Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study Comparative Study
A Cost-effectiveness Analysis Comparing a Clinical Decision Rule Versus Usual Care to Risk Stratify Children for Intraabdominal Injury After Blunt Torso Trauma.
Modelling implementation of a clinical decision rule to identify children at very low risk of significant intra-abdominal injury after blunt trauma:
- Saved on average US$55 per child.
- Avoided a CT scan in 1 in 10 children.
- Missed 1 in 2,000 intra-abdominal injuries requiring acute intervention.
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Multicenter Study
Risk Factors of Significant Pain Syndrome 90 Days After Minor Thoracic Injury: Trajectory Analysis.
The objective was to identify the risk factors of clinically significant pain at 90 days in patients with minor thoracic injury (MTI) discharged from the emergency department (ED). ⋯ To the authors' knowledge, this is the first prospective study of trajectory modeling to detect risk factors associated with significant pain at 90 days after MTI. These factors may help in planning specific treatment strategies and should be validated in another prospective cohort.
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Multicenter Study
Developing Emergency Department-based Education About Emergency Contraception: Adolescent Preferences.
The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. ⋯ Adolescents have specific preferences for how education about emergency contraception would best serve their needs. This information can inform clinicians as they work to improve adolescents' knowledge about pregnancy prevention and emergency contraception in particular.
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Multicenter Study
Generalizability of a Simple Approach for Predicting Hospital Admission From an Emergency Department.
The objective was to test the generalizability, across a range of hospital sizes and demographics, of a previously developed method for predicting and aggregating, in real time, the probabilities that emergency department (ED) patients will be admitted to a hospital inpatient unit. ⋯ The accuracy of regression models to predict ED patient admission likelihood was shown to be generalizable across hospitals of different sizes, populations, and administrative structures. Each hospital used a unique combination of predictive factors that may reflect these differences. This approach performed equally well when hospital staff coded patient data in real time versus the research team retrospectively.
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The diagnostic values of the aVR lead or "Vereckei algorithm," and the lead II R-wave peak time (RWPT) criterion, recently devised for the differential diagnosis of wide QRS complex tachycardias (WCTs), were compared. ⋯ The Vereckei algorithm was superior in overall test accuracy, sensitivity, and NPV for VT diagnosis and inferior in specificity and PPV to the RWPT criterion. All of these parameters were lower in "real life" than those reported by the original authors for each of the particular electrocardiographic methods.