Annals of emergency medicine
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Multicenter Study
Validity of a decision rule to reduce cervical spine radiography in elderly patients with blunt trauma.
A decision instrument based on 5 clinical criteria has been shown to be highly sensitive in selecting patients who require cervical spine imaging after blunt trauma, while simultaneously reducing overall imaging. We examine the performance of this instrument in the elderly and explore some of the common features of geriatric cervical spine injury (CSI). ⋯ The prevalence of CSI, and especially odontoid fracture, is relatively increased among geriatric patients with blunt trauma. The NEXUS decision instrument can be applied safely to these patients, with an expected reduction in cervical imaging comparable with that achieved in nongeriatric patients.
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Multicenter Study
Initial oxygen saturation as a predictor of admission in children presenting to the emergency department with acute asthma.
Previous studies have looked at the relationship between initial oxygen saturation (SaO (2)) and the need for admission in children presenting with an acute asthma exacerbation. If initial SaO (2) value is indeed predictive of admission, then the admission process could be initiated sooner, and time spent in the emergency department could be potentially lessened. ⋯ This large, clinical multicenter study does not support earlier findings that SaO (2) alone is a clinically useful predictor of hospital admission in children who present to the ED with acute asthma.
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Comparative Study
The use of dedicated methodology and statistical reviewers for peer review: a content analysis of comments to authors made by methodology and regular reviewers.
In 1997, Annals of Emergency Medicine initiated a protocol by which every original research article, in addition to each regular review, was concurrently evaluated by 1 of 2 methodology and statistical reviewers. We characterized and contrasted comments made by the methodology and regular peer reviewers. ⋯ The distributions of comments made by the 2 methodology and statistical reviewers were similar, although reviewer A emphasized presentation and reviewer B stressed statistical issues. The regular reviewers (most of whom were unaware that a dedicated methodology and statistical reviewer would be reviewing the article) paid much less attention to methodology issues. The 2 dedicated methodology and statistical reviewers created reviews that were similarly focused and emphasized methodology issues that were distinct from the issues raised by regular reviewers.
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We sought to characterize the quantity and quality of graphs in the Journal of American Medicine (JAMA), contrasting articles published in 1999 with those published in 2000 after the addition of a dedicated tables and figures editor. We also sought to compare the quality of graphs in JAMA with the quality of graphs in Annals of Emergency Medicine. ⋯ The graphs in JAMA were similar to those in Annals of Emergency Medicine and, although generally clear and without errors, often failed to depict detailed data. Authors and editors could improve data presentations by incorporating graphic formats that depict stratified, detailed data.