Emergency medicine journal : EMJ
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Who are EM3?
EM3 or ‘East Midlands Emergency Medicine Educational Media’ is an online emergency medicine educational resource, based out of Leicester Royal Infirmary ED. While their web presence is the foundation of their online resources, they are most interesting for the very successful way they translate emergency medicine research and education through multi-platform social media and FOAMed.
So, what happened?
In late October there were two inadvertent errors in educational resources simultaneously posted by EM3 to Twitter, Instagram, Facebook and Reddit. The errors were quickly identified and corrected, but despite this the incorrect posts continued to be shared, reaching some 15,000 people.
Edwards and Roland carefully describe the events, the approach EM3 took to correcting the errors, and analysis of the potential impact. They discuss the challenges when correcting what is by its very nature a dynamic resource, and one for which there is limited control once released. EM3 discuss the additional oversight added to their peer review process in response.
Their report is a cautionary tale for the FOAMed community and a useful resource for avoiding and managing SM errors when they inevitably occur.
Don’t be hasty...
Acknowledging that the reach and velocity offered by social media and FOAMed also bring accuracy and credibility concerns, traditional academic publishing is not without its own problems.
Whether outright academic fraud, replication crises or information overload, we already know that incorrect medical information persists for decades after being disproven. This is not a new problem, though FOAMed does accelerate the speed and scope for both good and bad.
Between the lines
The context of the article’s publication reveals the ongoing tension between FOAMed and the reality of traditional academic publishers, such as the BMJ: ‘Learning from mistakes on social media’ is not itself open access...
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Pain treatment in acute musculoskeletal injuries usually consists of paracetamol, non-steroidal antiinflammatory drugs (NSAIDs) or opioids. It would be beneficial to determine whether paracetamol is as effective as other analgesics. The objective of this study was to evaluate available evidence regarding efficacy of paracetamol in these patients. ⋯ Based on available evidence, paracetamol is as effective as NSAIDs or the combination of both in treating pain in adult patients with minor musculoskeletal injuries in the acute setting. The quality of evidence is low.
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To determine whether the impact of a thoracic CT scan on community-acquired pneumonia (CAP) diagnosis and patient management varies according to emergency physician's experience (≤10 vs >10 years). ⋯ In clinical practice, less-experienced emergency physicians were more likely to accurately modify their CAP diagnosis and patient management based on thoracic CT scan than more experienced emergency physicians.
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Editorial
Recognising bias in studies of diagnostic tests part 2: interpreting and verifying the index test.
Multiple pitfalls can occur with the conduct and analysis of a study of diagnostic tests, resulting in biased accuracy. Our conceptual model includes three stages: patient selection, interpretation of the index test and disease verification. ⋯ However, there are circumstances when certain choices in study design are unavoidable, and result in biased test characteristics. In this case, the informed reader will better judge the quality of a study by recognising the potential biases and limitations by being methodical in their approach to understanding the methods, and in turn, better apply studies of diagnostic tests into their clinical practice.
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For the London Olympic and Paralympic Games in 2012, a sentinel ED syndromic surveillance system was established to enhance public health surveillance by obtaining data from a selected network of EDs, focusing on London. In 2017, a new national standard Emergency Care Dataset was introduced, which enabled Public Health England (PHE) to initiate the expansion of their sentinel system to national coverage. Prior to this initiative, we estimated the added value, and potential additional resource use, of an expansion of the sentinel surveillance system. ⋯ We have quantified the added value of national ED syndromic surveillance systems, showing how they will enable detection of more localised events. Furthermore, national systems add value in enabling timelier public health interventions. Finally, we have highlighted areas where extra resource may be required to manage improvements in detection coverage.