Articles: sensitivity-specificity.
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Multicenter Study Observational Study
Lung ultrasound-implemented diagnosis of acute decompensated heart failure in the Emergency Department - A SIMEU multicenter study.
Lung ultrasonography (LUS) has emerged as a noninvasive tool for the differential diagnosis of pulmonary diseases. However, its use for the diagnosis of acute decompensated heart failure (ADHF) still raises some concerns. We tested the hypothesis that an integrated approach implementing LUS with clinical assessment would have higher diagnostic accuracy than a standard workup in differentiating ADHF from noncardiogenic dyspnea in the ED. ⋯ The implementation of LUS with the clinical evaluation may improve accuracy of ADHF diagnosis in patients presenting to the ED.
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Pediatr Crit Care Me · Jul 2015
Multicenter StudyFactor VIII May Predict Catheter-Related Thrombosis in Critically Ill Children: A Preliminary Study.
If we can identify critically ill children at high risk for central venous catheter-related thrombosis, then we could target them for pharmacologic thromboprophylaxis. We determined whether factor VIII activity or G value was associated with catheter-related thrombosis in critically ill children. ⋯ Factor VIII activity may be used to stratify critically ill children based on their risk for catheter-related thrombosis.
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Multicenter Study
Pilot study of a new mathematical algorithm for early detection of late-onset sepsis in very low-birth-weight infants.
Diagnosis of late onset sepsis (LOS) in very low birth weight (VLBW) preterm infants relies mainly on clinical suspicion, whereas prognosis depends on early initiation of antibiotic treatment. RALIS is a mathematical algorithm for early detection of LOS incorporating six vital signs measured every 2 hours. ⋯ RALIS has a promising potential as an easy to implement noninvasive early indicator of LOS, especially for ruling out LOS in VLBW high-risk infants.
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Multicenter Study
Association of hip pain with radiographic evidence of hip osteoarthritis: diagnostic test study.
Is there concordance between hip pain and radiographic hip osteoarthritis? ⋯ See the full paper on thebmj.com for funding. The authors have no competing interests. Additional data are available from bevochan@bu.edu.
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Multicenter Study Clinical Trial
Development, Evaluation and Implementation of Chief Complaint Groupings to Activate Data Collection: A Multi-Center Study of Clinical Decision Support for Children with Head Trauma.
Overuse of cranial computed tomography scans in children with blunt head trauma unnecessarily exposes them to radiation. The Pediatric Emergency Care Applied Research Network (PECARN) blunt head trauma prediction rules identify children who do not require a computed tomography scan. Electronic health record (EHR) based clinical decision support (CDS) may effectively implement these rules but must only be provided for appropriate patients in order to minimize excessive alerts. ⋯ CC groupings can be successfully developed and implemented across multiple sites to accurately identify patients who should have a CTA triggered to facilitate EHR data collection. However, CC groupings will necessarily vary in order to attain high sensitivity and moderate-to-high specificity. In future trials, the balance between sensitivity and specificity should be considered based on the nature of the clinical condition, including prevalence and morbidity, in addition to the goals of the intervention being considered.