Annals of emergency medicine
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Clinical research requires high-quality data collection. Data collected at the emergency department evaluation is generally considered more precise than data collected through chart abstraction but is cumbersome and time consuming. We test whether trained research assistants without a medical background can obtain clinical research data as accurately as physicians. We hypothesize that they would be at least as accurate because they would not be distracted by clinical requirements. ⋯ The relatively fair interrater reliability observed in our study is consistent with previous studies evaluating interrater reliability for cardiovascular disease in the inpatient setting. With respect to research data, we found that prospective ascertainment of clinical data is more often correct when done by research assistants compared with clinicians simultaneously evaluating patients.
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We determine the sensitivity, specificity, and clinical utility of the Gram's stain of peritoneal fluid in patients undergoing paracentesis. ⋯ The Gram's stain result was rarely positive in patients undergoing paracentesis, and when positive, it rarely provided clinically useful information.
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Since 2003, the Society of Chest Pain Centers (SCPC) has provided hospital accreditation for acute coronary syndrome care processes. Our objective is to evaluate the association between SCPC accreditation and adherence to the American College of Cardiology/American Heart Association (ACC/AHA) evidence-based guidelines for non-ST-segment elevation myocardial infarction (NSTEMI). The secondary objective is to describe the clinical outcomes and the association with accreditation. ⋯ SCPC-accredited hospitals had higher NSTEMI ACC/AHA evidence-based guideline adherence in the first 24 hours of care on 2 of the 5 measures. No difference in outcomes was observed. Further studies are needed to better understand the association between SCPC accreditation and improved care for patients with acute coronary syndrome.