Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules [NOOK Book]

Overview

This 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, ...

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

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Overview

This 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
“One of the things I enjoyed most about this book was being able to examine actual sensitivities, specificities, and likelihood ratios of various decision instruments and diagnostic tests that I use daily. It was also enlightening to learn several diagnostic strategies and decision instruments that I previously had not used.” (Annals of Emergency Medicine, 1 August 2013)

“This is an excellent resource for clinicians seeking to provide evidence-based care in emergency medicine. It is a comprehensive and reliable resource that helps reach a balance between overuse and underuse of diagnostic testing. The information is presented in a concise format that can be used during clinical encounters or for more exhaustive reviews of the literature surrounding a clinical question. As evidence-based emergency medicine is a rapidly changing and advancing field, this updated edition is certainly justified.” (Doody’s, 7 June 2013)

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.
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Product Details

  • ISBN-13: 9781118482148
  • Publisher: Wiley, John & Sons, Incorporated
  • Publication date: 11/20/2012
  • Series: Evidence-Based Medicine
  • Sold by: Barnes & Noble
  • Format: eBook
  • Edition number: 2
  • Pages: 504
  • File size: 11 MB
  • Note: This product may take a few minutes to download.

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

About the Authors, xi

Foreword, xv

Preface, xvii

Acknowledgments, xix

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

1 Diagnostic Testing in Emergency Care, 3

2 Evidence-Based Medicine: The Process, 11

3 The Epidemiology and Statistics of Diagnostic Testing, 19

4 Clinical Decision Rules, 36

5 Appropriate Testing in an Era of Limited Resources: Practice and Policy Considerations, 44

6 Understanding Bias in Diagnostic Research, 54

Section 2: Trauma

7 Cervical Spine Fractures, 67

8 Cervical Spine Fractures in Children, 80

9 Cervical Spine Fractures in Older Adults, 86

10 Blunt Abdominal Trauma, 92

11 Acute Knee Injuries, 97

12 Acute Ankle and Foot Injuries, 102

13 Blunt Head Injury in Children, 107

14 Blunt Head Injury, 117

15 Blunt Chest Trauma, 128

16 Occult Hip Fracture, 135

17 Blunt Soft Tissue Neck Trauma, 141

18 Occult Scaphoid Fractures, 147

19 Penetrating Abdominal Trauma, 153

20 Penetrating Trauma to the Extremities and Vascular Injuries, 162

Section 3: Cardiology

21 Heart Failure, 173

22 Syncope, 181

23 Acute Coronary Syndrome, 189

24 Palpitations, 205

Section 4: Infectious Disease

25 Bacterial Meningitis in Children, 219

26 Serious Bacterial Infections in Children Aged 1–3 Months, 223

27 Necrotizing Fasciitis, 227

28 Infective Endocarditis, 232

29 Pharyngitis, 238

30 Rhinosinusitis, 243

31 Pneumonia, 248

32 Urinary Tract Infection, 255

33 Sepsis, 259

34 Septic Arthritis, 270

35 Osteomyelitis, 278

36 Sexually Transmitted Diseases (STDs), 288

37 Influenza, 295

38 Pediatric Fever in Children Aged 3-36 Months, 303

Section 5: Surgical and Abdominal Complaints

39 Acute, Nonspecific, Nontraumatic Abdominal Pain, 309

40 Small Bowel Obstruction, 317

41 Acute Pancreatitis, 324

42 Acute Appendicitis, 330

43 Acute Cholecystitis, 340

44 Aortic Emergencies, 347

45 Ovarian Torsion, 351

Section 6: Urology

46 Nephrolithiasis, 359

47 Testicular Torsion, 365

Section 7: Neurology

48 Nontraumatic Subarachnoid Hemorrhage, 375

49 Acute Stroke, 381

50 Transient Ischemic Attack, 387

51 Seizure, 394

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

52 Venous Thromboembolism, 403

53 Temporal Arteritis, 415

54 Intraocular Pressure, 421

55 Asthma, 430

56 Nontraumatic Back Pain, 441

57 Intravascular Volume Status, 450

58 Geriatric Syndromes, 457

Index, 471

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