Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Performance of the pediatric glasgow coma scale in children with blunt head trauma.
To compare the accuracy of a pediatric Glasgow Coma Scale (GCS) score in preverbal children with blunt head trauma with the standard GCS score in older children. ⋯ This pediatric GCS for children 2 years and younger compares favorably with the standard GCS in the evaluation of children with blunt head trauma. The pediatric GCS is particularly accurate in evaluating preverbal children with blunt head trauma with regard to the need for acute intervention.
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To determine the sensitivity and specificity of a brief two-question depression screen for the detection of depression in older emergency department (ED) patients, and to determine the prevalence of depression in this population. ⋯ Depression is fairly prevalent in older ED patients. The brief two-question depression screen, using a cutoff score of at least one positive response, is promising for ED use. However, given lower specificity, patients scoring positive for depression should be followed up with a more specific tool such as the self-administered SFGDS prior to referral for further evaluation and treatment.
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Prior evidence suggests that physicians may alter process of care based on race/ethnicity. The objective of this study was to determine whether race/ethnicity predicts whether a patient receives computed tomography of the head (head CT) during evaluation of blunt head injury. ⋯ Minority and non-Hispanic white patients may not have significantly different rates of receiving head CT during evaluation of blunt head injury. A multicenter prospective study is necessary to confirm these preliminary findings.
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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 Clinical Trial
A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax.
Supine anteroposterior (AP) chest radiography may not detect the presence of a small or medium pneumothorax (PTX) in trauma patients. ⋯ With CT as the criterion standard, US is more sensitive than flat AP chest radiography in the diagnosis of traumatic PTX. Furthermore, US allowed sonologists to differentiate between small, medium, and large PTXs with good agreement with CT results.