Emergency Medicine Australasia最新文献_第2页

Building a Dataset for Emergency Care by Identifying Consumer-Informed Quality Indicators: An Analysis of Focus Group Discussions 通过识别消费者知情的质量指标建立急诊护理数据集：焦点小组讨论分析。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-26 DOI: 10.1111/1742-6723.70215

Emma Solly, Gerard M. O'Reilly, Elizabeth Flemming-Judge, Fiona J. Clay, Amelia Johnston, Shefton J. Parker, Simon Craig

Objective

To develop a clearer understanding of what ‘quality in emergency care’ means from the perspective of patients and families to assist with the development of consumer-informed measures of quality for emergency care in an Australian setting.

Methods

Qualitative analysis of transcripts from three semi-structured focus groups, with 24 participants recruited using purposive sampling from a pre-existing consumer expert Safer Care Victoria (SCV) panel. The focus groups were audio-recorded, transcribed and de-identified. Thematic analysis was performed using NVivo software.

Results

Six major themes were identified: Staff-patient interactions, Provision of information, Time spent in the ED, Emotional experience, Needs of specific groups and Perception of the emergency care system. Patient and carer experiences of accessing emergency care are highly influenced by the nature of their interactions with staff and the ease and accessibility of information exchange. Prolonged ED wait times are a negative experience; however, this can be improved with attention to symptom management, comfort and privacy. The needs of priority patient groups (e.g., patients with disabilities or people of older age) may be frequently overlooked in ED settings. Participants in this study reported that many of the negative aspects of emergency care they experienced may be attributed to the system being overburdened/staff having insufficient time.

Conclusions

Consumer-informed measures of quality in emergency care should address staff-patient interactions, emotional experience, information provision, time spent in the ED and be sensitive to the needs of priority groups.

目的：从患者和家庭的角度对“急诊护理质量”的含义有更清晰的理解，以协助在澳大利亚制定消费者知情的急诊护理质量措施。方法：对三个半结构化焦点小组的记录进行定性分析，其中24名参与者使用有目的的抽样从已有的消费者专家维多利亚安全护理（SCV）小组中招募。对焦点小组进行录音、转录和去识别。采用NVivo软件进行专题分析。结果：确定了六个主要主题：医护人员与患者的互动、信息的提供、在急诊科度过的时间、情感体验、特定群体的需求和对紧急护理系统的感知。患者和护理人员获得紧急护理的经验在很大程度上受到他们与工作人员互动的性质以及信息交流的便利性和可及性的影响。等待时间过长是一种负面体验；然而，这可以通过关注症状管理、舒适和隐私来改善。在急诊科的设置中，优先患者群体（例如，残疾患者或老年人）的需求可能经常被忽视。本研究的参与者报告说，他们所经历的紧急护理的许多负面方面可能归因于系统负担过重/工作人员没有足够的时间。结论：急诊护理质量的消费者知情措施应涉及医护人员与患者的互动、情感体验、信息提供、在急诊科花费的时间，并对优先群体的需求敏感。

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引用次数: 0

d-Dimer With the Aortic Dissection Detection Risk Score May Improve Patient Selection for Acute Aortic Syndrome Diagnostic Imaging d-二聚体与主动脉夹层检测风险评分可以改善急性主动脉综合征诊断影像学患者的选择。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-25 DOI: 10.1111/1742-6723.70217

Sameer Bhat, Shreya Bhat, Franco Schreve, Colleen J. Bergin, Peter G. Jones, Steve W. F. R. Waqanivavalagi

Objective

Acute aortic syndrome (AAS) refers to a group of life-threatening cardiovascular emergencies that require computerised tomographic aortography (CTA) for definitive diagnosis. However, there is currently no validated risk-stratification tool for AAS in low or intermediate risk patients using the aortic dissection detection risk score (ADD-RS). This study evaluated the efficacy of d-dimer in low or intermediate risk patients who underwent CTA for suspected AAS.

Methods

This retrospective, cross-sectional study included all atraumatic thoracic CTAs performed at Auckland City Hospital (Aotearoa New Zealand) between 2009 and 2019 for adults with suspected AAS presenting to the emergency department (ED). Pre-test probability for AAS was determined using the ADD-RS. The sensitivity and negative predictive value (NPV) of a negative d-dimer (< 500 ng/mL) for ruling out AAS in low or intermediate risk patients (ADD-RS ≤ 1) were calculated. Trends in d-dimer requests over time were also analysed.

Results

d-dimers were assessed in 181 low or intermediate risk patients with thoracic CTAs. Negative d-dimer had a sensitivity of 100% (95% CI: 66%–100%) and NPV of 100% (95% CI: 97%–100%) for ruling out AAS. There was a significant rise in the annual number of d-dimer requests among patients who underwent CTA scans (p = 0.0059). Significantly more of these requests returned negative values (p = 0.0036), while the number of positive results (≥ 500 ng/mL) remained unchanged (p = 0.15).

Conclusions

Our findings suggest that d-dimer < 500 ng/mL may be used to forgo unfavourable CTA scans in low or intermediate risk patients within our small AoNZ cohort in whom AAS is suspected.

目的：急性主动脉综合征（AAS）是指一组危及生命的心血管急症，需要计算机断层主动脉摄影（CTA）进行明确诊断。然而，目前尚无通过主动脉夹层检测风险评分（ADD-RS）对低或中危患者的AAS进行有效的风险分层工具。本研究评估了d-二聚体在接受CTA治疗疑似AAS的低或中危患者中的疗效。方法：这项回顾性横断面研究包括2009年至2019年期间在新西兰奥克兰市医院（Aotearoa New Zealand）对急诊（ED）疑似AAS的成人进行的所有非创伤性胸部cta。采用ADD-RS测定AAS的预测概率。d-二聚体阴性的敏感性和阴性预测值（NPV）(结果：对181例低或中危胸部cta患者进行了d-二聚体的评估。阴性d-二聚体排除AAS的敏感性为100% (95% CI: 66%-100%)， NPV为100% （95% CI: 97%-100%）。在接受CTA扫描的患者中，d-二聚体的年请求数量显著增加（p = 0.0059）。这些请求返回的阴性值明显更多（p = 0.0036），而阳性结果（≥500 ng/mL）的数量保持不变（p = 0.15）。结论：我们的研究结果表明d-二聚体

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引用次数: 0

Is Emergency Department Care for Low Back Pain Meeting Contemporary Standards? A Medical Record Review 急诊科对腰痛的护理是否符合当代标准？医疗记录回顾

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-22 DOI: 10.1111/1742-6723.70214

Pippa Flanagan, Piers Truter, Gustavo C. Machado, Kym Moiler, Rosalind Taylor, Paul Atkinson, Julie Bayliss, Ivan Lin, Karen Richards, Vinicius Cavalheri, Robert Waller

Background

In 2022, the Australian Commission on Safety and Quality in Healthcare released clinical care standards for managing low back pain (LBP), including in emergency departments (EDs), where guideline non-adherent care has been reported. This study aimed to describe LBP care in a tertiary hospital ED against these new clinical standards.

Methods

A 12-month retrospective review of medical records from a random sample of adults with LBP presenting to a tertiary hospital ED. Outcomes focused on key aspects of LBP care aligned with the eight quality statements in the Low Back Pain Clinical Care Standards (LBPCCS). Descriptive statistics were used to describe care against the quality indicators.

Results

Of the 1974 ED presentations with a LBP-related discharge diagnosis in 2023, 550 were randomly selected for review. After exclusions, 374 were assessed against the LBPCCS. All presentations were assessed against the clinical assessment outcomes (quality statements 1–3), and 335 presentations were assessed against the ED management outcomes (quality statements 4–8). Clinical assessment and screening for serious/specific pathology was documented in 278 cases (74%); appropriate imaging in 66 (56%); self-management advice in 56 (17%); and psychosocial risk screening with referral in 56 cases (17%). Opioids were administered in 208 cases (62%) and anti-convulsants in 52 (16%).

Conclusion

In a tertiary hospital ED, adherence to the LBPCCS is varied. The ED performed well against the clinical assessment/screening outcomes. However, findings suggest strategies are needed to improve performance against the management outcomes, including management advice, identification of psychosocial risk factors, and opioid use.

背景：2022年，澳大利亚卫生保健安全和质量委员会发布了管理腰痛（LBP）的临床护理标准，包括急诊科（ed），其中报告了指南非依从性治疗。本研究旨在根据这些新的临床标准描述三级医院急诊科的腰痛护理。方法：对在三级医院急诊科就诊的随机成年腰痛患者进行为期12个月的医疗记录回顾性分析。结果集中于腰痛护理的关键方面，与腰痛临床护理标准（LBPCCS）中的八项质量声明相一致。描述性统计用于描述护理质量指标。结果：在2023年诊断为lbp相关出院的1974例ED中，随机选择550例进行审查。排除后，374人被评估为LBPCCS。根据临床评估结果（质量声明1-3）对所有报告进行评估，根据ED管理结果（质量声明4-8）对335份报告进行评估。278例（74%）记录了严重/特殊病理的临床评估和筛查；66例（56%）有合适的影像学表现；自我管理建议56例（17%）；56例（17%）进行转诊的社会心理风险筛查。208例（62%）给予阿片类药物，52例（16%）给予抗惊厥药物。结论：在三级医院急诊科，遵守LBPCCS的情况各不相同。与临床评估/筛查结果相比，ED表现良好。然而，研究结果表明，需要采取策略来提高管理结果的表现，包括管理建议、社会心理风险因素的识别和阿片类药物的使用。

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引用次数: 0

Understanding Consumer Attitudes and Awareness After Admission to a Toxicology Unit 了解消费者的态度和意识入院后的毒理学单位。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-22 DOI: 10.1111/1742-6723.70218

Ingrid Berling, Patrice Albert-Thenet, Hayley Anderson, Geoffrey K. Isbister

Objective

Involvement of consumers is critical in the management of deliberate self-harm. We aimed to review the consumer experience in clinical toxicology patient management and research.

Methods

An anonymous, consenting non-consecutive 12-question survey was administered to toxicology in-patients between April 28th and October 14th 2025.

Results

From 440 presentations, 43 (9.8%) patients participated in the survey. The patients had a positive response to communication (91%, n = 39), confidence with the treating team (95%, n = 41), respect (93%, n = 40), and access to care (88%, n = 38), but only 11 patients (26%) expressed an interest in participating in further toxicology research.

Conclusion

There was a high level of satisfaction with the toxicology services, but almost three quarters of patients do not want to engage in further consumer feedback research.

目的：消费者的参与是至关重要的管理故意自残。我们的目的是回顾消费者在临床毒理学患者管理和研究中的经验。方法：在2025年4月28日至10月14日期间，对住院毒理学患者进行了一项匿名、同意的非连续12个问题的调查。结果：在440例报告中，43例（9.8%）患者参与了调查。患者对沟通（91%,n = 39）、对治疗团队的信心（95%,n = 41）、尊重（93%,n = 40）和获得护理（88%,n = 38）有积极反应，但只有11名患者（26%）表示有兴趣参与进一步的毒理学研究。结论：患者对毒理学服务的满意度较高，但近四分之三的患者不希望进行进一步的消费者反馈研究。

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引用次数: 0

Evaluating the Rate of Emergency Department Avoidance Achieved in a Collaboration Between an Ambulance and Virtual Care Service: A Retrospective Observational Study 评估在救护车和虚拟护理服务之间的协作中实现的急诊回避率：一项回顾性观察研究。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-19 DOI: 10.1111/1742-6723.70216

Chad Lumsden, Leah Maitland, Rachel Rossiter, Steven Chung

Objective

To evaluate whether a collaboration between Mid-North Coast Virtual Care (MNCVC) and NSW Ambulance (NSWA) was effective in diverting ED transfers.

Methods

A retrospective observational study over 30 months examined NSWA referrals to MNCVC. Referral characteristics, 7-day and 28-day ED presentations were analysed. ED avoidance was defined as an accepted referral without an ED presentation within 28 days.

Results

Of 629 referrals, 542 (86%) were accepted for management. ED presentations occurred in 53 (9.8%) within 7-days and 130 (24.0%) within 28-days, resulting in a 76% (412 patients) ED avoidance rate over 30 months.

Conclusions

An ambulance-diversion model to a virtual-care service showed a favourable ED avoidance rate.

目的：评估中北海岸虚拟护理（MNCVC）和新南威尔士州救护车（NSWA）之间的合作是否有效转移急诊科。方法：一项超过30个月的回顾性观察研究调查了NSWA转介到MNCVC的患者。分析转诊特征、7天和28天ED表现。ED回避被定义为在28天内没有ED表现的接受转诊。结果：629例患者中，542例（86%）接受治疗。53例（9.8%）在7天内出现ED， 130例（24.0%）在28天内出现ED，导致76%（412例）患者在30个月内避免出现ED。结论：虚拟医疗服务的救护车分流模式显示出良好的急诊避免率。

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引用次数: 0

Retrospective Case Series Ocular Exposure Referrals to a Poisons Centre 回顾性病例系列眼部暴露转介到中毒中心。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-19 DOI: 10.1111/1742-6723.70199

Arjune Murali, Christopher Martin, Keith Harris, Danielle Dean, Katherine Isoardi

Background

Ocular poisoning exposures are common, but there is limited research describing the Australian experience. This series aims to characterise the epidemiology and management of ocular exposures reported to a state poisons information centre.

Methods

This is a retrospective observational series of ocular exposure cases reported to the Queensland Poison Information Centre between 1 January 2023 and 30 June 2023. Data abstracted included patient demographics, poison exposure details, ocular symptomatology, poisoning severity, and management advice.

Results

There were 769 ocular exposures over the study period. Adults aged 20–74 years were the primary group exposed, comprising 406 (52.8%) of cases reported. Exposures were mostly unintentional (763 [99.2%] cases) and most commonly involved exposure to alkalis (123 [16.0%]). Most exposures were symptomatic (606 [78.8%]) and of minor severity (590 [76.7%]). Referral for medical review was advised in 361 (46.9%) cases with only 15 (2%) cases being of moderate severity, most following alkali exposures.

Conclusions

Most ocular exposures reported to the poison centre were accidental and of minor severity. Severe injuries were rare and occurred following alkali exposures.

背景：眼中毒暴露是常见的，但描述澳大利亚经验的研究有限。本系列旨在描述向国家毒物信息中心报告的眼部暴露的流行病学和管理。方法：对2023年1月1日至2023年6月30日期间向昆士兰毒物信息中心报告的眼部暴露病例进行回顾性观察。数据包括患者人口统计、中毒暴露细节、眼部症状、中毒严重程度和治疗建议。结果：研究期间共发生769次眼部暴露。20-74岁的成年人是主要暴露人群，占报告病例的406例（52.8%）。暴露大多是无意的（763例[99.2%]），最常见的是暴露于碱（123例[16.0%]）。大多数暴露者有症状（606例[78.8%]），严重程度较轻（590例[76.7%]）。361例（46.9%）病例建议转诊进行医学检查，其中只有15例（2%）为中度严重病例，大多数是在碱暴露之后。结论：大多数向中毒中心报告的眼部接触是意外的，严重程度较轻。严重的伤害是罕见的，发生在碱暴露后。

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引用次数: 0

A Review of 3 Years of Cardiac Arrest Phone Calls to a State-Based Poisons Centre 对3年来心脏骤停呼叫到国家毒物中心的回顾。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-12 DOI: 10.1111/1742-6723.70211

Pramod Chandru, Darren M. Roberts, Mark Salter, Úna Nic Ionmhain, Ben Tisdell, Angela L. Chiew

Objective

Poisoning-related cardiac arrests have reported survival rates as low as 3%. These events are often unwitnessed, occur in private settings, and are less likely to receive bystander cardiopulmonary resuscitation. Non-shockable rhythms are frequently observed. However, detailed understanding of aetiologies and clinical characteristics remains limited.

Methods

We performed a retrospective review of cardiac arrest calls to a state-based poisons information centre between 2020 and 2023. Data was extracted into a preformatted table and cross-referenced with patient's electronic medical records. Two extractors were used.

Results

A total of 53 cases were included. The median age was 36 years (IQR 22–51; range 15–66), with 29 (54%) male patients. Most arrests occurred in the community (n = 37, 70%). Hypoxia was the most common suspected single aetiology (n = 24), while cardiac toxins, through various mechanisms, accounted for 29 cases (55%). Non-shockable rhythms were present in 36 patients (68%). Despite this, 38 patients (71%) survived to hospital discharge, including 23 (64%) with non-shockable rhythms.

Conclusion

In this study, poisoning-related cardiac arrest was associated with a high survival rate, even in cases with non-shockable rhythms. Hypoxia and direct cardiac toxicity were identified as the primary aetiologies in many patients.

目的：据报道，与中毒相关的心脏骤停的存活率低至3%。这些事件通常是未被目击的，发生在私人环境中，并且不太可能接受旁观者心肺复苏。非震荡节奏经常被观察到。然而，对病因和临床特征的详细了解仍然有限。方法：我们对2020年至2023年期间向国家毒物信息中心拨打的心脏骤停电话进行了回顾性审查。数据被提取到一个预格式化的表格中，并与患者的电子医疗记录交叉引用。使用了两个萃取器。结果：共纳入53例。中位年龄36岁（IQR 22-51；范围15-66），男性29例（54%）。大多数逮捕发生在社区（n = 37,70 %）。缺氧是最常见的疑似单一病因（n = 24），而心脏毒素通过各种机制，占29例（55%）。36例（68%）患者出现非休克性心律。尽管如此，38名患者（71%）存活至出院，其中23名患者（64%）无震荡性心律。结论：在这项研究中，中毒相关的心脏骤停与高生存率相关，即使在非休克节律的病例中也是如此。缺氧和直接心脏毒性被确定为许多患者的主要病因。

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引用次数: 0

Long Term Trends in Emergency Department Presentation Characteristics and Performance 2015–2022: A State-Wide Data Linkage Analysis From New South Wales Australia 2015-2022年急诊部门表现特征和表现的长期趋势：来自澳大利亚新南威尔士州的全州数据链接分析。

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-12 DOI: 10.1111/1742-6723.70213

Thomas Stefoulis, Kendall Bein, Radhika Seimon, Michael M. Dinh

Objective

The study aimed to analyse trends in emergency department (ED) presentations in New South Wales (NSW) from 2015 to 2022, focusing on demographic and clinical factors influencing these trends and evaluating their impact on ED performance metrics.

Methods

This was a retrospective, longitudinal study using routinely collected data from all NSW public hospital EDs presentations between 2015 and 2022.

Main Outcome Measures

Key measures included the rate of ED presentations per 1000 population, emergency treatment performance (ETP), length of stay (LOS), and Did Not Wait (DNW) cases.

Results

The study identified that the rate of unique ED presentations increased by 0.51% per annum, in contrast to the higher rates reported in previous studies. The most notable increase was observed among individuals aged 60–80 and over 80 years. High-acuity cases (Categories 1 and 2) increased from 12.0% in 2015 to 15.0% in 2022, while low-acuity cases (Categories 4 and 5) decreased from 55.9% to 49.0%. ETP declined from 72.1% in 2015 to 56.4% in 2022, and DNW cases rose from 5.4% to 8.5%, indicating issues with patient flow and resource allocation.

Conclusions

This long-term study of ED presentations highlighted the stable demand for ED services associated with a dramatic decrease in ETP and an increase in DNW cases suggesting a health system operating at critical levels of capacity. Addressing these challenges requires a multifaceted approach, and our study may assist in providing a foundation for future research and policy development aimed at improving ED efficiency and patient outcomes.

目的：本研究旨在分析2015年至2022年新南威尔士州（NSW）急诊科（ED）报告的趋势，重点关注影响这些趋势的人口统计学和临床因素，并评估它们对急诊科绩效指标的影响。方法：这是一项回顾性的纵向研究，使用2015年至2022年期间新南威尔士州所有公立医院急诊科例行收集的数据。主要结局指标：主要指标包括每1000人中ED的发生率、急诊治疗表现（ETP）、住院时间（LOS）和未等待（DNW）病例。结果：该研究发现，与以往研究报告的较高比率相比，独特ED表现的比率每年增加0.51%。在60-80岁和80岁以上的人群中观察到最显著的增长。高视力病例（1、2类）从2015年的12.0%上升到2022年的15.0%，低视力病例（4、5类）从55.9%下降到49.0%。ETP从2015年的72.1%下降到2022年的56.4%，DNW病例从5.4%上升到8.5%，表明患者流动和资源分配存在问题。结论：这项关于急诊科报告的长期研究强调，急诊科服务的稳定需求与ETP的急剧下降和DNW病例的增加有关，这表明卫生系统的运行能力处于临界水平。应对这些挑战需要多方面的方法，我们的研究可能有助于为未来的研究和政策制定提供基础，旨在提高ED的效率和患者的治疗效果。

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引用次数: 0

Clinical Teacher in the Emergency Department: How Does It Benefit Emergency Medicine Trainees? 急诊科临床教师：如何使急诊医学学员受益？

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-07 DOI: 10.1111/1742-6723.70197

Christopher L. Jones

Introduction

Balancing training needs and service provision is a challenge in Emergency Departments (EDs). We implemented an ED Clinical Teacher (EDCT) role to provide bedside teaching for our trainees. Our objective was to establish in which domains of the Australasian College for Emergency Medicine training curriculum benefit was delivered.

Methods

An EDCT shift was introduced in February 2024. EDCTs were expected to perform a Work-place Based Assessment (WBA) each shift but no further guidance was provided. Clinicians performed the role as they deemed appropriate. Following each shift, a feedback form was completed referencing domains of the training curriculum in which the EDCT felt they delivered benefit. Free text supported the feedback.

Results

18/27 feedback forms were completed over a 5-month period. Training was most beneficial to the domains of ‘Medical Expertise’ (89% of shifts) and ‘Prioritisation and Decision Making’ (72%). All eight curriculum domains benefitted from the EDCT role. On a scale of 1–7 the benefit of the shift to the trainees was rated 5.39, with 78% of shifts rated as 5 or above (p = < 0.001). A Mini CEX, DOPS and communication WBA were performed during 72%, 56% and 17% of shifts, respectively. In total 24 Mini CEXs, 11 DOPS and 3 communication WBAs were performed.

Conclusions

Participating ED physicians felt that a designated EDCT role benefits trainees in all domains of the Australasian College for Emergency Medicine training program and provides an opportunity to perform workplace-based assessments.

简介：平衡培训需求和服务提供是急诊科（EDs）面临的挑战。我们实施了ED临床教师（EDCT）的角色，为我们的学员提供床边教学。我们的目标是确定澳大利亚急诊医学学院培训课程的哪些领域受益。方法：2024年2月引入EDCT换班。edct应每班进行基于工作场所的评估（WBA），但没有提供进一步的指导。临床医生扮演了他们认为合适的角色。每班结束后，完成一份反馈表格，参考培训课程中EDCT认为有益的领域。免费文本支持反馈。结果：在5个月的时间内完成了18/27份反馈表格。培训对“医疗专业知识”（89%的班次）和“优先排序和决策”（72%）领域最有益。所有八个课程领域都受益于EDCT的作用。在1-7的评分范围内，轮班对受训者的益处为5.39分，78%的轮班被评为5分或以上(p =结论：参与的急诊科医生认为，指定的EDCT角色对澳大利亚急诊医学学院所有领域的受训者都有好处，并提供了一个进行工作场所评估的机会。

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引用次数: 0

Identifying Predictor Variables for a Future Clinical Decision Rule for Ordering of Chest X-Rays (CXR) for Non-Traumatic Chest Pain in Adult Emergency Department (ED) Patients 确定成人急诊科（ED）患者非创伤性胸痛胸片（CXR）排序的未来临床决策规则的预测变量

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia

Pub Date : 2026-01-07 DOI: 10.1111/1742-6723.70210

Joe Anthony Rotella

Objective

We sought to identify predictor variables for a future clinical decision rule for CXR ordering in non-traumatic chest pain.

Methods

Emergency Medicine Physicians were asked to select variables that would result in a CXR being ordered. Inter-rater reliability (using Fleiss' kappa) was calculated for the most commonly agreed upon.

Results

Of the 40 candidate variables, 10 were most agreed upon; however, only three had perfect inter-rater agreement and reliability.

Conclusions

In this study, only an abnormal lung examination, a suspicion of pneumonia or of acute pulmonary oedema had perfect inter-rater agreement and reliability. Further research is required on a larger scale to refine and identify the optimal candidate variables for inclusion in a clinical decision rule.

目的：我们试图确定非外伤性胸痛的CXR排序的未来临床决策规则的预测变量。方法：急诊科医师被要求选择可能导致急诊检查的变量。评估者之间的信度（使用Fleiss的kappa）被计算为最普遍同意的。结果：在40个候选变量中，10个是最一致的；然而，只有三个具有完美的内部一致性和可靠性。结论：在本研究中，只有肺部检查异常、怀疑为肺炎或急性肺水肿才具有完全的一致性和可靠性。进一步的研究需要在更大的规模来完善和确定纳入临床决策规则的最佳候选变量。

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引用次数: 0