scholarly journals Old and New Geriatric Screening Tools in a Belgian Emergency Department: A Diagnostic Accuracy Study

2020 ◽  
Vol 68 (7) ◽  
pp. 1454-1461 ◽  
Author(s):  
Pieter Heeren ◽  
Els Devriendt ◽  
Nathalie I.H. Wellens ◽  
Mieke Deschodt ◽  
Johan Flamaing ◽  
...  
Keyword(s):  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Screening Tools ◽  
Diagnostic Accuracy Study ◽  
Accuracy Study ◽  
Geriatric Screening

scholarly journals The Prehospital Ambulance Stroke Test vs. the Cincinnati Prehospital Stroke Scale: a diagnostic accuracy study

2020 ◽  
Vol 17 ◽  
Author(s):  
Somayeh Karimi ◽  
Hassan Motamed ◽  
Ehsan Aliniagerdroudbari ◽  
Sepideh Babaniamansour ◽  
Arman Jami ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Facial Palsy ◽  
High Sensitivity ◽  
Assessment Tools ◽  
Screening Tools ◽  
Eye Position ◽  
Diagnostic Accuracy Study ◽  
Specificity And Sensitivity ◽  
Accuracy Study ◽  
Chain Of Care

IntroductionImmediate diagnosis of stroke is crucial in reducing its morbidity and mortality rate. There are various pre-hospital assessment tools, such as the Prehospital Ambulance Stroke Test (PreHAST) and the Cincinnati Prehospital Stroke Scale (CPSS) used to identify stroke early in the chain of care. The aim of this study is to compare the accuracy of PreHAST with CPSS in diagnosing stroke.MethodsIn this diagnostic accuracy study patients with suspicion of stroke were included in this study. In CPSS, the criterion used to indicate stroke are facial droop, speech and arm drift. In PreHAST it is eye position, visual field, facial palsy, right and left arms paresis, right and left legs paresis, sensory and speech. After data collection, sensitivity and specificity were calculated using standard formulae. Different cut-off points for the best diagnostic accuracy were examined in both CPSS and PreHAST.ResultsIn this study, 883 patients were investigated. The results demonstrated that in CPSS, the highest specificity and sensitivity was for facial droop (84.9%) and arm drift (82.7%); and in PreHAST it was eye position (99.6%) and facial palsy (49.2%). The best predictor of stroke in CPSS with highest sensitivity (78.5%) and specificity (66%) was a cut-off point of 1.5 (AUC: 0.744) (p<0.01(. In PreHAST, the highest sensitivity (68.4%) was a cut-off point of 2.5 and the highest specificity (90.2%) was a cut-off point of 5.5 (AUC: 0.775) (p<0.01).ConclusionBoth PreHAST and CPSS are useful screening tools in the pre-hospital diagnosis of stroke. In addition to high sensitivity, these tests provide a grading system in which higher cut-off points lead to higher specificity.

scholarly journals Using the clinical chemistry score in the emergency department to detect adverse cardiac events: a diagnostic accuracy study

CMAJ Open ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. E676-E684
Author(s):  
Peter A. Kavsak ◽  
Joshua O. Cerasuolo ◽  
Dennis T. Ko ◽  
Jinhui Ma ◽  
Jonathan Sherbino ◽  
...  
Keyword(s):  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Clinical Chemistry ◽  
Diagnostic Accuracy Study ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Accuracy Study

scholarly journals Diagnostic Errors Are Common in Acute Pediatric Respiratory Disease: A Prospective, Single-Blinded Multicenter Diagnostic Accuracy Study in Australian Emergency Departments

2021 ◽  
Vol 9 ◽  
Author(s):  
Paul Porter ◽  
Joanna Brisbane ◽  
Jamie Tan ◽  
Natasha Bear ◽  
Jennifer Choveaux ◽  
...  
Keyword(s):  
Emergency Department ◽  
Diagnostic Accuracy ◽  
Emergency Departments ◽  
Expert Panel ◽  
Diagnostic Errors ◽  
Pediatric Emergency ◽  
Diagnostic Accuracy Study ◽  
Respiratory Tract Disease ◽  
Accuracy Study ◽  
Tract Disease

Background: Diagnostic errors are a global health priority and a common cause of preventable harm. There is limited data available for the prevalence of misdiagnosis in pediatric acute-care settings. Respiratory illnesses, which are particularly challenging to diagnose, are the most frequent reason for presentation to pediatric emergency departments.Objective: To evaluate the diagnostic accuracy of emergency department clinicians in diagnosing acute childhood respiratory diseases, as compared with expert panel consensus (reference standard).Methods: Prospective, multicenter, single-blinded, diagnostic accuracy study in two well-resourced pediatric emergency departments in a large Australian city. Between September 2016 and August 2018, a convenience sample of children aged 29 days to 12 years who presented with respiratory symptoms was enrolled. The emergency department discharge diagnoses were reported by clinicians based upon standard clinical diagnostic definitions. These diagnoses were compared against consensus diagnoses given by an expert panel of pediatric specialists using standardized disease definitions after they reviewed all medical records.Results: For 620 participants, the sensitivity and specificity (%, [95% CI]) of the emergency department compared with the expert panel diagnoses were generally poor: isolated upper respiratory tract disease (64.9 [54.6, 74.4], 91.0 [88.2, 93.3]), croup (76.8 [66.2, 85.4], 97.9 [96.2, 98.9]), lower respiratory tract disease (86.6 [83.1, 89.6], 92.9 [87.6, 96.4]), bronchiolitis (66.9 [58.6, 74.5], 94.3 [80.8, 99.3]), asthma/reactive airway disease (91.0 [85.8, 94.8], 93.0 [90.1, 95.3]), clinical pneumonia (63·9 [50.6, 75·8], 95·0 [92·8, 96·7]), focal (consolidative) pneumonia (54·8 [38·7, 70·2], 86.2 [79.3, 91.5]). Only 59% of chest x-rays with consolidation were correctly identified. Between 6.9 and 14.5% of children were inappropriately prescribed based on their eventual diagnosis.Conclusion: In well-resourced emergency departments, we have identified a previously unrecognized high diagnostic error rate for acute childhood respiratory disorders, particularly in pneumonia and bronchiolitis. These errors lead to the potential of avoidable harm and the administration of inappropriate treatment.

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