The American journal of emergency medicine
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The Bayesian approach to disease diagnosis in the emergency department is facilitated by the use of likelihood ratios (LRs) to evaluate diagnostic tests. The use of dichotomous, interval, and joint LRs for single and multiple tests is reviewed, and comparison is made to regression modeling. The clinical motivation for a single statistic to describe the average change in the odds of disease associated with the use of a particular test or series of tests is described. ⋯ Application of both tests together to patients with wide QRS complex tachycardia changes the odds of ventricular tachycardia, on average, by a factor of 3.5 (95% confidence interval, 2.4-6.2). Challenges are described, and methods are provided to estimate the 95% confidence interval of the LR and AALR using bootstrapping techniques. The AALR is a test statistic that may be helpful for clinicians and researchers in evaluating and comparing diagnostic testing approaches.
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The aim of this study was to examine the effects of controlled hemorrhage and shock on oxygenation and ventilation using needle cricothyroidotomy and jet ventilation in an animal model. ⋯ Hemorrhagic shock anticipated and intensified the retention of carbon dioxide and respiratory acidosis during manual jet ventilation through needle cricothyroidotomy in comparison with animals with jet ventilation but without shock. The results found in this work should be considered in future protocols for the assistance of victims of trauma in prehospital settings.