Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To evaluate the evidence for interventions designed to improve outcomes for elders discharged from the emergency department (ED). ⋯ A significant number of programs to improve outcomes for elders discharged from the ED exist, but few have been systematically examined. Development of interventions to improve the care of elder patients following ED visits requires further research into system and patient-centered factors that impact health care delivery in this situation.
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Comparative Study
Reappraisal of criteria used to predict serious bacterial illness in febrile infants less than 8 weeks of age.
To re-evaluate the Philadelphia protocol and the Rochester criteria for identifying infants at low risk for serious bacterial illness (SBI) in a new population. ⋯ The Philadelphia protocol and the Rochester criteria maintained their previously reported NPVs when applied to a new population of febrile infants. These data illustrate the usefulness of retesting clinical decision rules in new populations prior to their universal acceptance.
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Widespread, appropriate use of clinical decision rules would result in many benefits for health care. While it is known that clinicians report using these rules, little is known about how the rules are actually used in everyday practice. ⋯ Most physicians report using and applying the OAR consistently, but most report that the rule is not the primary determinant of their decisions. Most apply this rule without referring to memory aids, yet their memory for this simple rule is imperfect. Future work should study how different memory aid strategies might improve the accuracy of rule application and reduce the use of nonpredictive cues.
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Editorial Historical Article
Changing times, changing opinions: history informing the family presence debate.