Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To determine the accuracy of mild traumatic brain injury (TBI) case ascertainment using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes proposed by the Centers for Disease Control and Prevention (CDC) in a 2003 Report to Congress. ⋯ The identification of mild TBI patients using retrospectively assigned ICD-9 codes appears to be inaccurate. These codes are associated with a significant number of false-positive and false-negative code assignments. Mild TBI incidence and prevalence estimates using these codes should be interpreted with caution. ICD-9 codes should not replace a clinical assessment for mild TBI when accurate case ascertainment is required.
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To update the profile of author-reported funding of reports of original research published since 1994 in the four U.S. peer-reviewed general emergency medicine (EM) journals. ⋯ Author-reported extramural funding rates for original research have increased in the EM literature over the past decade. Foundations have funded the largest number of studies, with public (government) sources increasing in 2003.
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Randomized Controlled Trial
Out-of-hospital auricular acupressure in elder patients with hip fracture: a randomized double-blinded trial.
Auricular acupressure is known to decrease the level of anxiety in patients during ambulance transport. The purpose of this randomized, double-blind, sham control study was to determine whether auricular acupressure can decrease not only the level of anxiety but also the level of pain in a group of elder patients with acute hip fracture. ⋯ The authors encourage physicians, health care providers, and emergency rescuers to learn this easy, noninvasive, and inexpensive technique for its effects in decreasing anxiety and pain during emergency transportation.
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Patients presenting with chest pain or related symptoms suggestive of myocardial ischemia, without ST-segment elevation (NSTE) on their presenting electrocardiograms, often present a diagnostic challenge in the emergency department (ED). Prompt and accurate risk stratification to identify those patients with NSTE chest pain who are at highest risk for adverse events is essential, however, to optimal management. Although validated and used frequently in patients already enrolled in acute coronary syndrome trials, the Thrombolysis in Myocardial Infarction (TIMI) risk score never has been examined for its value in risk stratification in an all-comers, non-trial-based ED chest pain population. ⋯ The TIMI risk score may be a useful tool for risk stratification of ED patients with chest pain syndrome.
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To determine the publication status and time to publication of randomized controlled trials (RCTs) that were presented at the Society for Academic Emergency Medicine (SAEM) meetings from 1995 to 2003. The impact of positive-outcome bias, time-lag bias, and gray literature bias also was assessed. ⋯ The proportion of emergency medicine RCT abstracts published is slightly lower than that for other biomedical specialties; however, biases reported by investigators in other biomedical areas do not appear to be as problematic in emergency medicine research. Differences between conclusions from abstracts and manuscripts must be considered when employing meeting abstracts as a source of evidence for future research or for systematic reviews in emergency medicine.