scholarly journals Correction to: A clinical prediction rule for diagnosing severe acute respiratory syndrome in the emergency department

2020 ◽  
Vol 26 ◽  
Keyword(s):  
Emergency Department ◽  
Severe Acute Respiratory Syndrome ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Clinical Prediction

scholarly journals A Clinical Prediction Rule for Diagnosing Severe Acute Respiratory Syndrome in the Emergency Department

2004 ◽  
Vol 141 (5) ◽  
pp. 333 ◽  
Author(s):  
Gabriel M. Leung ◽  
Timothy H. Rainer ◽  
Fei-Lung Lau ◽  
Irene O.L. Wong ◽  
Anna Tong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Severe Acute Respiratory Syndrome ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Clinical Prediction

scholarly journals LO87: Use of a clinical prediction rule would lead to more effective CTA utilization for urgent brain imaging of suspected TIA/mild stroke in the emergency department

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S58
Author(s):  
K. Votova ◽  
M. Bibok ◽  
R. Balshaw ◽  
M. Penn ◽  
M.L. Lesperance ◽  
...  
Keyword(s):  
Emergency Department ◽  
Brain Imaging ◽  
Practice Guidelines ◽  
Best Practice ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Decision Threshold ◽  
Clinical Prediction ◽  
Focal Neurological Deficit ◽  
Best Practice Guidelines

Introduction: Canadian stroke best practice guidelines recommend patients suspected of Acute Cerebrovascular Syndrome (ACVS) receive urgent brain imaging, preferably CTA. Yet, high requisition rates for non-ACVS patients overburdens limited radiological resources. We hypothesize that our clinical prediction rule (CPR) previously developed for diagnosis of ACVS in the emergency department (ED), and which incorporates Canadian guidelines, could improve CTA utilization. Methods: Our data consists of records for 1978 ED-referred patients to our TIA clinic in Victoria, BC from 2015-2016. Clinic referral forms captured all data needed for the CPR. For patients who received CTA, orders were placed in the ED or at the TIA clinic upon arrival. We use McNemar’s test to compare the sensitivity (sens) and specificity (spec) of our CPR vs. the baseline CTA orders for identifying ACVS. Results: Our sample (49.5% male, 60.6% ACVS) has a mean age of 70.9±13.6 yrs. Clinicians ordered 1190 CTAs (baseline) for these patients (60%). Where CTA was ordered, 65% of patients (n=768) were diagnosed as ACVS. To evaluate our CPR, predicted probabilities of ACVS were computed using the ED referral data. Those patients with probabilities greater than the decision threshold and presenting with at least one focal neurological deficit clinically symptomatic of ACVS were flagged as would have received a CTA. Our CPR would have ordered 1208 CTAs (vs. 1190 baseline). Where CTA would have been ordered, 74% of patients (n=893) had an ACVS diagnosis. This is a significantly improved performance over baseline (sens 74.5% vs. 64.1%, p<0.001; spec 59.6% vs. 45.9%, p<0.001). Specifically, the CPR would have ordered an additional 18 CTAs over the 2-yr period, while simultaneously increasing the number of imaged-ACVS patients by 125 with imaging 107 fewer non-ACVS patients. Conclusion: Using ED physician referral data, our CPR demonstrates significantly higher sensitivity and specificity for CTA imaging of ACVS patients than baseline CTA utilization. Moreover, our CPR would assist ED physicians to apply and practice the Canadian stroke best practice guidelines. ED physician use of our CPR would increase the number of ACVS patients receiving CTA imaging before ED discharge (rather than later at TIA clinics), and ultimately reduce the burden of false-positives on radiological departments.

A Clinical Prediction Rule for the Severe Acute Respiratory Syndrome

2005 ◽  
Vol 142 (3) ◽  
pp. 225 ◽  
Author(s):  
Timothy H. Rainer ◽  
Irene O.L. Wong ◽  
Gabriel M. Leung
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Clinical Prediction

Development of a Clinical Prediction Rule for 30-Day Cardiac Events in Emergency Department Patients With Chest Pain and Possible Acute Coronary Syndrome

2012 ◽  
Vol 59 (2) ◽  
pp. 115-125.e1 ◽  
Author(s):  
Erik P. Hess ◽  
Robert J. Brison ◽  
Jeffrey J. Perry ◽  
Lisa A. Calder ◽  
Venkatesh Thiruganasambandamoorthy ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Clinical Prediction ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Emergency Department Patients

A Clinical Prediction Rule for the Severe Acute Respiratory Syndrome

2005 ◽  
Vol 142 (3) ◽  
pp. 225 ◽  
Author(s):  
Matthew H.M. Ma ◽  
Shey-Ying Chen ◽  
Wen-Chu Chiang ◽  
Chan-Ping Su ◽  
Wen-Jone Chen
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Clinical Prediction

Abstract TP233: Clinical Predictors of Endovascular Stroke Treatment Among Emergency Department Patients Screened With Multimodal Computed Tomography

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Ken Smythe ◽  
John A Oostema
Keyword(s):  
Emergency Department ◽  
Clinical Characteristics ◽  
Multivariable Analysis ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Clinical Prediction ◽  
Clinical Predictors ◽  
Vessel Occlusion ◽  
Stroke Treatment ◽  
Ct Angiogram

Background: Endovascular therapy (EVT) offers dramatic benefit to selected patients with large vessel occlusion (LVO) ischemic stroke. However, identification of EVT candidates requires advanced imaging and often interfacility transfer. We sought to quantify the yield of such testing as well as identify clinical predictors of EVT candidacy. Methods: This retrospective cohort study identified consecutive Emergency Department (ED) patients with stroke symptoms who underwent CT angiogram and brain perfusion (CTA/P) imaging to assess for EVT candidacy. Demographics, medical history, clinical characteristics, final diagnosis, and outcomes were abstracted. We compared clinical characteristics among those who did and did not undergo EVT. Multivariable logistic regression was used to identify independent clinical predictors of EVT and derive a clinical prediction rule to quantify the probability of EVT. Results: Over a 12-month period, 835 patients underwent CTA/P imaging in the ED. EVT was undertaken for 116 (13.9%) patients; 321 (38.4%) ultimately received a non-stroke diagnosis. Patients who received EVT were older and had higher stroke scores (Table). Patients with an unknown last known well (LKW) time were less likely to receive EVT, however increasing time form LKW to door did not predict EVT (test for trend p=0.976). Multivariable analysis results are presented in the Table. A clinical decision rule based on the regression coefficients demonstrated moderately high discrimination for predicting EVT with an AUC of 0.79 (0.74 to 0.83). Among 102 patients transferred for CTA/P, 24 (24%) had and a score <1, none of whom received EVT. Conclusions: EVT Candidates are common among ED patients screened with CTA/P. Clinical factors can predict the likelihood of EVT candidacy. If validated in other populations, a simple clinical prediction rule may assist in triaging patients in need of urgent transfer to a thrombectomy-capable facility.

Mortality in Emergency Department Sepsis (MEDS) score: A prospectively derived and validated clinical prediction rule*

2003 ◽  
Vol 31 (3) ◽  
pp. 670-675 ◽  
Author(s):  
Nathan I. Shapiro ◽  
Richard E. Wolfe ◽  
Richard B. Moore ◽  
Eric Smith ◽  
Elizabeth Burdick ◽  
...  
Keyword(s):  
Emergency Department ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Clinical Prediction

Towards prompt electrocardiogram acquisition in triage: Preliminary testing of a symptom-based clinical prediction rule for the Android tablet

2019 ◽  
Vol 18 (4) ◽  
pp. 289-298
Author(s):  
Sharon O’Donnell ◽  
Peter Monahan ◽  
Gabrielle McKee ◽  
Geraldine McMahon ◽  
Elizabeth Curtin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
St Elevation Myocardial Infarction ◽  
Clinical Prediction ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
St Elevation

Background: For patients with suspected acute coronary syndrome, international guidelines indicate that an Electrocardiogram (ECG) should be performed within 10 min of first medical contact, however success at achieving these guidelines is limited. Aims: The purpose of this study was to develop and perform initial testing of a clinical prediction rule embedded in a tablet application, and to expedite the identification of patients who require an electrocardiogram within 10 min. Methods: This derivation of the Acute Coronary Syndrome Application (AcSAP) comprised of three local studies, an unpublished audit and literature critique. The AcSAP was prospectively tested over four months in patients presenting to the Emergency Department (ED) of a Dublin teaching hospital. An audit form retrieved data pertaining to times of: registration to the emergency department, triage, first electrocardiogram and diagnosis. The AcSAP was subsequently evaluated by experienced triage nurses ( n=18) who had utilised it. Results: The AcSAP was activated 379 times. Patients with ST Elevation Myocardial Infarction (STEMI) and non-ST Elevation Myocardial Infarction (NSTEMI) were significantly more likely to return a categorisation of ‘immediate ECG’ or ‘ECG within 10 min’ ( p<0.001). There was a significant difference in ‘triage to ECG’ times across categories, the ‘immediate ECG’ categorisation resulting in the shortest time ( p=0.002). Evaluations suggest that staff found the tool quick and easy to use and results seemed accurate. Conclusion: Testing of the AcSAP suggests that it accurately identifies patients who require an ECG within 10 min. As such, it has the potential to support the meeting of clinical guidelines for ECG acquisition.

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