2023
Clinical criteria to exclude acute vascular pathology on CT angiogram in patients with dizziness
Tu L, Malhotra A, Venkatesh A, Taylor R, Sheth K, Yaesoubi R, Forman H, Sureshanand S, Navaratnam D. Clinical criteria to exclude acute vascular pathology on CT angiogram in patients with dizziness. PLOS ONE 2023, 18: e0280752. PMID: 36893103, PMCID: PMC9997874, DOI: 10.1371/journal.pone.0280752.Peer-Reviewed Original ResearchMeSH KeywordsAdultAngiographyCross-Sectional StudiesDizzinessEmergency Service, HospitalHumansStrokeTomography, X-Ray ComputedVertigoConceptsAcute vascular pathologyEmergency departmentVascular pathologyNegative predictive valueDizzy patientsStroke codeCTA headPredictive valueAdult ED encountersTransient ischemic attackHalf of patientsLong-term smokersLarge vessel occlusionCoronary artery diseasePast medical historySeparate validation cohortCross-sectional analysisIschemic attackAnalysis cohortArterial dissectionArtery diseaseClinical factorsED encountersMedication useChief complaint
2016
Determination of a Testing Threshold for Lumbar Puncture in the Diagnosis of Subarachnoid Hemorrhage after a Negative Head Computed Tomography: A Decision Analysis
Taylor RA, Gill H, Marcolini EG, Meyers HP, Faust JS, Newman DH. Determination of a Testing Threshold for Lumbar Puncture in the Diagnosis of Subarachnoid Hemorrhage after a Negative Head Computed Tomography: A Decision Analysis. Academic Emergency Medicine 2016, 23: 1119-1127. PMID: 27378053, DOI: 10.1111/acem.13042.Peer-Reviewed Original ResearchMeSH KeywordsDecision Support TechniquesEmergency Service, HospitalHeadacheHumansMiddle AgedNeuroimagingReference StandardsSpinal PunctureSubarachnoid HemorrhageTomography, X-Ray ComputedConceptsProbabilistic sensitivity analysesNegative head CTAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageLumbar punctureNegative CTTesting thresholdHead CTNormal neurologic findingsContrast-induced nephropathyNonaneurysmal subarachnoid hemorrhageLong-term morbidityHead Computed TomographyTwo-way sensitivity analysesDecision analytic modelProbability of deathNeurologic findingsRenal failureClinical variablesCurrent guidelinesPretest probabilityComputed tomographySecondary aimCTHemorrhageThe Association Between Physician Empathy and Variation in Imaging Use
Melnick ER, O'Brien EG, Kovalerchik O, Fleischman W, Venkatesh AK, Taylor RA. The Association Between Physician Empathy and Variation in Imaging Use. Academic Emergency Medicine 2016, 23: 895-904. PMID: 27343485, PMCID: PMC5884096, DOI: 10.1111/acem.13017.Peer-Reviewed Original ResearchConceptsCT utilizationEmergency physician performanceEmergency physiciansPhysician performanceCT utilization ratesEmergency Department CTPhysician survey respondentsPatient-level variablesCross-sectional studyCohort of physiciansPhysician empathyLarge health systemPsychometric testsMixed effects regression modelsPhysician-based factorsPsychometric scalesSurvey response rateAcademic EDSubset analysisPhysician demographicsHead CTInterphysician variationResponse rateImaging useRTS score
2015
Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection
Pare JR, Liu R, Moore CL, Sherban T, Kelleher MS, Thomas S, Taylor RA. Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection. The American Journal Of Emergency Medicine 2015, 34: 486-492. PMID: 26782795, DOI: 10.1016/j.ajem.2015.12.005.Peer-Reviewed Original ResearchMeSH KeywordsAortic Aneurysm, ThoracicAortic DissectionAutopsyDiagnostic ErrorsEchocardiography, TransesophagealEmergency Medical ServicesEmergency MedicineFemaleHumansMaleMedical RecordsMiddle AgedMulticenter Studies as TopicMulti-Institutional SystemsOutcome Assessment, Health CareRetrospective StudiesTime FactorsTomography, X-Ray ComputedConceptsAortic dissectionCardiac ultrasoundEmergency departmentEmergency physiciansAscending aortic dissectionPrimary outcome measureFocus groupsNonspecific presentationED visitsSecondary outcomesAortic dilationMedian timeRetrospective reviewResuscitate statusMedical recordsThoracic aortaDeadly diagnosisOutcome measuresAutopsy reportsPatientsMisdiagnosis rateDissectionUltrasoundMortalityPhysiciansComparative Effectiveness Research: Alternatives to “Traditional” Computed Tomography Use in the Acute Care Setting
Moore CL, Broder J, Gunn ML, Bhargavan‐Chatfield M, Cody D, Cullison K, Daniels B, Gans B, Hall M, Gaines BA, Goldman S, Heil J, Liu R, Marin JR, Melnick ER, Novelline RA, Pare J, Repplinger MD, Taylor RA, Sodickson AD. Comparative Effectiveness Research: Alternatives to “Traditional” Computed Tomography Use in the Acute Care Setting. Academic Emergency Medicine 2015, 22: 1465-1473. PMID: 26576033, DOI: 10.1111/acem.12831.Peer-Reviewed Original ResearchConceptsAcute care settingCare settingsComputed tomography (CT) useCare of patientsAlternative diagnostic strategiesComputed tomography scanningEssential diagnostic toolTomography useCT useEmergency physiciansEmergency radiologistsComparative effectivenessTomography scanningDiagnostic strategiesDiagnostic toolDelphi techniqueSettingPatientsMedical physicistsPhysiciansCareCTRedefining Overuse to Include Costs: A Decision Analysis for Computed Tomography in Minor Head Injury
Melnick ER, Keegan J, Taylor RA. Redefining Overuse to Include Costs: A Decision Analysis for Computed Tomography in Minor Head Injury. The Joint Commission Journal On Quality And Patient Safety 2015, 41: 313-ap2. PMID: 26108124, DOI: 10.1016/s1553-7250(15)41041-4.Peer-Reviewed Original ResearchConceptsNet monetary benefitCurrent clinical decision rulesMonetary benefitsInclusion of costsCosts outweigh benefitsDecision analysisDecision analytic modelTwo-way sensitivity analysesDecision rulesProbability of lesionCanadian CT Head RuleMain driversOnly effectivenessCostSignificant impactSensitivity analysisCost of CT
2013
A decision analysis to determine a testing threshold for computed tomographic angiography and d-dimer in the evaluation of aortic dissection
Taylor RA, Iyer NS. A decision analysis to determine a testing threshold for computed tomographic angiography and d-dimer in the evaluation of aortic dissection. The American Journal Of Emergency Medicine 2013, 31: 1047-1055. PMID: 23702073, DOI: 10.1016/j.ajem.2013.03.039.Peer-Reviewed Original ResearchConceptsThoracic aortic dissectionD-dimerTesting thresholdAortic dissectionTomographic angiographyAcute renal failureHigh-risk featuresRenal replacement therapyClinical decision ruleD-dimer testingD-dimer sensitivityD-dimer testLarge mortality benefitMortality benefitPatient ageRenal failureReplacement therapyPretest probabilityLow prevalenceCTA testSmall riskDecision analysis softwareDisease probabilityCTAAngiography