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.
Author(s): Ali S. Raja, Jesse M. Pines, Fernanda Bellolio, Christopher R. Carpenter
Series: Evidence-Based Medicine
Publisher: Wiley-Blackwell
Year: 2023
Language: English
Pages: 768
City: Hoboken
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
