Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
The accuracy and completeness of data collected by prospective and retrospective methods.
To describe and test a model that compares the accuracy of data gathered prospectively versus retrospectively among adult emergency department patients admitted with chest pain. ⋯ Information obtained retrospectively from the abstraction of medical records is measurably less accurate than information obtained prospectively from research subjects. For certain items, more than half of the information is not available. This loss of information is related to the data types included in the study and by the assumptions that a researcher performing a retrospective study makes about implied versus explicitly stated responses. A model of information flow that incorporates the concepts of reliability and validity can be used to measure some of the loss of information that occurs at each step along the way from subject to clinician to medical record abstractor.
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Comparative Study
Association between the "seat belt sign" and intra-abdominal injury in children with blunt torso trauma.
To determine the association between an abdominal "seat belt sign" (SBS) and intra-abdominal injury (IAI) in children presenting to the emergency department (ED) after blunt trauma. ⋯ Patients with an SBS after an MVC are more likely to have IAIs than patients without an SBS, predominately due to a higher rate of gastrointestinal injuries. Patients with an SBS but without abdominal pain or tenderness appear to be at low risk for IAI.
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Historical Article
The influence of critical care medicine on the development of the specialty of emergency medicine: a historical perspective.
Through their largely concurrent development, the specialties of emergency medicine and critical care medicine have exerted a great deal of influence on each other. In this article, the authors trace the commonalities that emergency medicine and critical care medicine have shared and report on the historical relationship between the two specialties. As issues between emergency medicine and critical care medicine continue to emerge, the authors hope to inform the current discussion by bringing to light the controversies and questions that have been debated in the past.
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To prospectively validate a previously published out-of-hospital clinical decision rule to identify seriously injured children involved in motor vehicle crashes (MVCs). ⋯ Although definitive conclusions are limited by the sample size, the decision rule identified all seriously injured children involved in MVCs and had moderate specificity. The decision rule was less sensitive for identifying children requiring specialized trauma care. Larger validation studies are needed to adequately assess the utility of this rule before implementation.