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Clinical Decision Rule

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141. Clinical Decision Rule for Pediatric Intracranial Pathology

Clinical Decision Rule for Pediatric Intracranial Pathology Clinical Decision Rule for Pediatric Intracranial Pathology - 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. Clinical Decision Rule for Pediatric (...) Hospitals and Clinics of Minnesota Information provided by (Responsible Party): Children's Hospitals and Clinics of Minnesota Study Details Study Description Go to Brief Summary: The purpose of this study is to develop a clinical decision rule for patients seen in the pediatric emergency department for possible intracranial pathology. This a prospective study evaluating patients presenting with headache and migraine. The study is observational and does not impact patient care. Condition or disease

2015 Clinical Trials

142. Age and sex-dependent trends in pulmonary embolism testing and derivation of a clinical decision rule for young patients. (Abstract)

Age and sex-dependent trends in pulmonary embolism testing and derivation of a clinical decision rule for young patients. Despite low prevalence of pulmonary embolism (PE) in young adults, they are frequently imaged for PE, which involves radiation exposure and substantial financial cost.Determine the use and positive proportions for PE imaging by age, differences in clinical presentation of PE by age and the projected impact of an age-targeted decision rule.Analysis of two national population (...) proportion of positive examinations in young adults than older adults (2.3% vs 17.4%, p<0.001 in women; 4.0% vs 21.4%, p<0.001 in men). Clinical predictors of PE varied by age. Tachycardia was a significant predictor of PE in older patients (OR: 1.2-1.9, p<0.001), but not young patients. Fever was a significant predictor only in young patients (OR: 1.4-7.2, p<0.01). A modification of the previously described PERC rule to include age-specific risk factors could reduce PE imaging by 51% in young patients

2015 Emergency Medicine Journal

143. Clinical decision rule for primary care patient with acute low back pain at risk of developing chronic pain. Full Text available with Trip Pro

Clinical decision rule for primary care patient with acute low back pain at risk of developing chronic pain. Primary care clinicians need to identify candidates for early interventions to prevent patients with acute pain from developing chronic pain.We conducted a 2-year prospective cohort study of risk factors for the progression to chronic pain and developed and internally validated a clinical decision rule (CDR) that stratifies patients into low-, medium-, and high-risk groups for chronic (...) pain.This is a prospective cohort study in primary care.Patients with acute low back pain (LBP, ≤30 days duration) were included.Outcome measures were self-reported perceived nonrecovery and chronic pain.Patients were surveyed at baseline, 6 months, and 2 years. We conducted bivariate and multivariate regression analyses of demographic, clinical, and psychosocial variables for chronic pain outcomes, developed a CDR, and assessed its performance by calculating the bootstrapped areas under the receiver

2015 The Spine Journal

144. Model for prediction of pediatric OSA: Proposal for a clinical decision rule. (Abstract)

Model for prediction of pediatric OSA: Proposal for a clinical decision rule. Obstructive sleep apnea (OSA) is a syndrome frequently diagnosed in children; however, it lacks optimal diagnostic methods. This study aimed to provide a clinical decision rule for predicting pediatric OSA using commonly available clinical information.A prospective cohort study.Children between the ages of 3 to 6 years-old, referred for an otorhinolaryngology consultation due to clinical suspicion of OSA, were (...) OSA in the final model (odds ratio, 95% confidence interval) included PSQ score (5.12; 3.3-6.5), ODI (1.34; 1.0-1.79) and tonsil size (6.7; 3.22-9.75). The final decision rule had a sensitivity of 88% and a specificity of 86%. The area under the receiver operating characteristic curve was 0.897.The proposed clinical decision rule, based on three readily available variables, is a promising discriminating instrument for prediction of OSA among children between 3 and 6 years.2b.© 2015 The American

2015 Laryngoscope

145. Decision-making criteria for CT head scans on patients not on anti-coagulants

clinical decision rules, and excludes studies deriving new adult clinical decision rules. ? The Guideline Development Group (GDG) recommends clinical decision rules that had been well tested in relevant populations. ? Full literature searches, critical appraisals and evidence reviews were completed to address the question: “What is the best clinical decision rule for selecting adults, infants and children with head injury for CT head scan?” ? Literature review and extensive consultation (...) - reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. ? Where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. ? The review presents several clinical decision rules which have been tested in clinical practice and reports the results of their use. Criteria for patient selection for CT head scans Criteria for performing a CT head

2019 Monash Health Evidence Reviews

146. Focused Update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation

of the indications for treatment. The document is a focused update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation, with some sections updated and others added in light of the publication of new trial data related to secondary MR, among other developments. A structured approach to evaluation based on clinical findings, accurate echocardiographic imaging, and, when necessary, adjunctive testing, can help clarify decision making. Treatment goals include timely (...) Relationships With Industry and Other Entities (Relevant) 74 Appendix 2: Peer Reviewer Information 78 Appendix 3: Abbreviations 80 5 PREFACE The American College of Cardiology (ACC) has a longstanding history of developing documents (decision pathways, health policy statements, appropriate use criteria, etc.) to provide members with guidance on both clinical and non-clinical topics relevant to cardiovascular care. In most circumstances, these resources have been created to complement clinical practice

2020 American College of Cardiology

147. Prediction rule: Use of the M-CHAT follow-up interview (M-CHAT/F) by paediatricians during well-child care visits is feasible, valid and reliable

and reliable Article Text Diagnosis Prediction rule Use of the M-CHAT follow-up interview (M-CHAT/F) by paediatricians during well-child care visits is feasible, valid and reliable Thyde Dumont-Mathieu Statistics from Altmetric.com Citation: Sturner R, Howard B, Bergmann P, et al . Autism screening with online decision support by primary care pediatricians aided by M-CHAT/F. Pediatrics . 2016 Sep;138: e20153036. Context Early identification of children with autism spectrum disorders (ASDs) leads to early (...) Prediction rule: Use of the M-CHAT follow-up interview (M-CHAT/F) by paediatricians during well-child care visits is feasible, valid and reliable Use of the M-CHAT follow-up interview (M-CHAT/F) by paediatricians during well-child care visits is feasible, valid and reliable | 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

2017 Evidence-Based Medicine

148. Failure of Prospective Validation and Derivation of a Refined Clinical Decision Rule for Chest Radiography in Emergency Department Patients With Chest Pain and Possible Acute Coronary Syndrome (Abstract)

Failure of Prospective Validation and Derivation of a Refined Clinical Decision Rule for Chest Radiography in Emergency Department Patients With Chest Pain and Possible Acute Coronary Syndrome The authors previously derived a clinical decision rule (CDR) for chest radiography in patients with chest pain and possible acute coronary syndrome (ACS) consisting of the absence of three predictors: history of congestive heart failure, history of smoking, and abnormalities on lung auscultation. The aim (...) %) and a negative predictive value of 100.0% (95% CI = 96.3% to 100.0%).Prospective validation of our previously derived CDR for clinically important chest radiographic abnormalities was not successful. Derivation of a refined rule identified all clinically important radiographic abnormalities, but was insufficiently specific. No CDR with adequate sensitivity and specificity could be found.© 2012 by the Society for Academic Emergency Medicine.

2012 EvidenceUpdates

149. Feasibility and Security of a Rapid Rule-out and rule-in Troponin Protocol in the Management of NSTEMI in an Emergency Departement

reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Feasibility and Security of a Rapid Rule-out and rule-in Troponin Protocol in the Management of NSTEMI in an Emergency Departement (ICTUS) 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 (...) for consultation in emergency departments. Among cardiological causes, quickly diagnosing NSTEMI optimize patient treatment. To do this, the European Society of Cardiology, proposed in 2015 an one hour rule-in rule out troponin dosage based protocol. These recommendations should allow a faster diagnosis of NSTEMI but also a rule-out of patients with a low to moderate clinical probability of coronary heart disease. It could also improve efficiency in emergency departements decreasing the length of stay

2018 Clinical Trials

150. Rapid Use of High-sensitive Cardiac Troponin I for ruling-in and Ruling-out of Acute Myocardial Infarction

). Please remove one or more studies before adding more. Rapid Use of High-sensitive Cardiac Troponin I for ruling-in and Ruling-out of Acute Myocardial Infarction (RACING-MI) 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 (...) Rapid Use of High-sensitive Cardiac Troponin I for ruling-in and Ruling-out of Acute Myocardial Infarction Rapid Use of High-sensitive Cardiac Troponin I for ruling-in and Ruling-out of Acute Myocardial Infarction - 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

2018 Clinical Trials

151. 'Rule-in' and 'Rule-out' Algorithms using Accelerated Serial High-sensitivity Cardiac Troponins Sampling for the Early Diagnosis of NSTEMI Patients: Systematic Review and Meta-analysis

'Rule-in' and 'Rule-out' Algorithms using Accelerated Serial High-sensitivity Cardiac Troponins Sampling for the Early Diagnosis of NSTEMI Patients: Systematic Review and Meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility (...) full research paper (e.g. review, editorial) 2. Not an in vivo animal study 3. No metastases/ only primary tumor 4. No control group 5. Combination therapy or contamination 6. Not about analgesics used in the clinic Full text-screening: As above, with the addition of: 7. No relevant outcome measure reported ">Prioritise the exclusion criteria Example: Two reviewers will independently extract data from each article. We first try to extract numerical data from tables, text or figures

2020 PROSPERO

152. A novel approach to the determination of clinical decision thresholds

and Swiss physicians that may be a function of differences in healthcare systems. Our results can also guide development of clinical decision rules and guidelines. Acknowledgments The authors would like to thank the physicians who took the time to complete our survey, in particular the members of the Swiss Sentinella Network. Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You (...) A novel approach to the determination of clinical decision thresholds A novel approach to the determination of clinical decision thresholds | 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

2015 Evidence-Based Medicine

153. Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning based clinical decision support system in an inpatient setting. (Abstract)

Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning based clinical decision support system in an inpatient setting. Drug prescription errors are made, worldwide, on a daily basis, resulting in a high burden of morbidity and mortality. Existing rule-based systems for prevention of such errors are unsuccessful and associated with substantial burden of false alerts.In this prospective study, we evaluated the accuracy, validity, and clinical (...) in subsequent medical orders.A clinical decision support system that used a probabilistic, machine-learning approach based on statistically derived outliers to detect medication errors generated clinically useful alerts. The system had high accuracy, low alert burden and low false-positive rate, and led to changes in subsequent orders.© The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email

2019 Journal of the American Medical Informatics Association

154. A prospective observational study to assess the diagnostic accuracy of clinical decision rules for children presenting to emergency departments after head injuries (protocol): the Australasian Paediatric Head Injury Rules Study (APHIRST). Full Text available with Trip Pro

A prospective observational study to assess the diagnostic accuracy of clinical decision rules for children presenting to emergency departments after head injuries (protocol): the Australasian Paediatric Head Injury Rules Study (APHIRST). Head injuries in children are responsible for a large number of emergency department visits. Failure to identify a clinically significant intracranial injury in a timely fashion may result in long term neurodisability and death. Whilst cranial computed (...) tomography (CT) provides rapid and definitive identification of intracranial injuries, it is resource intensive and associated with radiation induced cancer. Evidence based head injury clinical decision rules have been derived to aid physicians in identifying patients at risk of having a clinically significant intracranial injury. Three rules have been identified as being of high quality and accuracy: the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) from Canada, the Children's Head

2014 BMC Pediatrics

155. Spinal Injections Coverage Decision

and/or anesthetic into the spine or space around the spinal nerves and joints. This coverage decision describes the purpose of each type of injection and addresses the criteria required for authorization. The criteria for allowing these injections are based on L&I’s Medical Aid Rules (WACs) and decisions of the statutory Health Technology Clinical Committee (HTCC). Decisions of the HTCC are mandatory for state agencies. Hyperlinks to the basis for these decisions are in a coverage table at the end (...) of at least 6 weeks of conservative therapy. 3. Fluoroscopic or CT guidance is used. 4. No more than one injection without clinically meaningful improvement, as documented by a validated scale. Additional injections require clinical review. * For therapeutic sacroiliac injections, this coverage decision does not apply to those with a known systemic inflammatory disease such as ankylosing spondylitis, psoriatic arthritis or enteropathic arthritis. Intradiscal Injections Therapeutic intradiscal injections

2019 Washington State Department of Labor and Industries

156. Enhancing Shared Decision Making in Neonatal Care

the parents at the time as the action is considered to be in the baby’s ‘best interest’. Where able, parents should be given adequate time to consider their views on non-emergency treatments. 8. Clear documentation of the conversation in the clinical notes, indicating the key aspects of the information given to parents, their apparent understanding and agreement to proceed is the most important validation of consent. Enhancing Shared Decision Making in Neonatal Care: A BAPM Framework for Practice 4 © (...) professionals and parents. This Framework is intended for professionals that look after babies in all locations (labour ward, postnatal ward, transitional care units, special care units, local neonatal units and neonatal intensive care units) and for all levels of care. It does not cover: • Clinical trial consent • Palliative care decisions • Consent for post-mortem examinations Introduction and overview Since the publication of the BAPM Good Practice Framework for consent (2004), there have been many

2019 British Association of Perinatal Medicine

157. Can emergency physicians safely rule in or rule out pediatric intussusception in the Emergency Department using bedside ultrasound?

, however, were much lower (85–89% with wide CI), which seems clinically unacceptable when a diagnosis with such possible dismal consequences is suspected. Both studies were based on relatively small size resulting in large CI making the final decision difficult. Editor Comment ED, emergency department; EP, emergency physician; LR, likelihood ratio; NPV, negative predictive value; PPV, positive predictive value; USS, ultrasound scan. Clinical Bottom Line ED bedside ultrasound could possibly be used (...) Can emergency physicians safely rule in or rule out pediatric intussusception in the Emergency Department using bedside ultrasound? BestBets: Can emergency physicians safely rule in or rule out pediatric intussusception in the Emergency Department using bedside ultrasound? Can emergency physicians safely rule in or rule out pediatric intussusception in the Emergency Department using bedside ultrasound? Report By: Éliane Raymond-Dufresne - PGY-3, Emergency Medicine Search checked by Hisham

2013 BestBETS

158. Stent placement for benign esophageal leaks, perforations, and fistulae: a clinical prediction rule for successful leakage control. Full Text available with Trip Pro

predictive value was 64 % and 86 %, respectively.This prediction rule, consisting of four clinical predictors, could identify patients with esophageal leaks who were likely to benefit from or fail on stent therapy. The prediction rule can support clinical decision-making when the predicted probability of success is ≥ 70 % or ≤ 50 %.© Georg Thieme Verlag KG Stuttgart · New York. (...) Stent placement for benign esophageal leaks, perforations, and fistulae: a clinical prediction rule for successful leakage control. Sealing esophageal leaks by stent placement allows healing in 44 % - 94 % of patients. We aimed to develop a prediction rule to predict the chance of successful stent therapy.In this multicenter retrospective cohort study, patients with benign upper gastrointestinal leakage treated with stent placement were included. We used logistic regression analysis including

2017 Endoscopy

159. Tools, Clinical Prediction Rules, and Algorithms for the Insertion of Peripheral Intravenous Catheters in Adult Hospitalized Patients: A Systematic Scoping Review of Literature. Full Text available with Trip Pro

Tools, Clinical Prediction Rules, and Algorithms for the Insertion of Peripheral Intravenous Catheters in Adult Hospitalized Patients: A Systematic Scoping Review of Literature. First-time peripheral intravenous catheter (PIVC) insertion success is dependent on patient, clinician, and product factors. Failed PIVC insertion are an under-recognized clinical phenomenon.To provide a scoping review of decision aids for PIVC insertion including tools, clinical prediction rules, and algorithms (TRAs (...) ) and their findings on factors associated with insertion success.In June 2016, a systematic literature search was performed using the medical subject heading of peripheral catheterization and tool* or rule* or algorithm*. Data extraction included clinician, patient, and/or product variables associated with PIVC insertion success. Information about TRA reliability, validity, responsiveness, and utility was also extracted.We screened 36 studies, and included 13 for review. Seven papers reported insertion success

2017 Journal of Hospital Medicine

160. Clinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews. Full Text available with Trip Pro

Clinical classification in low back pain: best-evidence diagnostic rules based on systematic reviews. Clinical examination findings are used in primary care to give an initial diagnosis to patients with low back pain and related leg symptoms. The purpose of this study was to develop best evidence Clinical Diagnostic Rules (CDR] for the identification of the most common patho-anatomical disorders in the lumbar spine; i.e. intervertebral discs, sacroiliac joints, facet joints, bone, muscles (...) for symptomatic intervertebral disc, sacroiliac joint, spondylolisthesis, disc herniation with nerve root involvement, and spinal stenosis. Single clinical test appear not to be as useful as clusters of tests that are more closely in line with clinical decision making.This is the first comprehensive systematic review of diagnostic accuracy studies that evaluate clinical examination findings for their ability to identify the most common patho-anatomical disorders in the lumbar spine. In some diagnostic

2017 BMC Musculoskeletal Disorders

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