Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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An emergency medicine (EM) clerkship can provide a medical student with a unique educational experience. The authors sought to describe the current experiential curriculum of the EM clerkship, along with methods of evaluation, feedback, and grading. ⋯ Medical students are exposed to a variety of didactic lectures and procedure labs but have similar experiences regarding shift length and work hours. Methods of evaluation of clinical performance vary across clinical sites.
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Randomized Controlled Trial
Determination of the effect of in vitro time, temperature, and tourniquet use on whole blood venous point-of-care lactate concentrations.
The authors sought to determine the effect of in vitro time, temperature, and removable tourniquet use on changes in venous point-of-care lactate concentrations. ⋯ Whole blood point-of-care lactate concentrations in healthy subjects do not change significantly over 15 minutes at either -1 degrees C or 23 degrees C, and the use of a tourniquet has no appreciable effect on lactate concentrations.
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In September 2006, the Centers for Disease Control and Prevention released its revised recommendations for human immunodeficiency virus (HIV) testing. Prominent among these were the recommendations that emergency departments should perform routine screening for HIV infection. ⋯ It contains the lessons that were learned when such a program was initiated at an academic emergency department. Consideration of these steps will help streamline the establishment of the program, but there should be careful consideration of the program's costs and sustainability before embarking on the process.
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Comparative Study
Prospective study of the clinical features and outcomes of emergency department patients with delayed diagnosis of pulmonary embolism.
The authors hypothesized that emergency department (ED) patients with a delayed diagnosis of pulmonary embolism (PE) will have a higher frequency of altered mental status, older age, comorbidity, and worsened outcomes compared with patients who have PE diagnosed by tests ordered in the ED. ⋯ In this single-center study, the diagnosis of PE was frequently delayed and outcomes of patients with delayed diagnosis were worse than those of patients with PE diagnosed in the ED.
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In part 1 of this series, the authors describe the importance of incomplete data in clinical research, and provide a conceptual framework for handling incomplete data by describing typical mechanisms and patterns of censoring, and detailing a variety of relatively simple methods and their limitations. In part 2, the authors will explore multiple imputation (MI), a more sophisticated and valid method for handling incomplete data in clinical research. This article will provide a detailed conceptual framework for MI, comparative examples of MI versus naive methods for handling incomplete data (and how different methods may impact subsequent study results), plus a practical user's guide to implementing MI, including sample statistical software MI code and a deidentified precoded database for use with the sample code.