2017
Predictors of Hospital Admission and Urological Intervention in Adult Emergency Department Patients with Computerized Tomography Confirmed Ureteral Stones
Daniels B, Schoenfeld E, Taylor A, Weisenthal K, Singh D, Moore CL. Predictors of Hospital Admission and Urological Intervention in Adult Emergency Department Patients with Computerized Tomography Confirmed Ureteral Stones. Journal Of Urology 2017, 198: 1359-1366. PMID: 28652122, PMCID: PMC5693671, DOI: 10.1016/j.juro.2017.06.077.Peer-Reviewed Original ResearchConceptsComputerized tomography findingsUrological interventionPredictors of interventionTomography findingsHospital admissionRenal ultrasoundC-statisticEmergency departmentUreteral stonesPrior proceduresAdult emergency department patientsLonger pain durationSimilar C-statisticsEmergency department patientsPredictors of admissionLarge stonesObstructing ureteral stonePatients 66Kidney injuryPain durationDepartment patientsRegression modelsSymptomatic stonesProspective dataDiagnostic pathway
2016
Ureteral Stones: Implementation of a Reduced-Dose CT Protocol in Patients in the Emergency Department with Moderate to High Likelihood of Calculi on the Basis of STONE Score.
Moore CL, Daniels B, Singh D, Luty S, Gunabushanam G, Ghita M, Molinaro A, Gross CP. Ureteral Stones: Implementation of a Reduced-Dose CT Protocol in Patients in the Emergency Department with Moderate to High Likelihood of Calculi on the Basis of STONE Score. Radiology 2016, 280: 743-51. PMID: 26943230, PMCID: PMC5341691, DOI: 10.1148/radiol.2016151691.Peer-Reviewed Original ResearchConceptsReduced-dose CTEmergency departmentUrologic interventionUreteral stonesHigher likelihoodDose CTAverage dose-length productSingle-center studyClinical prediction ruleDose-length productComputed tomography protocolStandard-dose CTInstitutional review boardHIPAA authorizationNonurologic causesPrimary outcomeClinical courseClinician's discretionDose reductionClinical reportsPatientsSTONE scoreCT protocolInformed consentReview board
2015
STONE PLUS: Evaluation of Emergency Department Patients With Suspected Renal Colic, Using a Clinical Prediction Tool Combined With Point-of-Care Limited Ultrasonography
Daniels B, Gross CP, Molinaro A, Singh D, Luty S, Jessey R, Moore CL. STONE PLUS: Evaluation of Emergency Department Patients With Suspected Renal Colic, Using a Clinical Prediction Tool Combined With Point-of-Care Limited Ultrasonography. Annals Of Emergency Medicine 2015, 67: 439-448. PMID: 26747219, PMCID: PMC5074842, DOI: 10.1016/j.annemergmed.2015.10.020.Peer-Reviewed Original ResearchConceptsHigh-risk patientsEmergency department patientsSymptomatic stonesUrologic interventionUreteral stonesComputed tomographyDepartment patientsUncomplicated ureteral stonesAbsence of hydronephrosisAdult ED patientsModerate-risk patientsProspective observational studyClinical prediction toolPresence of hydronephrosisClinical prediction scoreSymptomatic ureteral stonesAlternative findingsRenal pointSecondary outcomesPrimary outcomeED patientsRecord reviewRenal colicRisk stratificationScore patientsIndependent evaluation of a simple clinical prediction rule to identify right ventricular dysfunction in patients with shortness of breath
Russell FM, Moore CL, Courtney DM, Kabrhel C, Smithline HA, Nordenholz KE, Richman PB, O'Neil BJ, Plewa MC, Beam DM, Mastouri R, Kline JA. Independent evaluation of a simple clinical prediction rule to identify right ventricular dysfunction in patients with shortness of breath. The American Journal Of Emergency Medicine 2015, 33: 542-547. PMID: 25769797, PMCID: PMC7032017, DOI: 10.1016/j.ajem.2015.01.026.Peer-Reviewed Original ResearchConceptsRight ventricular dysfunctionClinical decision ruleSimple clinical prediction ruleRV dysfunctionPersistent dyspneaClinical prediction ruleVentricular dysfunctionDyspneic emergency department (ED) patientsProspective observational multicenter studyPrediction ruleIsolated RV dysfunctionUnexplained persistent dyspneaObservational multicenter studySevere tricuspid regurgitationShortness of breathEmergency department patientsNormal CTPARV hypokinesisStandard careTreatable causeTricuspid regurgitationDepartment patientsMulticenter studyEmergency departmentSame complaint
2014
Accuracy of Reduced-Dose Computed Tomography for Ureteral Stones in Emergency Department Patients
Moore CL, Daniels B, Ghita M, Gunabushanam G, Luty S, Molinaro AM, Singh D, Gross CP. Accuracy of Reduced-Dose Computed Tomography for Ureteral Stones in Emergency Department Patients. Annals Of Emergency Medicine 2014, 65: 189-198.e2. PMID: 25441242, PMCID: PMC5131573, DOI: 10.1016/j.annemergmed.2014.09.008.Peer-Reviewed Original ResearchConceptsUreteral stonesReduced-dose CT protocolDose CTBlinded observational studyEmergency department patientsSize-specific dose estimateEmergency department settingComputed tomography scanSymptomatic ureteral stonesReduced-dose CTDose computed tomography (CT) scansAcademic medical centerDose CT scansReduced-dose protocolObese patientsSubstantial dose reductionDepartment patientsPrimary outcomeED patientsAbdominal diameterDepartment settingTomography scanObservational studyMedical CenterCT scanDerivation and validation of a clinical prediction rule for uncomplicated ureteral stone—the STONE score: retrospective and prospective observational cohort studies
Moore CL, Bomann S, Daniels B, Luty S, Molinaro A, Singh D, Gross CP. Derivation and validation of a clinical prediction rule for uncomplicated ureteral stone—the STONE score: retrospective and prospective observational cohort studies. The BMJ 2014, 348: g2191. PMID: 24671981, PMCID: PMC3966515, DOI: 10.1136/bmj.g2191.Peer-Reviewed Original ResearchConceptsUncomplicated ureteral stonesClinical prediction ruleUreteral stonesDerivation cohortValidation cohortComputed tomographyProbability groupEmergency departmentSTONE scoreUrban tertiary care emergency departmentProspective observational cohort studyTertiary care emergency departmentNon-Contrast Computed TomographyPrediction ruleModerate probability groupCommunity emergency departmentsObservational cohort studyPresence of nauseaNon-black raceMultivariate logistic regressionLow probability groupHigh probability groupSymptomatic ureteral stonesAlternative findingsHigh score groupSpleen volume and clinical disease manifestations of severe Plasmodium falciparum malaria in African children
Kotlyar S, Nteziyaremye J, Olupot-Olupot P, Akech SO, Moore CL, Maitland K. Spleen volume and clinical disease manifestations of severe Plasmodium falciparum malaria in African children. Transactions Of The Royal Society Of Tropical Medicine And Hygiene 2014, 108: 283-289. PMID: 24639372, PMCID: PMC5693319, DOI: 10.1093/trstmh/tru040.Peer-Reviewed Original ResearchConceptsSevere malarial anemiaTotal body surface areaCerebral malariaPlasmodium falciparum malariaSpleen volumeFalciparum malariaSevere malariaZ-scoreDisease manifestationsSevere P. falciparum malariaSevere Plasmodium falciparum malariaAfrican childrenProspective observational studyP. falciparum malariaSevere disease manifestationsClinical disease manifestationsBody surface areaMalarial anemiaSpleen enlargementClinical manifestationsSMA groupSplenic sequestrationHealthy controlsObservational studyCM groupEffect of Provider Experience on Clinician-Performed Ultrasonography for Hydronephrosis in Patients With Suspected Renal Colic
Herbst MK, Rosenberg G, Daniels B, Gross CP, Singh D, Molinaro AM, Luty S, Moore CL. Effect of Provider Experience on Clinician-Performed Ultrasonography for Hydronephrosis in Patients With Suspected Renal Colic. Annals Of Emergency Medicine 2014, 64: 269-276. PMID: 24630203, PMCID: PMC5131571, DOI: 10.1016/j.annemergmed.2014.01.012.Peer-Reviewed Original ResearchConceptsComputed tomographyRenal colicPositive likelihood ratioNegative likelihood ratioFellowship trainingTest characteristicsEmergency cliniciansUreteral stonesPhysician cliniciansAcademic medical center emergency departmentMedical Center Emergency DepartmentClinician-performed ultrasonographyAbsence of hydronephrosisCenter emergency departmentDegree of hydronephrosisLikelihood ratioDetection of hydronephrosisDirect patient careUnique cliniciansDefinitive test resultsProspective studyEmergency departmentBedside ultrasonographyUltrasonographic resultsEmergency physiciansRadiation Dose Index of Renal Colic Protocol CT Studies in the United States: A Report from the American College of Radiology National Radiology Data Registry
Lukasiewicz A, Bhargavan-Chatfield M, Coombs L, Ghita M, Weinreb J, Gunabushanam G, Moore CL. Radiation Dose Index of Renal Colic Protocol CT Studies in the United States: A Report from the American College of Radiology National Radiology Data Registry. Radiology 2014, 271: 445-451. PMID: 24484064, PMCID: PMC5341688, DOI: 10.1148/radiol.14131601.Peer-Reviewed Original ResearchConceptsDose-length productDose indexRadiation dose indicesCT studiesMean dose-length productInstitutional review board approvalReview board approvalCT dose indexRenal colicMean ageSingle institutionCT examinationsAmerican CollegeData registryBoard approvalPatientsPatient habitusRegistryCTSpearman correlationUnited StatesExamination typesDescriptive statisticsInstitutional-level factorsIndex
2013
Bedside optic nerve sheath diameter ultrasound for the evaluation of suspected pediatric ventriculoperitoneal shunt failure in the emergency department
Hall MK, Spiro DM, Sabbaj A, Moore CL, Hopkins KL, Meckler GD. Bedside optic nerve sheath diameter ultrasound for the evaluation of suspected pediatric ventriculoperitoneal shunt failure in the emergency department. Child's Nervous System 2013, 29: 2275-2280. PMID: 23728433, DOI: 10.1007/s00381-013-2172-y.Peer-Reviewed Original ResearchConceptsOptic nerve sheath diameterMean optic nerve sheath diameterVentriculoperitoneal shunt failureShunt failureVPS failureEmergency departmentOptic nerve sheath diameter ultrasoundScreening toolAcademic pediatric emergency departmentEmergency department evaluationMethodsProspective observational studyNerve sheath diameterPediatric emergency departmentYears of agePrimary screening toolDepartment evaluationOcular ultrasoundResultsA totalONSD measurementsSheath diameterObservational studyChildren 6ONSD ultrasoundTest characteristicsConvenience sample
2012
Evaluation of Pulmonary Embolism in the Emergency Department and Consistency With a National Quality Measure: Quantifying the Opportunity for Improvement
Venkatesh AK, Kline JA, Courtney DM, Camargo CA, Plewa MC, Nordenholz KE, Moore CL, Richman PB, Smithline HA, Beam DM, Kabrhel C. Evaluation of Pulmonary Embolism in the Emergency Department and Consistency With a National Quality Measure: Quantifying the Opportunity for Improvement. JAMA Internal Medicine 2012, 172: 1028-1032. PMID: 22664742, PMCID: PMC3775003, DOI: 10.1001/archinternmed.2012.1804.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedDiagnosis, DifferentialEmergency Service, HospitalFemaleFibrin Fibrinogen Degradation ProductsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioProspective StudiesPulmonary EmbolismQuality ImprovementQuality of Health CareRadiation InjuriesRadiographyRisk AssessmentSensitivity and SpecificityUnited StatesUnnecessary ProceduresConceptsNegative D-dimer test resultD-dimer test resultPulmonary embolismLow pretest probabilityD-dimer testEmergency departmentNational Quality ForumED patientsPretest probabilitySecondary analysisNQF measureMulticenter observational studyLow-risk patientsPatient-level predictorsUS emergency departmentsD-dimer testingMultivariable logistic regressionNational quality measuresInappropriate imagingAdult patientsPrimary outcomeMalignant diseaseObservational studyPatientsUnnecessary irradiation
2010
Simulation Training in Central Venous Catheter Insertion: Improved Performance in Clinical Practice
Evans LV, Dodge KL, Shah TD, Kaplan LJ, Siegel MD, Moore CL, Hamann CJ, Lin Z, D'Onofrio G. Simulation Training in Central Venous Catheter Insertion: Improved Performance in Clinical Practice. Academic Medicine 2010, 85: 1462-1469. PMID: 20736674, DOI: 10.1097/acm.0b013e3181eac9a3.Peer-Reviewed Original ResearchMeSH KeywordsCatheterization, Central VenousChi-Square DistributionClinical CompetenceCompetency-Based EducationEducation, Medical, GraduateEducational MeasurementHumansIntensive Care UnitsInternship and ResidencyPatient SimulationProspective StudiesRegression AnalysisSingle-Blind MethodStatistics, NonparametricUltrasonography, InterventionalConceptsCentral venous catheter insertionVenous catheter insertionCVC insertionFirst cannulationIntervention groupControl groupCatheter insertionMechanical complicationsClinical practiceTertiary care teaching hospitalSingle-blind studyInsertion success rateTechnical errorsBlinded independent ratersSimulation trainingPatient comorbiditiesPrimary outcomeSecondary outcomesTeaching hospitalInsertion successSecond-year residentsCannulationResident specialtyConfidence intervalsSimulation training courseClinical Features From the History and Physical Examination That Predict the Presence or Absence of Pulmonary Embolism in Symptomatic Emergency Department Patients: Results of a Prospective, Multicenter Study
Courtney DM, Kline JA, Kabrhel C, Moore CL, Smithline HA, Nordenholz KE, Richman PB, Plewa MC. Clinical Features From the History and Physical Examination That Predict the Presence or Absence of Pulmonary Embolism in Symptomatic Emergency Department Patients: Results of a Prospective, Multicenter Study. Annals Of Emergency Medicine 2010, 55: 307-315.e1. PMID: 20045580, PMCID: PMC2847003, DOI: 10.1016/j.annemergmed.2009.11.010.Peer-Reviewed Original ResearchMeSH KeywordsAdultChest PainConfidence IntervalsEmergency Service, HospitalFemaleHumansLogistic ModelsMaleMedical History TakingMiddle AgedOdds RatioPhysical ExaminationPredictive Value of TestsProspective StudiesPulmonary EmbolismRisk FactorsSex FactorsThrombophiliaTomography, X-Ray ComputedVenous ThromboembolismVenous ThrombosisConceptsPleuritic chest painDeep venous thrombosisPulmonary embolismEmergency department patientsVenous thromboembolismChest painOdds ratioDepartment patientsVenous thrombosisFamily historySymptomatic emergency department (ED) patientsUS emergency department patientsPrediction rulePossible pulmonary embolismSubsternal chest painUnilateral leg swellingVenous thromboembolism outcomesProspective cohort studyAdjusted odds ratioActive malignancyRecent surgeryCohort studyLeg swellingPrimary outcomeFemale patients
2009
Potential Impact of Adjusting the Threshold of the Quantitative D‐dimer Based on Pretest Probability of Acute Pulmonary Embolism
Kabrhel C, Courtney D, Camargo CA, Moore CL, Richman PB, Plewa MC, Nordenholtz KE, Smithline HA, Beam DM, Brown MD, Kline JA. Potential Impact of Adjusting the Threshold of the Quantitative D‐dimer Based on Pretest Probability of Acute Pulmonary Embolism. Academic Emergency Medicine 2009, 16: 325-332. PMID: 19298619, DOI: 10.1111/j.1553-2712.2009.00368.x.Peer-Reviewed Original ResearchConceptsNegative predictive valuePulmonary embolismD-dimer testingQuantitative D-dimerPretest probabilityD-dimerVenous thromboembolismQuantitative D-dimer testingPossible pulmonary embolismAcute pulmonary embolismObservational multicenter studyMajority of patientsEmergency department patientsIntermediate pretest probabilityEmergency medicine cliniciansD-dimer cutoffHigh pretest probabilityDifferent D-dimer assaysD-dimer assayEligible patientsDepartment patientsMulticenter studyMedicine cliniciansUnstructured estimatePatientsRisk of Thromboembolism Varies, Depending on Category of Immobility in Outpatients
Beam DM, Courtney DM, Kabrhel C, Moore CL, Richman PB, Kline JA. Risk of Thromboembolism Varies, Depending on Category of Immobility in Outpatients. Annals Of Emergency Medicine 2009, 54: 147-152. PMID: 19135280, DOI: 10.1016/j.annemergmed.2008.10.033.Peer-Reviewed Original ResearchConceptsVenous thromboembolismOdds ratioSymptomatic ED patientsPrevious venous thromboembolismEmergency department patientsSignificant risk factorsLongitudinal outcome studyPositive imaging resultsCause of immobilityActive malignancyLimb immobilityNeurologic paralysisRecent surgeryDepartment patientsClinical featuresED patientsRisk factorsThromboembolismLarge cohortPresence of limbsOutcome studiesUnilateral legPatientsTypes of immobilityMultivariate analysis
2008
Prospective multicenter evaluation of the pulmonary embolism rule‐out criteria
KLINE JA, COURTNEY DM, KABRHEL C, MOORE CL, SMITHLINE HA, PLEWA MC, RICHMAN PB, O'NEIL BJ, NORDENHOLZ K. Prospective multicenter evaluation of the pulmonary embolism rule‐out criteria. Journal Of Thrombosis And Haemostasis 2008, 6: 772-780. PMID: 18318689, DOI: 10.1111/j.1538-7836.2008.02944.x.Peer-Reviewed Original ResearchConceptsPulmonary embolismLow suspicionGestalt estimateLow-risk patientsPulmonary Embolism RuleProspective multicenter evaluationPretest probability estimatesPost-test probabilityChest painChief complaintEmergency departmentMAIN OUTCOMEMulticenter evaluationPatientsFalse negative rateDiagnostic testsSuspicionOutpatientsCliniciansTest ordersDeathData formInitial testingDaysDyspnea
2007
Diagnosis and Guided Reduction of Forearm Fractures in Children Using Bedside Ultrasound
Chen L, Kim Y, Moore CL. Diagnosis and Guided Reduction of Forearm Fractures in Children Using Bedside Ultrasound. Pediatric Emergency Care 2007, 23: 528-531. PMID: 17726410, DOI: 10.1097/pec.0b013e318128f85d.Peer-Reviewed Original ResearchConceptsPediatric emergency medicine physiciansForearm fracturesEmergency medicine physiciansBedside ultrasoundMedicine physiciansUltrasound-guided reductionUrban pediatric EDInitial success ratePediatric EDPostreduction radiographsRadiograph findingsCommon injuriesUltrasound findingsUltrasound guidanceForearm bonesUltrasound diagnosisPatientsStudy periodDiagnosisUltrasoundSuccess rateUltrasound unitFluoroscopy unitChildrenRadiographs
2005
Utility of Bedside Bladder Ultrasound Before Urethral Catheterization in Young Children
Chen L, Hsiao AL, Moore CL, Dziura JD, Santucci KA. Utility of Bedside Bladder Ultrasound Before Urethral Catheterization in Young Children. Pediatrics 2005, 115: 108-111. PMID: 15629989, DOI: 10.1542/peds.2004-0738.Peer-Reviewed Original ResearchConceptsPediatric emergency medicine physiciansAmount of urineUrethral catheterizationEmergency medicine physiciansBedside ultrasoundSufficient urineMedicine physiciansUrban pediatric emergency departmentIntervention phasePediatric emergency departmentPediatric emergency physiciansSuccess rateObservation phaseSimple noninvasive procedureSubsequent ultrasoundBladder ultrasoundFirst catheterizationUnsuccessful proceduresUrine cultureEmergency departmentIntervention periodInvasive testingEmergency physiciansCatheterizationUncomfortable procedure
2002
Determination of Left Ventricular Function by Emergency Physician Echocardiography of Hypotensive Patients
Moore CL, Rose GA, Tayal VS, Sullivan DM, Arrowood JA, Kline JA. Determination of Left Ventricular Function by Emergency Physician Echocardiography of Hypotensive Patients. Academic Emergency Medicine 2002, 9: 186-193. DOI: 10.1197/aemj.9.3.186.Peer-Reviewed Original ResearchConceptsEjection fractionEmergency physiciansPrimary cardiologistHypotensive patientsVentricular functionHypotensive emergency department patientsUrban teaching EDEmergency department patientsLeft ventricular functionVisits/yearAcute myocardial infarctionHistory of traumaGoal-directed trainingCardiac causesSymptomatic hypotensionAdult patientsTransthoracic echocardiogramDepartment patientsMyocardial infarctionObservational studyExclusion criteriaChest compressionsPrior ultrasound experiencePatientsEchocardiographic qualityDetermination of left ventricular function by emergency physician echocardiography of hypotensive patients.
Moore C, Rose G, Tayal V, Sullivan D, Arrowood J, Kline J. Determination of left ventricular function by emergency physician echocardiography of hypotensive patients. Academic Emergency Medicine 2002, 9: 186-93. PMID: 11874773, DOI: 10.1111/j.1553-2712.2002.tb00242.x.Peer-Reviewed Original ResearchConceptsEjection fractionEmergency physiciansPrimary cardiologistHypotensive patientsVentricular functionHypotensive emergency department patientsUrban teaching EDEmergency department patientsVisits/yearAcute myocardial infarctionHistory of traumaGoal-directed trainingCardiac causesSymptomatic hypotensionAdult patientsTransthoracic echocardiogramDepartment patientsMyocardial infarctionObservational studyExclusion criteriaChest compressionsPrior ultrasound experiencePatientsEchocardiographic qualityCardiologists