Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Accurate estimation of the risk of SARS-CoV-2 infection based on bedside data alone has importance to emergency department (ED) operations and throughput. The 13-item CORC (COVID [or coronavirus] Rule-out Criteria) rule had good overall diagnostic accuracy in retrospective derivation and validation. The objective of this study was to prospectively test the inter-rater reliability and diagnostic accuracy of the CORC score and rule (score ≤ 0 negative, > 0 positive) and compare the CORC rule performance with physician gestalt. ⋯ In this prospective study, the CORC score and rule demonstrated good inter-rater reliability and reproducible diagnostic accuracy for estimating the pretest probability of SARs-CoV-2 infection.
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Review Meta Analysis
Effect of Pre-Hospital Workflow Optimization on Treatment Delays and Clinical Outcomes in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.
The prehospital phase is critical in ensuring that stroke treatment is delivered quickly and is a major source of time delay. This study sought to identify and examine prehospital stroke workflow optimizations (PSWOs) and their impact on improving health systems, reperfusion rates, treatment delays, and clinical outcomes. ⋯ This systematic review and meta-analysis found that PSWO significantly improves several time metrics related to stroke treatment leading to improvement in IVT reperfusion rates. Thus, the implementation of these measures in stroke networks is a promising avenue to improve an often-neglected aspect of the stroke response. However, the limited available data suggest functional outcomes and mortality are not significantly improved by PSWO; hence, further studies and improvement strategies vis-à-vis PSWOs are warranted.