Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The objective of this study was to determine the test characteristics for two different ultrasound (US) measures of severe dehydration in children (aorta to inferior vena cava [IVC] ratio and IVC inspiratory collapse) and one clinical measure of severe dehydration (the World Health Organization [WHO] dehydration scale). ⋯ Ultrasound of the aorta/IVC ratio can be used to identify severe dehydration in children presenting with acute diarrhea and may be helpful in guiding clinical management.
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Comment Letter Comparative Study
Re: "COMLEX-1 and USMLE-1 are not interchangeable examinations".
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Multicenter Study Comparative Study
Safety of intravenous thrombolytic use in four emergency departments without acute stroke teams.
The objective was to evaluate safety of intravenous (IV) tissue plasminogen activator (tPA) delivered without dedicated thrombolytic stroke teams. ⋯ In these EDs there was no evidence of increased risk with respect to mortality, ICH, systemic hemorrhage, or worsened functional outcome when tPA was administered without dedicated thrombolytic stroke teams. Additional effort is needed to improve guideline compliance.
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Review Comparative Study
Parametric versus nonparametric statistical tests: the length of stay example.
This study examined selected effects of the proper use of nonparametric inferential statistical methods for analysis of nonnormally distributed data, as exemplified by emergency department length of stay (ED LOS). The hypothesis was that parametric methods have been used inappropriately for evaluation of ED LOS in most recent studies in leading emergency medicine (EM) journals. To illustrate why such a methodologic flaw should be avoided, a demonstration, using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), is presented. The demonstration shows how inappropriate analysis of ED LOS increases the probability of type II errors. ⋯ ED LOS, a key ED operational metric, is frequently analyzed incorrectly in the EM literature. Applying parametric statistical tests to such nonnormally distributed data reduces power and increases the probability of a type II error, which is the failure to find true associations. Appropriate use of nonparametric statistics should be a core component of statistical literacy because such use increases the validity of ED research and quality improvement projects.
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Written examinations are frequently used to assess medical student performance. Within emergency medicine (EM), a National Board of Medical Examiners (NBME) subject examination for EM clerkships does not exist. As a result, clerkship directors frequently generate examinations within their institution. This article reviews the literature behind the use of standardized examinations in evaluating medical student performance, describes methods for generating well-written test questions, reviews the statistical concepts of reliability and validity that are necessary to evaluate an examination, and proposes future directions for testing EM students.