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Clinical Decision Rule

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21. This Article Corrects: “GLASS Clinical Decision Rule Applied to Thoracolumbar Spinal Fractures in Patients Involved in Motor Vehicle Crashes” Full Text available with Trip Pro

This Article Corrects: “GLASS Clinical Decision Rule Applied to Thoracolumbar Spinal Fractures in Patients Involved in Motor Vehicle Crashes” [This corrects the article on p. 1108 in vol. 18, PMID: 29085544.].

2018 Western Journal of Emergency Medicine

22. Acceptability of a Mobile Clinical Decision Tool Among Emergency Department Clinicians: Development and Evaluation of The Ottawa Rules App Full Text available with Trip Pro

Acceptability of a Mobile Clinical Decision Tool Among Emergency Department Clinicians: Development and Evaluation of The Ottawa Rules App The Ottawa Ankle Rules, Ottawa Knee Rule, and Canadian C-Spine Rule-together known as The Ottawa Rules-are a set of internationally validated clinical decision rules developed to decrease unnecessary diagnostic imaging in the emergency department. In this study, we sought to develop and evaluate the use of a mobile app version of The Ottawa Rules.The primary (...) to colleagues (81/108, 75.0%), and that they would continue using the app (73/108, 67.6%). Feedback from study participants highlighted a desire for access to more clinical decision rules and a higher degree of interactivity of the app. Between April 21, 2016, and June 1, 2017, The Ottawa Rules app was downloaded approximately 4000 times across 89 countries.We have found The Ottawa Rules app to be an effective means to disseminate the Ottawa Ankle Rules, Ottawa Knee Rule, and Canadian C-Spine Rule among all

2018 JMIR mHealth and uHealth

23. Derivation of a Clinical Decision Rule for Emergency Department Head CT Scanning in Seniors Who Have Fallen

Derivation of a Clinical Decision Rule for Emergency Department Head CT Scanning in Seniors Who Have Fallen Derivation of a Clinical Decision Rule for Emergency Department Head CT Scanning in Seniors Who Have Fallen - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (...) (100). Please remove one or more studies before adding more. Derivation of a Clinical Decision Rule for Emergency Department Head CT Scanning in Seniors Who Have Fallen The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier

2018 Clinical Trials

24. A clinical decision rule to predict intracranial hypertension in severe traumatic brain injury. Full Text available with Trip Pro

A clinical decision rule to predict intracranial hypertension in severe traumatic brain injury. OBJECTIVEWhile existing guidelines support the treatment of intracranial hypertension in severe traumatic brain injury (TBI), it is unclear when to suspect and initiate treatment for high intracranial pressure (ICP). The objective of this study was to derive a clinical decision rule that accurately predicts intracranial hypertension.METHODSUsing Delphi methods, the authors identified a set (...) of potential predictors of intracranial hypertension and a clinical decision rule a priori by consensus among a group of 43 neurosurgeons and intensivists who have extensive experience managing severe TBI without ICP monitoring. To validate these predictors, the authors used data from a Latin American trial (n = 150; BEST TRIP). To report on the performance of the rule, they calculated sensitivity, specificity, and positive and negative predictive values with 95% confidence intervals. In a secondary

2018 Journal of Neurosurgery

25. Utility of Clinical and Laboratory Decision Rules in Identifying Bacterial Meningitis Among Children With suspicion of Central Nervous System Infections in a Malaria-Endemic Area, Mbarara Uganda. Full Text available with Trip Pro

Utility of Clinical and Laboratory Decision Rules in Identifying Bacterial Meningitis Among Children With suspicion of Central Nervous System Infections in a Malaria-Endemic Area, Mbarara Uganda. Several decision rules combining clinical and biological parameters have been proposed to distinguish bacterial from aseptic meningitis, but have not been evaluated in Africa. In children hospitalized with suspected central nervous system infections in Uganda, we found that the Bacterial Meningitis (...) Score and Meningitest showed lower performance than in European children, and that a decision rule designed specifically using parameters associated with bacterial meningitis also showed inadequate diagnostic performance for clinical use.

2018 Pediatric Infectious Dsease Journal

26. Best practices for preventing malfunctions in rule-based clinical decision support alerts and reminders: Results of a Delphi study. Full Text available with Trip Pro

Best practices for preventing malfunctions in rule-based clinical decision support alerts and reminders: Results of a Delphi study. Developing effective and reliable rule-based clinical decision support (CDS) alerts and reminders is challenging. Using a previously developed taxonomy for alert malfunctions, we identified best practices for developing, testing, implementing, and maintaining alerts and avoiding malfunctions.We identified 72 initial practices from the literature, interviews (...) , deployment, monitoring and feedback, and people and governance. Round 2 developed consensus on the importance and feasibility of each best practice.The Delphi panel identified a range of best practices that may help to improve implementation of rule-based CDS and avert malfunctions. Due to limitations on resources and personnel, not everyone can implement all best practices. The most robust processes require investing in a data warehouse. Experts also pointed to the issue of shared responsibility between

2018 International journal of medical informatics

27. The "Petechiae in children" (PiC) study: evaluating potential clinical decision rules for the management of feverish children with non-blanching rashes, including the role of point of care testing for Procalcitonin & Neisseria meningitidis DNA - a stu Full Text available with Trip Pro

The "Petechiae in children" (PiC) study: evaluating potential clinical decision rules for the management of feverish children with non-blanching rashes, including the role of point of care testing for Procalcitonin & Neisseria meningitidis DNA - a stu Children commonly present to Emergency Departments (ED) with a non-blanching rash in the context of a feverish illness. While most have a self-limiting viral illness, this combination of features potentially represents invasive serious bacterial (...) ) clinicians on research without prior consent using qualitative methodology Report on the aetiology of NBRs in children with a feverish illness DISCUSSION: The PiC study will provide important information for policy makers regarding the value of POCT and on the utility and cost of emerging diagnostic strategies. The study will also identify which elements of existing CPGs may merit inclusion in any future study to derive clinical decision rules for this population.NCT03378258 . Retrospectively registered

2018 BMC Pediatrics

28. Development of a new clinical decision rule for cervical CT to detect cervical spine injury in patients with head or neck trauma. Full Text available with Trip Pro

Development of a new clinical decision rule for cervical CT to detect cervical spine injury in patients with head or neck trauma. Previous cervical spine imaging decision rules have been based on positive findings on plain X-ray and are limited by lack of specificity, age restrictions and complicated algorithms. We previously derived and validated a clinical decision rule (Rule 1) for detecting cervical spine injury (CSI) on CT in a single-centre study. This recommended CT for patients with (1 (...) ) GCS score <14, (2) GCS 14-15 and posterior cervical tenderness or neurological deficit, (3) age ≥60 years and fall down stairs, or (4) age <60 and injured in a motorcycle collision or fallen from height. This study assessed the accuracy and reliability of this rule and refined the rule.We conducted a prospective, dual-centre study at two Japanese EDs between August 2012 and March 2014. Patients with head or neck injury ≥16 years of age were included. Clinical data were collected from medical

2018 Emergency Medicine Journal

29. Aortic Dissection Detection-Risk Score: A Clinical Decision Rule that Needs Some Parenting. (Abstract)

Aortic Dissection Detection-Risk Score: A Clinical Decision Rule that Needs Some Parenting. 30312510 2018 11 20 1553-2712 2018 Oct 12 Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Aortic Dissection Detection Risk Score: A Clinical Decision Rule That Needs Some Parenting. 10.1111/acem.13636 Hill Jeffery M JM University of Cincinnati College of Medicine, Cincinnati, OH. Murphy Timothy G TG University of Cincinnati College of Medicine

2018 Academic Emergency Medicine

30. A Cost-Effectiveness Analysis Comparing Clinical Decision Rules PECARN, CATCH, and CHALICE With Usual Care for the Management of Pediatric Head Injury. Full Text available with Trip Pro

A Cost-Effectiveness Analysis Comparing Clinical Decision Rules PECARN, CATCH, and CHALICE With Usual Care for the Management of Pediatric Head Injury. To determine the cost-effectiveness of 3 clinical decision rules in comparison to Australian and New Zealand usual care: the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE), the Pediatric Emergency Care Applied Research Network (PECARN), and the Canadian Assessment of Tomography for Childhood Head (...) Injury (CATCH).A decision analytic model was constructed from the Australian health care system perspective to compare costs and outcomes of the 3 clinical decision rules compared with Australian and New Zealand usual care. The study involved multicenter recruitment from 10 Australian and New Zealand hospitals; recruitment was based on the Australian Pediatric Head Injury Rules Study involving 18,913 children younger than 18 years and with a head injury, and with Glasgow Coma Scale score 13 to 15

2018 Annals of Emergency Medicine

31. The DIPEP (Diagnosis of Pulmonary Embolism in Pregnancy) Study and the limited accuracy of Clinical Decision Rules and D-dimer: what next? Full Text available with Trip Pro

The DIPEP (Diagnosis of Pulmonary Embolism in Pregnancy) Study and the limited accuracy of Clinical Decision Rules and D-dimer: what next? 29873174 2019 03 13 2019 03 13 1471-0528 126 3 2019 02 BJOG : an international journal of obstetrics and gynaecology BJOG The DiPEP (diagnosis of pulmonary embolism in pregnancy) study and the limited accuracy of clinical decision rules and D-dimer: what next? 393 10.1111/1471-0528.15309 Okonofua F F Obstetrics and Gynaecology, College of Medical Sciences

2018 BJOG

32. Effect of clinical decision rules, patient cost and malpractice information on clinician brain CT image ordering: a randomized controlled trial. Full Text available with Trip Pro

Effect of clinical decision rules, patient cost and malpractice information on clinician brain CT image ordering: a randomized controlled trial. The frequency of head computed tomography (CT) imaging for mild head trauma patients has raised safety and cost concerns. Validated clinical decision rules exist in the published literature and on-line sources to guide medical image ordering but are often not used by emergency department (ED) clinicians. Using simulation, we explored whether (...) the presentation of a clinical decision rule (i.e. Canadian CT Head Rule - CCHR), findings from malpractice cases related to clinicians not ordering CT imaging in mild head trauma cases, and estimated patient out-of-pocket cost might influence clinician brain CT ordering. Understanding what type and how information may influence clinical decision making in the ordering advanced medical imaging is important in shaping the optimal design and implementation of related clinical decision support systems.Multi

2018 Medical Informatics and Decision Making Controlled trial quality: uncertain

33. Rare adverse events in clinical trials: understanding the rule of three

Rare adverse events in clinical trials: understanding the rule of three Rare adverse events in clinical trials: understanding the rule of three | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username (...) * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Rare adverse events in clinical trials: understanding the rule of three Article Text EBM opinion and debate Rare adverse events in clinical trials: understanding the rule of three Igho J Onakpoya Statistics from Altmetric.com Investigators should

2018 Evidence-Based Medicine

34. Knowledge-based clinical decision support systems

support system implementations on patient outcomes in inpatient care: a systematic review. J Am Med Inform Assoc. 2018;25(5):593-602. 16. Kennedy G, Gallego B. Clinical prediction rules: a systematic review of healthcare provider opinions and preferences. Int J Med Inform. 2019;123:1-10. 17. Blum D, Raj SX, Oberholzer R, Riphagen II, Strasser F, Kaasa S, et al. Computer-based clinical decision support systems and patient-reported outcomes: a systematic review. Patient. 2015;8(5):397-409. 18. Hussain (...) ):e001213. 37. Bellodi E, Vagnoni E, Bonvento B, Lamma E. Economic and organizational impact of a clinical decision support system on laboratory test ordering. BMC Med Inform Decis Mak. 2017;17(1):179. SHTG Assessment | 28 Appendix 1: Abbreviations AMSTAR assessing the methodological quality of systematic reviews CDS computerised decision support CDSS clinical decision support systems CI confidence interval CPOE computerised physician / prescriber order entry CPR clinical prediction rules CRD EED Centre

2020 SHTG Advice Statements

35. Decision rule to predict pneumonia in children presented with acute febrile respiratory illness. (Abstract)

radiograph examination for pediatric patients. While promising, the PAFRI rule requires further validation.It is often a challenge for physicians to identify pneumonia in children acutely febrile with respiratory symptoms, particularly in those who are stable without respiratory distress. The decision to order chest radiograph was based on clinical assessment with heterogenous practice. A valid and verified clinical prediction rule for ordering chest radiograph examination for stable febrile children (...) Decision rule to predict pneumonia in children presented with acute febrile respiratory illness. It is a frequent challenge for physicians to identify pneumonia in patients with acute febrile respiratory symptoms, particularly in stable pediatric patients without respiratory distress. A decision rule is required to assist judgement on the need of ordering a chest radiograph.This was a multicenter prospective study in 3 emergency departments. Children younger than 6 years old with an acute onset

2020 American Journal of Emergency Medicine

36. Modified decision-making rule supported by scheduled telephone follow-up reduces head computed tomography utilization in children with mild traumatic brain injury: A cohort study. Full Text available with Trip Pro

period, there were no differences in the rates of delayed imaging (2.3% vs. 2.2%, P = .814) or the rates of delayed diagnosis of significant radiological findings (0.1% vs 0.2%, P = .672) in cases with versus without immediate computed tomography.Adoption of a modified decision-making rule supported by scheduled telephone follow-up can reduce head computed tomography utilization without increasing the rate of missed or delayed diagnosis of clinically significant TBI in children with mild TBI. (...) Modified decision-making rule supported by scheduled telephone follow-up reduces head computed tomography utilization in children with mild traumatic brain injury: A cohort study. Unnecessary computed tomography utilization is common in children with a mild traumatic head injury. It is valuable to find a reasonable strategy for the patient's management.The aim of this study was to investigate the effect of scheduled telephone follow-up on computed tomography utilization in children with a mild

2020 Medicine

37. External validation of computed tomography decision rules for minor head injury: prospective, multicentre cohort study in the Netherlands. Full Text available with Trip Pro

between March 2015 and December 2016.The primary outcome was any intracranial traumatic finding on CT; the secondary outcome was a potential neurosurgical lesion on CT, which was defined as an intracranial traumatic finding on CT that could lead to a neurosurgical intervention or death. The sensitivity, specificity, and clinical usefulness (defined as net proportional benefit, a weighted sum of true positive classifications) of the four CT decision rules. The rules included the CT in head injury (...) External validation of computed tomography decision rules for minor head injury: prospective, multicentre cohort study in the Netherlands. To externally validate four commonly used rules in computed tomography (CT) for minor head injury.Prospective, multicentre cohort study.Three university and six non-university hospitals in the Netherlands.Consecutive adult patients aged 16 years and over who presented with minor head injury at the emergency department with a Glasgow coma scale score of 13-15

2018 BMJ

38. Prospective Validation and Refinement of a Decision Rule to Obtain Chest X-ray in Patients With Nontraumatic Chest Pain in the Emergency Department Full Text available with Trip Pro

in the United States with a chief complaint of nontraumatic CP. Previously defined high-risk history and examination elements were combined into a refined decision rule and these elements were recorded for each patient by the ED physician. CXR results were reviewed and analyzed to determine the presence of clinically significant findings including pneumonia, pleural effusion, pneumothorax, congestive heart failure, or the presence of a new mass. Odds ratios for each history and examination element were (...) analyzed as well as sensitivity, specificity, and negative predictive value (NPV) of the rule overall.A total of 1,111 patients were enrolled and 1,089 CXRs were analyzed. There were 70 (6.4%) patients with clinically relevant findings on CXR. The refined decision rule had a sensitivity of 92.9% (confidence interval [CI] = 83.4%-97.3%) and specificity of 30.4% (CI = 27.6%-33.4%) to predict clinically relevant findings on CXR, with a NPV of 98.4% (CI = 96.1%-99.4%). Five CXRs with clinically significant

2018 EvidenceUpdates

39. Increasing Complexity in Rule-Based Clinical Decision Support: The Symptom Assessment and Management Intervention Full Text available with Trip Pro

Increasing Complexity in Rule-Based Clinical Decision Support: The Symptom Assessment and Management Intervention Management of uncontrolled symptoms is an important component of quality cancer care. Clinical guidelines are available for optimal symptom management, but are not often integrated into the front lines of care. The use of clinical decision support (CDS) at the point-of-care is an innovative way to incorporate guideline-based symptom management into routine cancer care.The objective (...) of this study was to develop and evaluate a rule-based CDS system to enable management of multiple symptoms in lung cancer patients at the point-of-care.This study was conducted in three phases involving a formative evaluation, a system evaluation, and a contextual evaluation of clinical use. In Phase 1, we conducted iterative usability testing of user interface prototypes with patients and health care providers (HCPs) in two thoracic oncology clinics. In Phase 2, we programmed complex algorithms derived

2016 JMIR medical informatics

40. Prospective validation of a clinical decision rule to identify patients presenting to the emergency department with chest pain who can safely be removed from cardiac monitoring Full Text available with Trip Pro

Prospective validation of a clinical decision rule to identify patients presenting to the emergency department with chest pain who can safely be removed from cardiac monitoring Most patients with chest pain in the emergency department are assigned to cardiac monitoring for several hours, blocking access for patients in greater need. We sought to validate a previously derived decision rule for safe removal of patients from cardiac monitoring after initial evaluation in the emergency (...) department.We prospectively enrolled adults (age ≥ 18 yr) who presented with chest pain and were assigned to cardiac monitoring at 2 academic emergency departments over 18 months. We collected standardized baseline characteristics, findings from clinical evaluations and predictors for the Ottawa Chest Pain Cardiac Monitoring Rule: whether the patient is currently free of chest pain, and whether the electrocardiogram is normal or shows only nonspecific changes. The outcome was an arrhythmia requiring

2017 EvidenceUpdates

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