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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. Computed tomography of the head for adult patients with minor head injury: are clinical decision rules a necessary evil? Full Text available with Trip Pro

Computed tomography of the head for adult patients with minor head injury: are clinical decision rules a necessary evil? This study aimed to evaluate compliance with and performance of the Canadian Computed Tomography Head Rule (CCHR), and its applicability to the Singapore adult population with minor head injury.We conducted a retrospective study over six months of consecutive patients who presented to the adult emergency department (ED) with minor head injury. Data on predictor variables (...) indicated in the CCHR was collected and compliance with the CCHR was assessed by comparing the recommendations for head computed tomography (CT) to its actual usage.In total, 349 patients satisfied the inclusion criteria. Common mechanisms of injury were falls (59.3%), motor vehicle crashes (16.9%) and assault (12.0%). 249 (71.3%) patients underwent head CT, yielding 42 (12.0%) clinically significant findings. 1 (0.3%) patient required neurosurgical intervention. According to the CCHR, head CT

2018 Singapore medical journal

24. Clinical decision rules in emergency care Full Text available with Trip Pro

Clinical decision rules in emergency care 29749424 2018 10 24 2018 11 14 0037-5675 59 4 2018 04 Singapore medical journal Singapore Med J Clinical decision rules in emergency care. 169 10.11622/smedj.2018042 Lim Swee Han SH eng Editorial Singapore Singapore Med J 0404516 0037-5675 IM Adult Aged Canada Child Decision Making Decision Support Systems, Clinical Emergency Medical Services methods Emergency Service, Hospital Emergency Treatment methods Female Humans Pneumonia diagnosis Retrospective

2018 Singapore medical journal

25. 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

26. 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

27. 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

28. 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

29. 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

30. How to use the Kaiser score as a clinical decision rule for diagnosis in multiparametric breast MRI: a pictorial essay Full Text available with Trip Pro

How to use the Kaiser score as a clinical decision rule for diagnosis in multiparametric breast MRI: a pictorial essay Due to its superior sensitivity, breast MRI (bMRI) has been established as an important additional diagnostic tool in the breast clinic and is used for screening in patients with an elevated risk for breast cancer. Breast MRI, however, is a complex tool, providing multiple images containing several contrasts. Thus, reading bMRI requires a structured approach. A lack (...) of structure will increase the rate of false-positive findings and sacrifice most of the advantages of bMRI as additional work-up will be required. While the BI-RADS (Breast Imaging Reporting And Data System) lexicon is a major step toward standardised and structured reporting, it does not provide a clinical decision rule with which to guide diagnostic decisions. Such a clinical decision rule, however, is provided by the Kaiser score, which combines five independent diagnostic BI-RADS lexicon criteria

2018 Insights into imaging

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. Translation of a C. difficile Treatment Clinical Pathway Into Machine-Readable Clinical Decision Support Artifacts Prototyped for Electronic Health Record Integration

Translation of a C. difficile Treatment Clinical Pathway Into Machine-Readable Clinical Decision Support Artifacts Prototyped for Electronic Health Record Integration Methods Research Report Translation of a C. difficile Treatment Clinical Pathway Into Machine-Readable Clinical Decision Support Artifacts Prototyped for Electronic Health Record Integration Methods Research Report Translation of a C. difficile Treatment Clinical Pathway Into Machine-Readable Clinical Decision Support Artifacts (...) AHRQ Publication No. 20-EHC001-EF November 2019 ii Key Messages Purpose of Project To translate an evidence-based Clostridioides difficile* (CDI) treatment clinical pathway using a systematic, transparent process into machine readable clinical decision support (CDS) prototyped for electronic health record (EHR) integration. (*The bacterium Clostridium difficile was renamed Clostridioides difficile in August 2016.) Key Messages • Getting evidence into practice to improve clinical decision making

2019 Effective Health Care Program (AHRQ)

33. Systematic review: Clinical decision rules for the assessment of mild head injury, used in combination with clinical judgment, can inform the use of head imaging

Systematic review: Clinical decision rules for the assessment of mild head injury, used in combination with clinical judgment, can inform the use of head imaging Clinical decision rules for the assessment of mild head injury, used in combination with clinical judgment, can inform the use of head imaging | 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 Clinical decision rules for the assessment of mild head injury, used in combination

2012 Evidence-Based Medicine

34. 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

35. 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

36. 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

37. 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

38. Best practice to identify and prevent cognitive bias in clinical decision-making

Best practice to identify and prevent cognitive bias in clinical decision-making Cognitive Bias 1 Best practice to identify and prevent cognitive bias in clinical decision-making Citation Garrubba M, Joseph C. & Melder A. 2019. Best practice to identify and prevent cognitive bias in clinical decision-making: Scoping review. Centre for Clinical Effectiveness, Monash Innovation and Quality, Monash Health, Melbourne, Australia. Summary about evidence of best practice This review reports (...) that there is limited evidence to inform best practice to manage cognitive bias. The review included information about the different types of cognition bias that exist and how this might impact clinical decision making. Literature explained the influence and impact of cognitive bias on diagnostic accuracy, management errors and patient outcomes. Findings suggest that cognitive biases may be associated with diagnostic inaccuracies and, some evidence suggest a potential influence of cognitive biases on management

2019 Monash Health Evidence Reviews

39. 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

40. 3 Derivation and internal validation of a clinical decision rule to guide whole body computed tomography scanning in trauma. (Abstract)

3 Derivation and internal validation of a clinical decision rule to guide whole body computed tomography scanning in trauma.

2017 Emergency Medicine Journal

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