Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Pediatric appendicitis remains a challenging diagnosis in the emergency department (ED). Available risk prediction algorithms may contribute to excessive ED imaging studies. Incorporation of physician gestalt assessment could help refine predictive tools and improve diagnostic imaging decisions. ⋯ Physician gestalt for acute appendicitis diagnosis performed well, especially in low-risk patients and when employed by experienced physicians.
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The Centers for Disease Control and Prevention recommends screening baby boomers and high-risk patients for hepatitis C virus (HCV); however, the incidence of HCV is rapidly increasing among younger populations, and screening is limited by access to care and risk factor assessment. The purpose of this study was to evaluate characteristics of HCV antibody-positive (Ab+) and ribonucleic acid (RNA)-confirmed-positive patients identified via two screening models in an Appalachian emergency department (ED). ⋯ This study was the first to present characteristics of HCV Ab+ and RNA-confirmed-positive patients identified during the transition to a universal screening model in an Appalachian ED. Most diagnoses were new regardless of screening model, but more patients screened HCV Ab+, and a similar proportion were RNA-confirmed-positive, under the universal model. Given that adoption of universal screening was modest, and risk factors remained similar, future research should investigate how to more effectively implement a universal screening model on a wider scale to identify early infections.