Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules

Description

EVIDENCE-BASED EMERGENCY CARE DIAGNOSTIC TESTING AND CLINICAL DECISION RULES THIRD EDITION Improve and streamline the diagnostic decision-making process in emergency care The newly revised third edition of Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules offers an updated review of the evidence and expert discussion of relevant issues in diagnostic testing in the everyday practice of emergency medicine. This book also provides a detailed overview of the science of diagnostic testing and reviews the process behind the development of clinical decision rules. The focus is asking and answering practical questions using original research studies, while commenting on the best available evidence for relevant clinical topics. Readers will also find: Comprehensive explorations of COVID-19, telemedicine, trauma, cardiology, infectious disease, and surgical and abdominal complaints Practical discussions of urology, neurology, hematology, ophthalmology, pulmonology, rheumatology, and geriatric medicine Exploration of practice and policy considerations of testing in an era of limited resources The book is perfect for emergency medicine physicians, nurses, and other allied health professionals. Readers of Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules, Third Edition will also earn a place in the libraries of administrators and managers in healthcare settings seeking to optimize the use of scarce resources while maintaining the highest standards of care. Cover Title Page Copyright Page Contents About the Editors List of Contributors Foreword Acknowledgments Section 1 The Science of Diagnostic Testing and Clinical Decision Rules Chapter 1 Diagnostic Testing in Emergency Care References Chapter 2 Evidence-Based Medicine: The Process Chapter 3 The Epidemiology and Statistics of Diagnostic Testing The 2 × 2 table Sensitivity and specificity Incidence and prevalence Predictive values Integrating concepts Using 2 × 2 tables: an example Odds, probability, and the odds ratio Likelihood ratios and interval likelihood ratios Using odds, probabilities, and likelihood ratios: an example Bayes theorem Confidence intervals Receiver operator characteristic (ROC) curves Chapter 4 Clinical Decision Rules The clinical decision rule development process The future of CDRs References Chapter 5 Appropriate Testing in an Era of Limited Resources: Practice and Policy Considerations Impact of diagnostic testing on healthcare expenditures Downstream costs of diagnostic testing Variation in testing and inappropriate testing Causes of inappropriate testing Improving appropriateness in diagnostic testing: practice considerations Health policy considerations Comment References Chapter 6 Understanding Bias in Diagnostic Research Types of bias Recognizing and overcoming diagnostic biases References Section 2 Trauma Chapter 7 Cervical Spine Fractures Background Clinical question Clinical question Clinical question Clinical question Clinical question Clinical question Clinical question Comment References Chapter 8 Blunt Abdominal Trauma Background Clinical questions Clinical question Comment References Chapter 9 Acute Knee Injuries Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 10 Acute Ankle and Foot Injuries Background Clinical question Clinical question Clinical question Comment References Chapter 11 Blunt Head Injury in Children Background Clinical question Clinical question Clinical question Comments References Chapter 12 Adult Blunt Head Injury Background Clinical question Clinical question Clinical question Comments References Chapter 13 Chest Trauma Background Clinical question Clinical question Clinical question Comment References Chapter 14 Occult Hip Fracture Background Clinical question Clinical question Comment References Chapter 15 Blunt Soft Tissue Neck Trauma Background Clinical question Clinical question Comments References Chapter 16 Occult Scaphoid Fractures Background Clinical question Clinical question Comments References Chapter 17 Penetrating Abdominal Trauma Background Clinical question Thoraco-abdominal injuries Back and flank injuries Anterior abdominal injuries Comment References Chapter 18 Penetrating Trauma to the Extremities and Vascular Injuries Background Clinical question Clinical question Clinical question Comments References Section 3 Cardiology Chapter 19 Heart Failure Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 20 Syncope Background Clinical question San Francisco Syncope Rule (SFSR) Boston syncope criteria Short-Term Prognosis of Syncope (STePS) Syncope risk score Risk stratification of syncope in the ED (ROSE) Canadian Syncope Risk Score (CSRS) FAINT score Clinical question Clinical question Clinical question Comment References Chapter 21 Chest Pain Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 22 Palpitations Background Clinical question Clinical question Comment References Section 4 Infectious Disease Chapter 23 Bacterial Meningitis in Children Background Clinical question Clinical question Comment References Chapter 24 Serious Bacterial Infections in Children Aged 0 to 60/90 Days Background Clinical question Clinical question Clinical question Comment References Chapter 25 Necrotizing Soft Tissue Infection Background Clinical question Clinical question Clinical question Computed tomography and plain radiographs Ultrasound Magnetic resonance imaging (MRI) Comment References Chapter 26 Infective Endocarditis Background Clinical question Comment References Chapter 27 Pharyngitis Background Clinical question Clinical question Comment References Chapter 28 Rhinosinusitis Background Clinical question Comment References Chapter 29 Pneumonia Background Clinical question Clinical question Clinical question Clinical question Clinical question Clinical question Comment References Chapter 30 Urinary Tract Infection Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 31 Sepsis Background Clinical question Clinical question Comments References Chapter 32 Adult Septic Arthritis Background Clinical question Clinical question Clinical question Comment References Chapter 33 Osteomyelitis Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 34 Sexually Transmitted Infections (STIs) Background Clinical question Clinical question Comment References Chapter 35 Influenza Background Clinical question Clinical question Comment References Chapter 36 Fever without a Source 3–36 Months Background Clinical question Clinical question References Section 5 Surgical and Abdominal Complaints Chapter 37 Acute, Nonspecific, Nontraumatic Abdominal Pain Background Clinical question Older adults Clinical question Comments References Chapter 38 Small Bowel Obstruction Background Clinical question Clinical question Comment References Chapter 39 Acute Pancreatitis Background Clinical question Clinical question Comments References Chapter 40 Acute Appendicitis Background Clinical question Clinical question Clinical question Clinical question Clinical question Clinical question Clinical question Comment References Chapter 41 Acute Cholecystitis Background Clinical question Clinical question Comment References Chapter 42 Aortic Emergencies Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 43 Ovarian Torsion Background Clinical question Clinical question Clinical question Comment References Section 6 Urology Chapter 44 Nephrolithiasis Background Clinical question Clinical question Clinical question Clinical question Clinical question Comment References Chapter 45 Testicular Torsion Background Clinical question Clinical question Comment References Section 7 Neurology Chapter 46 Nontraumatic Subarachnoid Hemorrhage Background Clinical question Clinical question Clinical question Comment References Chapter 47 Acute Stroke Background Clinical question Clinical question Clinical question Clinical question Clinical question Comment References Chapter 48 Transient Ischemic Attack Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 49 First-Episode Seizure Background Clinical question Clinical question Clinical question Comment References Section 8 Miscellaneous: Hematology Ophthalmology Pulmonology Rheumatology and Geriatrics Chapter 50 Pulmonary Embolism Background Clinical question Clinical question Clinical question Clinical question Clinical question Clinical question Clinical question Comment References Chapter 51 Deep Vein Thrombosis Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 52 Temporal Arteritis Background Clinical question Clinical question Comments References Chapter 53 Intraocular Pressure Background Clinical question Comments References Chapter 54 Asthma Background Clinical question Reproducibility of the clinical exam Severity scores in asthmatic children Predicting hospitalization in asthmatic children Treatment relapses in asthmatic children Predicting hospitalization in asthmatics (children and adults) Predicting hospitalization in asthmatic adults Treatment relapses in asthmatic adults Comments References Chapter 55 Acute Low Back Pain Background Clinical question Clinical question Comment References Chapter 56 Intravascular Volume Status Background Clinical question Clinical question Clinical question Comment References Chapter 57 Geriatric Screening Background Clinical question Clinical question Clinical question Clinical question Comment References Chapter 58 Skin and Soft Tissue Infections Background Clinical question Clinical question Comment References Chapter 59 Shared Decision-Making in Diagnostic Testing What is SDM? When is it appropriate to engage a patient in SDM? Why use SDM in EM? What are decision aids? SDM in clinical settings Examples of SDM for diagnostic testing Chest pain Thunderclap headache Head trauma Considerations for SDM Misconceptions about SDM Barriers and facilitators of SDM Summary References Chapter 60 Cognitive Biases and Mitigation Strategies in Emergency Diagnosis Introduction Scope of the problem Dual processing, executive function, and cognitive errors Prospect theory Uncertainty and risk Mitigation strategies Prominent cognitive biases and interventions Premature closure Diagnostic momentum Anchoring Availability heuristic and recency effect The Dunning–Kruger effect and overconfidence Base rate neglect Sunk cost bias Ambiguity aversion Comment References Chapter 61 Diagnosis in Telemedicine Does the telemedicine evaluation have the same fidelity as the in-person evaluation? Can you obtain a reliable history of present illness, past history, family history, and social history in the telemedicine format? Besides the microphone and camera, what other peripheral tools are available to increase the amount of perceptual information available to the clinician? Can wearable devices enhance the telemedicine encounter? Can patients accurately measure their own vital signs? Can you assess dyspnea in the telemedicine format? Can the National Institute of Health Stroke Scale (NIHSS) be performed in the telemedicine format? Can a psychiatric assessment be done in the telemedicine format? Can orthopedic injuries be reliably assessed in the telemedicine format? Can a patient self-assess abdominal tenderness to palpation? What is the risk of serious misdiagnosis in the telemedicine format for other common acute emergency department chief complaints? What is the malpractice landscape for telemedicine? Can telehealth address disparities? Conclusions References Chapter 62 Diagnosing COVID-19 Background Clinical question Clinical question Clinical question Comments References Index EULA