Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules / Edition 1

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Overview

This useful handbook provides a concise compilation of the evidence supporting diagnostic testing and clinical decision rules in emergency care. Clinical decision rules are now widely recognised as best practice for the ordering of diagnostic tests in the emergency department.

Aimed at all physicians working with emergency and acute patients, the book begins with an overview of how to evaluate a diagnostic test using an evidence-based approach, followed by an explanation of the clinical decision rules and the methods of assessing the strength and applicability of the clinical prediction rule.

These introductory chapters are followed by sections covering the following clinical areas:

* Traumatic Injuries

* Cardiology

* Infectious Disease

* Surgical and Abdominal Complaints

* Urology

* Neurology

* Ophthalmology, Hematology, Rheumatology

* Pulmonology.

For each test and clinical decision rule, the most current and best available studies in the literature are discussed and applied to emergency department and acute care patients in addressing the question at hand, followed by an overall recommendation on how to use the test or rule in the clinical context.

Evidence-Based Emergency Care is an accessible and extremely useful reference for physicians at all levels to use in applying an evidence-based approach to ordering and interpreting tests in an acute care environment.

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Editorial Reviews

From the Publisher
?Until now there has been a paucity of truly evidence-based guidance for diagnostic and clinical decision making in the ED. Pines and Everett have smartly aggregated a substantial body of information into a compact textbook format for emergency practitioners.? ( Annals of Emergency Medicine, September 2009)

?Presentation of clinical examples and the comprehensive discussion of current decision rules as worked out from the literature will appeal not only to those working in emergency medicine but also to those involved in developing clinical guidelines.? (Journal of Tropical Pediatrics, November 2008)

?Evidence based Emergency Care has a strong place in current practice. The authors review a large number of clinical decision rules and studies comparing diagnostic modalities? (Respiratory Care, June 2009)

?The chapter structure works very well and the author commentary provides a useful bottom-line conclusion and practical insight. The book is well organized and well written, with sufficient depth to address each of the clinical diagnostic questions. The authors provide a balanced, evidence-based approach that encourages readers to review relevant data and draw their own conclusions. Overall, emergency medicine and critical care pharmacists will find this a useful pocket-sized diagnostic testing and clinical decision guide.? (Annals of Pharmacotherapy, December 2008)

?This practical guide will be useful to anyone practicing emergency medicine. The authors are well regarded, board-certified emergency medicine physicians. The authors do an excellent job of providing clinically relevant evidence that we can use to support our daily decisions in the emergency department. Provide[s] a good summary of clinically useful information that will help each of us to make better informed, evidence-based decisions.? (Doody's Book Reviews, November 2008)

Doody's Review Service
Reviewer: Melinda A Graber, BA, MD (University of Chicago Pritzker School of Medicine)
Description: This book addresses how we make diagnostic decisions in the emergency department. Much of what we do is guided by clinical decision rules, and in this book the authors discuss how these clinical rules are made and the up-to-date research behind them. Each chapter is based on clinical decisions that emergency medicine practitioners make every day, with evidence provided to help guide these decisions.
Purpose: The purpose is to address relevant questions on diagnostic testing that emergency medicine practitioners face daily, and to answer these questions with a review of the current literature. The authors consistently address useful questions and provide the evidence to help back up our decision-making process.
Audience: This practical guide will be useful to anyone practicing emergency medicine. The authors are well regarded, board-certified emergency medicine physicians.
Features: Two sections make up this book. Initially, it addresses the process we use to make clinical decisions and the process that is used to produce a clinical decision rule. This section gives a step-by-step approach to analyzing clinical studies and how to apply them to practice. There is also a good review of basic epidemiology. The larger section of the book is divided up by diagnoses, and addresses specific questions related to the diagnostic testing and clinical decision rules that surround each diagnosis. Each question is answered with a thorough but readable review of the current literature.
Assessment: The authors do an excellent job of providing clinically relevant evidence that we can use to support our daily decisions in the emergency department. While this is not an exhaustive review of emergency medicine research, it does provide a good summary of clinically useful information that will help each of us to make better informed, evidence-based decisions.
From The Critics
Reviewer: Melinda A Graber, BA, MD(University of Chicago Pritzker School of Medicine)
Description: This book addresses how we make diagnostic decisions in the emergency department. Much of what we do is guided by clinical decision rules, and in this book the authors discuss how these clinical rules are made and the up-to-date research behind them. Each chapter is based on clinical decisions that emergency medicine practitioners make every day, with evidence provided to help guide these decisions.
Purpose: The purpose is to address relevant questions on diagnostic testing that emergency medicine practitioners face daily, and to answer these questions with a review of the current literature. The authors consistently address useful questions and provide the evidence to help back up our decision-making process.
Audience: This practical guide will be useful to anyone practicing emergency medicine. The authors are well regarded, board-certified emergency medicine physicians.
Features: Two sections make up this book. Initially, it addresses the process we use to make clinical decisions and the process that is used to produce a clinical decision rule. This section gives a step-by-step approach to analyzing clinical studies and how to apply them to practice. There is also a good review of basic epidemiology. The larger section of the book is divided up by diagnoses, and addresses specific questions related to the diagnostic testing and clinical decision rules that surround each diagnosis. Each question is answered with a thorough but readable review of the current literature.
Assessment: The authors do an excellent job of providing clinically relevant evidence that we can use to support our daily decisions in the emergency department. While this is not an exhaustive review of emergency medicine research, it does provide a good summary of clinically useful information that will help each of us to make better informed, evidence-based decisions.
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Product Details

  • ISBN-13: 9781405154000
  • Publisher: Wiley, John & Sons, Incorporated
  • Publication date: 7/21/2008
  • Series: Evidence-Based Medicine Series , #20
  • Edition number: 1
  • Pages: 296
  • Product dimensions: 5.40 (w) x 8.40 (h) x 0.70 (d)

Meet the Author

Jesse M. Pines, MD, MBA and Worth Everett, MD

Both Dr. Pines and Dr. Everett practice emergency medicine at the Hospital of the University of Pennsylvania

They are trained in clinical epidemiology and biostatistics, and well versed in evidence-based medicine methodology

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Table of Contents

Preface.

Foreword.

About the Authors.

Section 1: The Science of Diagnostic Testing and Clinical Decision Rules.

1 Diagnostic Testing in Emergency Care.

2 Evidence-Based Medicine: the Process.

3 The Epidemiology and Statistics of Diagnostic Testing.

4 Clinical Decision Rules.

Section 2: Traumatic Injuries.

5 Cervical Spine Fractures.

6 Cervical Spine Fractures in Older Adults.

7 Cervical Spine Fractures in Children.

8 Blunt Abdominal Trauma.

9 Acute Knee Injuries.

10 Blunt Head Injury.

11 Blunt Head Trauma in Children.

12 Acute Ankle and Foot Injuries.

13 Occult Scaphoid Fractures.

14 Blunt Chest Trauma.

15 Occult Hip Fracture.

Section 3: Cardiology.

16 Heart Failure.

17 Syncope.

18 Acute Coronary Syndrome.

Section 4: Infectious Disease.

19 Serious Bacterial Infections and Occult Bacteremia in Children.

20 Bacterial Meningitis in Children.

21 Necrotizing Fasciitis.

22 Pharyngitis.

23 Infective Endocarditis.

24 Urinary Tract Infection.

25 Sinusitis.

26 Pneumonia.

27 Spontaneous Bacterial Peritonitis.

Section 5: Surgical and Abdominal Complaints.

28 Acute Nonspecific, Nontraumatic Abdominal Pain.

29 Bowel Obstruction.

30 Acute Pancreatitis.

31 Acute Appendicitis.

32 Acute Cholecystitis.

Section 6: Urology.

33 Kidney Stones.

34 Testicular Torsion.

Section 7: Neurology.

35 Subarachnoid Hemorrhage.

36 Acute Stroke.

Section 8: Miscellaneous: Ophthalmology, Hematology, Rheumatology, and Pulmonology.

37 Pulmonary Embolism and Deep Vein Thrombosis.

38 Temporal Arteritis.

39 Intraocular Pressure.

40 Asthma.

Index.

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