to categorize the
Triage factors accordingly. The identified factors were classified into six main categories based on the stages
Uncertainty of care and the corresponding decision-making.
Patient management Results: The expert panel consisted of 10 clinicians from various fields. The potential factors were
categorized into six categories. A total of 293 factors were found in the literature review. The findings
of the consensus survey revealed 10 factors related to the decisions on the length of stay, eight factors
*Corresponding authors: for ward referral decisions, one factor for decisions on home referrals, six factors for deterioration
Marsa Gholamzadeh diagnosis decisions, two factors for discharge decisions, and 10 factors for decisions on intensive care
Department of Health Information Management, unit referrals. In addition, the study identified respiratory rate, oxygen saturation at administration,
School of Allied Medical Sciences, Tehran
University of Medical Sciences, Fardanesh arterial oxygen pressure, sequential organ failure assessment score, and glomerular filtration rate as
Alley, Qods Street, Tehran, Iran. significant decision-making factors for COVID-19 patient management.
Email: marsa.gholamzadeh@yahoo.com Conclusion: For medical emergencies (e.g., COVID-19 management), fewer but more significant
factors may increase the efficiency of decision-making, thereby improving the quality of patient
© 2024 Author(s). This is an Open-Access management. On this basis, this study identified the essential and critical factors for decision-making
article distributed under the terms of the at different stages of COVID-19 patient management.
Creative Commons Attribution-Noncommercial Relevance for Patients: This study identified the most important factors in diagnosing the deterioration
License, permitting all non-commercial use, of COVID-19 patients to improve the treatment outcome of COVID-19 patients.
distribution, and reproduction in any medium,
which provided that the original work is
properly cited.
1. Introduction
The COVID-19 pandemic has been known as a global challenge that requires inclusive
approaches to control. COVID-19 is caused by a new virus that was officially named
DOI: https://doi.org/10.36922/jctr.22.00226