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Acad Emerg Med. 2015 Dec;22(12):1406-16. doi: 10.1111/acem.12828. Epub 2015 Nov 14.

Clinical Decision Rules for Diagnostic Imaging in the Emergency Department: A Research Agenda.

Author information

1
Department of Emergency Medicine, The Ohio State University College of Medicine, Columbus, OH.
2
Department of Emergency Medicine, University of California San Francisco School of Medicine, San Francisco, CA.
3
Department of Emergency Medicine, Division of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO.
4
Department of Emergency Medicine, Oregon Health & Science University, Portland, OR.
5
Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI.
6
Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.
7
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN.
8
Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN.
9
Department of Emergency Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA.
10
Department of Emergency Medicine, University of Minnesota Medical School, Minneapolis, MN.
11
Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.
12
Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA.

Abstract

BACKGROUND:

Major gaps persist in the development, validation, and implementation of clinical decision rules (CDRs) for diagnostic imaging.

OBJECTIVES:

The objective of this working group and article was to generate a consensus-based research agenda for the development and implementation of CDRs for diagnostic imaging in the emergency department (ED).

METHODS:

The authors followed consensus methodology, as outlined by the journal Academic Emergency Medicine (AEM), combining literature review, electronic surveys, telephonic communications, and a modified nominal group technique. Final discussions occurred in person at the 2015 AEM consensus conference.

RESULTS:

A research agenda was developed, prioritizing the following questions: 1) what are the optimal methods to justify the derivation and validation of diagnostic imaging CDRs, 2) what level of evidence is required before disseminating CDRs for widespread implementation, 3) what defines a successful CDR, 4) how should investigators best compare CDRs to clinical judgment, and 5) what disease states are amenable (and highest priority) to development of CDRs for diagnostic imaging in the ED?

CONCLUSIONS:

The concepts discussed herein demonstrate the need for further research on CDR development and implementation regarding diagnostic imaging in the ED. Addressing this research agenda should have direct applicability to patients, clinicians, and health care systems.

PMID:
26567885
DOI:
10.1111/acem.12828
[Indexed for MEDLINE]
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