Difference between revisions of "Ranapurwala"
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| − | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:"><span style="color:black">The addition of a formal pre-dive checklist reduced the rate of both major and minor mishaps reported during recreational scuba-diving</span></span></span>'''</span> |
| − | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:"><span style="color:black">Clinical bottom line:</span></span></span>'''</span> |
| − | {| class="Table" style="width: | + | {| class="Table" style="width: 766px; border: 1pt solid windowtext;" width="0" |
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| − | <span style="font-size:large;"><span style="line-height:normal"><span style="height:27.5pt | + | '''<span style="font-size:large;"><span style="line-height:normal"><span style="height:27.5pt">1. The addition of a checklist reduced the incidence of major mishaps reported by 36%</span></span></span>''' |
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| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. Ranapurwala SI, Denoble PJ, Poole C, Kucera KL, Marshall SW, Wing S. The effect of using a pre-dive checklist on the incidence of diving mishaps in recreational scuba diving: a cluster-randomized trial. Int J Epidemiol. 2016 Feb;45(1):223-31.<br/> '''Lead author's name and email: '''Shabbar Ranapurwala shabbarkaid@gmail.com</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Three-part Clinical Question:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">For recreational scuba divers, does the addition of a pre-dive checklist to the usual pre-dive preparation, result in any improvement in the rate of diving mishaps?<br/> '''Search Terms:''' scuba; checklists; safety</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Study:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Single-blinded randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Adult qualified scuba divers at four locations and recruited at the shore before a planned dive.<br/> '''Control group''' (N = 467; 426 analysed): No intervention except the request to complete a post-dive log.<br/> '''Experimental group''' (N = 693; 617 analysed): As above but with the addition of a pre-dive checklist</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span> |
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{| class="Table" style="border:solid windowtext 1.0pt" | {| class="Table" style="border:solid windowtext 1.0pt" | ||
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| − | | style="width:125.1pt; border:solid windowtext 1.0pt" width="170" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:125.1pt; border:solid windowtext 1.0pt" width="170" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Non-Event Outcomes</span></span>'''</span></p> |
| − | | style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Time to outcome/s</span></span>'''</span></p> |
| − | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control group</span></span>'''</span></p> |
| − | | style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Checklist group</span></span>'''</span></p> |
| − | | style="width:151.1pt; border:solid windowtext 1.0pt" width="204" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:151.1pt; border:solid windowtext 1.0pt" width="204" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Relative risk</span></span>'''</span></p> |
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| style="width:125.1pt; border:solid windowtext 1.0pt" width="170" | | | style="width:125.1pt; border:solid windowtext 1.0pt" width="170" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Rate of major mishaps/100 dives</span></span>'''</span> |
| − | | style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">Post-dive</span></span></span></p> |
| − | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">10.2</span></span></span></p> |
| − | | style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">7.5</span></span></span></p> |
| − | | style="width:151.1pt; border:solid windowtext 1.0pt" width="204" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:151.1pt; border:solid windowtext 1.0pt" width="204" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">RR 0.64 (95%CI 0.46 to 0.87)</span></span></span></p> |
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| style="width:125.1pt; border:solid windowtext 1.0pt" width="170" | | | style="width:125.1pt; border:solid windowtext 1.0pt" width="170" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Rate of major or minor mishaps/100 dives</span></span>'''</span> |
| − | | style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.2pt; border:solid windowtext 1.0pt" width="76" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">Post-dive</span></span></span></p> |
| − | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">19.5</span></span></span></p> |
| − | | style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">15.5</span></span></span></p> |
| − | | style="width:151.1pt; border:solid windowtext 1.0pt" width="204" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:151.1pt; border:solid windowtext 1.0pt" width="204" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">RR 0.68 (95%CI 0.50 to 0.93)</span></span></span></p> |
|} | |} | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. This trial was cluster randomised by computer generated sequence and was concealed allocation. There were 70 intervention allocations (30 control, 40 intervention) including a total of 1043 individual divers. The imbalance of numbers between groups was discussed and seems due to chance. <br/> 2. Authors used a complicated regression process for known confounders including sex, age, BMI, poor visibility, animal attack and others. They also examined adherence to the checklist.<br/> 3. NNT to avoid a major mishap was 37 dives.</span></span></span></span> |
| − | <span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">'''Appraised by: '''Mike bennett m.bennett@unsw.edu.au ; Monday, 23 August 2021<br/> '''Kill or Update By:''' August 2026</span></span></span></span> |
| + | <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> | ||
| + | = [[Diving_Medicine|BACK]] = | ||
Latest revision as of 03:49, 23 August 2021
The addition of a formal pre-dive checklist reduced the rate of both major and minor mishaps reported during recreational scuba-diving
Clinical bottom line:
|
1. The addition of a checklist reduced the incidence of major mishaps reported by 36% |
Citation/s:1. Ranapurwala SI, Denoble PJ, Poole C, Kucera KL, Marshall SW, Wing S. The effect of using a pre-dive checklist on the incidence of diving mishaps in recreational scuba diving: a cluster-randomized trial. Int J Epidemiol. 2016 Feb;45(1):223-31.
Lead author's name and email: Shabbar Ranapurwala shabbarkaid@gmail.com
Three-part Clinical Question:For recreational scuba divers, does the addition of a pre-dive checklist to the usual pre-dive preparation, result in any improvement in the rate of diving mishaps?
Search Terms: scuba; checklists; safety
The Study:Single-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Adult qualified scuba divers at four locations and recruited at the shore before a planned dive.
Control group (N = 467; 426 analysed): No intervention except the request to complete a post-dive log.
Experimental group (N = 693; 617 analysed): As above but with the addition of a pre-dive checklist
The Evidence:
Non-Event Outcomes |
Time to outcome/s |
Control group |
Checklist group |
Relative risk |
|
Rate of major mishaps/100 dives |
Post-dive |
10.2 |
7.5 |
RR 0.64 (95%CI 0.46 to 0.87) |
|
Rate of major or minor mishaps/100 dives |
Post-dive |
19.5 |
15.5 |
RR 0.68 (95%CI 0.50 to 0.93) |
Comments:
1. This trial was cluster randomised by computer generated sequence and was concealed allocation. There were 70 intervention allocations (30 control, 40 intervention) including a total of 1043 individual divers. The imbalance of numbers between groups was discussed and seems due to chance.
2. Authors used a complicated regression process for known confounders including sex, age, BMI, poor visibility, animal attack and others. They also examined adherence to the checklist.
3. NNT to avoid a major mishap was 37 dives.
Appraised by: Mike bennett m.bennett@unsw.edu.au ; Monday, 23 August 2021
Kill or Update By: August 2026
