Latest & greatest articles for Clinical Decision Rule

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Top results for Clinical Decision Rule

1. Evaluation of a clinical decision rule to guide antibiotic prescription in children with suspected lower respiratory tract infection in The Netherlands: A stepped-wedge cluster randomised trial Full Text available with Trip Pro

Evaluation of a clinical decision rule to guide antibiotic prescription in children with suspected lower respiratory tract infection in The Netherlands: A stepped-wedge cluster randomised trial Evaluation of a Clinical Decision Rule to Guide Antibiotic Prescription in Children With Suspected Lower Respiratory Tract Infection in The Netherlands: A Stepped-Wedge Cluster Randomised Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set (...) : Send at most: Send even when there aren't any new results Optional text in email: Save Cancel Create a file for external citation management software Create file Cancel Actions Cite Share Permalink Copy Page navigation PLoS Med Actions . 2020 Jan 31;17(1):e1003034. doi: 10.1371/journal.pmed.1003034. eCollection 2020 Jan. Evaluation of a Clinical Decision Rule to Guide Antibiotic Prescription in Children With Suspected Lower Respiratory Tract Infection in The Netherlands: A Stepped-Wedge Cluster

2020 EvidenceUpdates

2. Development and Validation of a Penicillin Allergy Clinical Decision Rule

Development and Validation of a Penicillin Allergy Clinical Decision Rule Development and Validation of a Penicillin Allergy Clinical Decision Rule - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health U.S. National Library of Medicine National Center (...) . 2020 Mar 16;e200403. doi: 10.1001/jamainternmed.2020.0403. Online ahead of print. Development and Validation of a Penicillin Allergy Clinical Decision Rule , , , , , , , , , , Affiliations Expand Affiliations 1 Centre for Antibiotic Allergy and Research, Department of Infectious Diseases, Austin Health, Heidelberg, Australia. 2 Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Australia. 3 Peter MacCallum Cancer Centre, Department of Infectious Diseases and The National

2020 EvidenceUpdates

3. "HERDOO2" clinical decision rule to guide duration of anticoagulation in women with unprovoked venous thromboembolism. Can I use any d-Dimer? Full Text available with Trip Pro

"HERDOO2" clinical decision rule to guide duration of anticoagulation in women with unprovoked venous thromboembolism. Can I use any d-Dimer? The "HERDOO2 rule" is a prospectively validated clinical decision rule used to identify low-risk women who can safely discontinue anticoagulants after completing 5-12 months of anticoagulant treatment for unprovoked venous thromboembolism. The VIDAS®d-Dimer (DD) assay, a component of the rule, was used in the derivation and validation of the rule at half (...) , -0.004-0.07)).The "HERDOO2 rule" is the only prospectively validated clinical decision rule that can be used to identify low-risk women with unprovoked venous thrombosis who can safely discontinue anticoagulants. An important implementation issue is whether any commercial DD assay can be used in the HERDOO2 rule, and at what cut-point. Our analysis shows that the HemosIL®, Innovance®, Liatest® and Tina-quant® DD assays should not be used in the "HERDOO2" rule due to poor concordance with the VIDAS®

2018 EvidenceUpdates

4. Validation and refinement of a clinical decision rule for the use of computed tomography in children with minor head injury in the emergency department Full Text available with Trip Pro

Validation and refinement of a clinical decision rule for the use of computed tomography in children with minor head injury in the emergency department There is uncertainty about which children with minor head injury need to undergo computed tomography (CT). We sought to prospectively validate the accuracy and potential for refinement of a previously derived decision rule, Canadian Assessment of Tomography for Childhood Head injury (CATCH), to guide CT use in children with minor head (...) injury.This multicentre cohort study in 9 Canadian pediatric emergency departments prospectively enrolled children with blunt head trauma presenting with a Glasgow Coma Scale score of 13-15 and loss of consciousness, amnesia, disorientation, persistent vomiting or irritability. Phys icians completed standardized assessment forms before CT, including clinical predictors of the rule. The primary outcome was neurosurgical intervention and the secondary outcome was brain injury on CT. We calculated test

2018 EvidenceUpdates

5. Clinical Decision Rules and Strategies for the Diagnosis of Group A Streptococcal Infection: A Review of Clinical Utility and Guidelines

Clinical Decision Rules and Strategies for the Diagnosis of Group A Streptococcal Infection: A Review of Clinical Utility and Guidelines Clinical Decision Rules and Strategies for the Diagnosis of Group A Streptococcal Infection: A Review of Clinical Utility and Guidelines | CADTH.ca Find the information you need Clinical Decision Rules and Strategies for the Diagnosis of Group A Streptococcal Infection: A Review of Clinical Utility and Guidelines Clinical Decision Rules and Strategies (...) for the Diagnosis of Group A Streptococcal Infection: A Review of Clinical Utility and Guidelines Last updated: May 23, 2018 Project Number: RC0982-000 Product Line: Research Type: Other Diagnostics Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical utility of clinical decision rules for the initial screening of patients with suspected group A strep infection? What are the evidence-based guidelines regarding the diagnosis of suspected group A strep infection? Key

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

6. 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

7. 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

8. Derivation and validation of a clinical decision rule to identify young children with skull fracture following isolated head trauma Full Text available with Trip Pro

Derivation and validation of a clinical decision rule to identify young children with skull fracture following isolated head trauma There is no clear consensus regarding radiologic evaluation of head trauma in young children without traumatic brain injury. We conducted a study to develop and validate a clinical decision rule to identify skull fracture in young children with head trauma and no immediate need for head tomography.We performed a prospective cohort study in 3 tertiary care emergency (...) was at the physician's discretion. The clinical decision rule was derived using recursive partitioning.A total of 811 patients (49 with skull fracture) were recruited during the derivation phase. The 2 predictors identified through recursive partitioning were parietal or occipital swelling or hematoma and age less than 2 months. The rule had a sensitivity of 94% (95% confidence interval [CI] 83%-99%) and a specificity of 86% (95% CI 84%-89%) in the derivation phase. During the validation phase, 856 participants (44

2015 EvidenceUpdates

9. A simple clinical decision rule to rule out appendicitis in patients with nondiagnostic ultrasound results (Abstract)

A simple clinical decision rule to rule out appendicitis in patients with nondiagnostic ultrasound results The objective was to identify a set of clinical features that can rule out appendicitis in patients with suspected acute appendicitis and nondiagnostic ultrasound (US) results, allowing safe discharge and next-day reevaluation without initial computed tomography (CT) or magnetic resonance imaging (MRI).Data on clinical and US evaluation, including a number of prespecified variables (...) potentially associated with acute appendicitis, were prospectively collected in two diagnostic accuracy studies of imaging. These studies included patients with suspected appendicitis seen in the emergency department (ED). For development and validation of the clinical decision rule (CDR), only patients with inconclusive or negative US results were included. There were 199 (of 422) patients in the development cohorts and 120 (of 211) patients in the validation cohort. Logistic regression analysis was used

2014 EvidenceUpdates

10. The Massachusetts abscess rule: a clinical decision rule using ultrasound to identify methicillin-resistant Staphylococcus aureus in skin abscesses Full Text available with Trip Pro

The Massachusetts abscess rule: a clinical decision rule using ultrasound to identify methicillin-resistant Staphylococcus aureus in skin abscesses Treatment failure rates for incision and drainage (I&D) of skin abscesses have increased in recent years and may be attributable to an increased prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Previous authors have described sonographic features of abscesses, such as the presence of interstitial fluid (...) , characteristics of abscess debris, and depth of abscess cavity. It is possible that the sonographic features are associated with MRSA and can be used to predict the presence of MRSA. The authors describe a potential clinical decision rule (CDR) using sonographic images to predict the presence of CA-MRSA.This was a pilot CDR derivation study using databases from two emergency departments (EDs) of patients presenting to the ED with uncomplicated skin abscesses who underwent I&D and culture of the abscess

2014 EvidenceUpdates

11. Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. Full Text available with Trip Pro

Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. Three clinical decision rules were previously derived to identify patients with headache requiring investigations to rule out subarachnoid hemorrhage.To assess the accuracy, reliability, acceptability, and potential refinement (ie, to improve sensitivity or specificity) of these rules in a new cohort of patients with headache.Multicenter cohort study conducted at 10 university-affiliated Canadian tertiary care (...) (6.2%) had subarachnoid hemorrhage. The decision rule including any of age 40 years or older, neck pain or stiffness, witnessed loss of consciousness, or onset during exertion had 98.5% (95% CI, 94.6%-99.6%) sensitivity and 27.5% (95% CI, 25.6%-29.5%) specificity for subarachnoid hemorrhage. Adding "thunderclap headache" (ie, instantly peaking pain) and "limited neck flexion on examination" resulted in the Ottawa SAH Rule, with 100% (95% CI, 97.2%-100.0%) sensitivity and 15.3% (95% CI, 13.8%-16.9

2013 JAMA

12. Accuracy of the "traffic light" clinical decision rule for serious bacterial infections in young children with fever: a retrospective cohort study. Full Text available with Trip Pro

Accuracy of the "traffic light" clinical decision rule for serious bacterial infections in young children with fever: a retrospective cohort study. To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children.Retrospective analysis of data from a two year

2013 BMJ

13. 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

14. Systematic review: diagnostic accuracy of clinical decision rules for venous thromboembolism in elderly

Systematic review: diagnostic accuracy of clinical decision rules for venous thromboembolism in elderly Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2012 DARE.

15. How Accurate are Clinical Decision Rules for Pediatric Minor Head Injury?

How Accurate are Clinical Decision Rules for Pediatric Minor Head Injury? SystematicReviewSnapshot TAKE-HOME MESSAGE The Pediatric Emergency Care Applied Research Network (PECARN) decision rule is very sensitive for detecting clinically important brain injury in children with minor head trauma. METHODS DATA SOURCES Investigators searched MEDLINE (to March 2010), EMBASE, CINAHL, and CENTRAL (to April 2009), the Web of Knowledge’s Science Citation In- dex, Social Science Citation Index (...) studies. Al- though the investigators planned to perform a meta-analysis of rules that were independently validated, only a systematic review without pooling results was feasible. How Accurate Are Clinical Decision Rules for Pediatric Minor Head Injury? EBEM Commentators Kelly Medwid, MD New York University School of Medicine/Bellevue Hospital Center Department of Emergency Medicine New York, NY Gene G. Couri, MD OSF Saint Francis Medical Center Peoria, IL Results Of the 14 cohorts studying children

2012 Annals of Emergency Medicine Systematic Review Snapshots

16. 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

17. Performance of 4 Clinical Decision Rules in the Diagnostic Management of Acute Pulmonary Embolism: A Prospective Cohort Study. (Abstract)

Performance of 4 Clinical Decision Rules in the Diagnostic Management of Acute Pulmonary Embolism: A Prospective Cohort Study. Several clinical decision rules (CDRs) are available to exclude acute pulmonary embolism (PE), but they have not been directly compared.To directly compare the performance of 4 CDRs (Wells rule, revised Geneva score, simplified Wells rule, and simplified revised Geneva score) in combination with d-dimer testing to exclude PE.Prospective cohort study.7 hospitals (...) Wells rule) to 72% (Wells rule). Combined with a normal d-dimer result, the CDRs excluded PE in 22% to 24% of patients. The total failure rates of the CDR and d-dimer combinations were similar (1 failure, 0.5% to 0.6% [upper-limit 95% CI, 2.9% to 3.1%]). Even though 30% of patients had discordant CDR outcomes, PE was not detected in any patient with discordant CDRs and a normal d-dimer result.Management was based on a combination of decision rules and d-dimer testing rather than only 1 CDR combined

2011 Annals of Internal Medicine

18. Comparing the diagnostic performance of 2 clinical decision rules to rule out deep vein thrombosis in primary care patients Full Text available with Trip Pro

Comparing the diagnostic performance of 2 clinical decision rules to rule out deep vein thrombosis in primary care patients The Wells rule is widely used for clinical assessment of patients with suspected deep vein thrombosis (DVT), especially in the secondary care setting. Recently a new clinical decision rule for primary care patients (the primary care rule) has been proposed, because the Wells rule is not sufficient to rule out DVT in this setting. The objective was to compare the ability (...) of both rules to safely rule out DVT and to efficiently reduce the number of referrals for leg ultrasound investigation that would result in a negative finding.Family physicians collected data on 1,086 patients to calculate the scores for both decision rules before leg ultrasonography was performed. In all patients D-dimer (dimerized plasmin fragment D) testing was performed using a rapid point-of-care assay. Patients were stratified into risk categories defined by each rule and the D-dimer result

2011 EvidenceUpdates

19. Distinguishing between bacterial and aseptic meningitis in children: European comparison of two clinical decision rules (Abstract)

Distinguishing between bacterial and aseptic meningitis in children: European comparison of two clinical decision rules Clinical decision rules (CDRs) could be helpful to safely distinguish between bacterial and aseptic meningitis (AM).To compare the performance of two of these CDRs for children: the Bacterial Meningitis Score (BMS) and the Meningitest.Secondary analysis of retrospective multicentre hospital-based cohort study.Six paediatric emergency or intensive care units of tertiary care (...) for the sensitivity of both rules, which can be used cautiously. However, use of the BMS could safely avoid significantly more unnecessary antibiotic treatments for children with AM than can the Meningitest in this population.

2011 EvidenceUpdates

20. The World Health Organization clinical decision rule was specific but not sensitive for predicting group A ß haemolytic streptococcus in children with pharyngitis

The World Health Organization clinical decision rule was specific but not sensitive for predicting group A ß haemolytic streptococcus in children with pharyngitis The World Health Organization clinical decision rule was specific but not sensitive for predicting group A β haemolytic streptococcus in children with pharyngitis | 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 The World Health Organization clinical decision rule

2007 Evidence-Based Medicine