Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2020
Using data mining to predict emergency department length of stay greater than 4 hours: Derivation and single-site validation of a decision tree algorithm.
Health services have an imperative to reduce prolonged patient length of stay (LOS) in ED. Our objective is to develop and validate an accurate prediction model for patient LOS in ED greater than 4 hours using a data mining technique. ⋯ This model performed very well in predicting ED LOS >4 hours for each individual patient and demonstrated a number of clinically relevant patterns. Identifying patterns that influence ED LOS is important for health managers in order to develop and implement interventions targeted at those clinical scenarios. Future work should look at the utility of displaying individual patient risk of ED LOS >4 hours using this model in real-time at the point-of-care.
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Emerg Med Australas · Jun 2020
Observational StudyPrevalence of illicit substance use among patients presenting to the emergency department with acute behavioural disturbance: Rapid point-of-care saliva screening.
To determine the prevalence of illicit substance use among patients presenting to one ED with acute behavioural disturbance using point-of-care saliva testing. ⋯ The prevalence of illicit substance use among this cohort was 40%. Self-reporting was unreliable. Point-of-care saliva testing is feasible. Early identification of harmful drug use may assist clinical decision making in selected or undifferentiated cases and provide an opportunity to implement harm minimisation strategies and make referrals.
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Emerg Med Australas · Jun 2020
ReviewReview article: A primer for clinical researchers in the emergency department: Part XI. Inertia before investigation: Pre-test probability in emergency medicine.
In this series, we address research topics in emergency medicine. Rational clinical decision making is based on knowledge of the disease prevalence, clinical assessment features and test characteristics such as sensitivity and specificity. The concept of pre-test probability is important as it will allow the clinician and patient decide together if a 'test threshold' or 'treatment threshold' has been reached, or if further investigations are required to make such a decision. This research primer uses three case scenarios to explore these concepts.