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 pathwayRight Upper Quadrant Pain: Ultrasound First!
Revzin MV, Scoutt LM, Garner JG, Moore CL. Right Upper Quadrant Pain: Ultrasound First! Journal Of Ultrasound In Medicine 2017, 36: 1975-1985. PMID: 28586152, DOI: 10.1002/jum.14274.Peer-Reviewed Original ResearchConceptsUpper quadrant painQuadrant painRight upper quadrant painFirst-line imaging modalityUpper abdominal pathologyCommon presenting symptomInitial imaging modalityDiagnosis of gallstonesImaging modalitiesLimitations of ultrasoundOutpatient medical practicePresenting symptomSurgical causesAbdominal pathologyEmergency departmentHepatic pathologyUltrasound examinationPatient managementCorrect diagnosisPathologyPainMedical practiceDiagnosisUltrasoundModalities
2016
Cost‐effectiveness of the Cardiac Component of the Focused Assessment of Sonography in Trauma Examination in Blunt Trauma
Hall MK, Omer T, Moore CL, Taylor RA. Cost‐effectiveness of the Cardiac Component of the Focused Assessment of Sonography in Trauma Examination in Blunt Trauma. Academic Emergency Medicine 2016, 23: 415-423. PMID: 26857839, DOI: 10.1111/acem.12936.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedBlood PressureCost-Benefit AnalysisDecision Support TechniquesFemaleHeart InjuriesHumansHypotensionLife ExpectancyMedicareMiddle AgedModels, EconometricPoint-of-Care SystemsQuality-Adjusted Life YearsReproducibility of ResultsUltrasonographyUnited StatesWounds, NonpenetratingConceptsNormotensive blunt trauma patientsIncremental cost-effectiveness ratioBlunt trauma patientsTrauma patientsBlunt traumaNormotensive patientsHypotensive patientsFocused assessmentBlunt cardiac injuryIncidental pericardial effusionCardiac componentCost-effectiveness ratioDecision analytic modelProbability of deathPericardial effusionPrompt treatmentClinical probabilityCardiac injurySurgical interventionTrauma (FAST) examFAST examLow prevalencePatientsTrauma (FAST) examinationPay thresholdsUreteral 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 boardImpact of point-of-care ultrasonography on ED time to disposition for patients with nontraumatic shock
Hall MK, Taylor RA, Luty S, Allen IE, Moore CL. Impact of point-of-care ultrasonography on ED time to disposition for patients with nontraumatic shock. The American Journal Of Emergency Medicine 2016, 34: 1022-1030. PMID: 26988105, DOI: 10.1016/j.ajem.2016.02.059.Peer-Reviewed Original ResearchConceptsPOC ultrasonographyEmergency departmentNontraumatic shockCare ultrasonographyPropensity scorePropensity score matchElectronic health recordsHospital mortalityShock patientsPrompt diagnosisED arrivalED patientsED physiciansPoint of careRetrospective studyUnique patientsImpact of pointMean reductionPropensity score modelPatientsUltrasonographyED timeDiagnostic ultrasonographyCovariates of timeEvidence of reduction
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 patientsEmergency 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 rateDissectionUltrasoundMortalityPhysiciansMcConnell's Sign Is Not Specific for Pulmonary Embolism: Case Report and Review of the Literature
Walsh BM, Moore CL. McConnell's Sign Is Not Specific for Pulmonary Embolism: Case Report and Review of the Literature. Journal Of Emergency Medicine 2015, 49: 301-304. PMID: 25986329, DOI: 10.1016/j.jemermed.2014.12.089.Peer-Reviewed Original ResearchConceptsPulmonary embolismMcConnell's signAcute right heart strainChronic obstructive pulmonary diseaseRight heart strainDeep venous thrombosisObstructive pulmonary diseaseSystemic lupus erythematosusComputed tomography angiogramRV free wallFour-chamber viewPulmonary hypertensionApical sparingHeart strainLeg swellingLupus erythematosusPulmonary diseaseVenous thrombosisD-dimerTomography angiogramEmergency departmentCase reportLower extremitiesEmergency physiciansFree wallIncidental Findings on CT for Suspected Renal Colic in Emergency Department Patients: Prevalence and Types in 5,383 Consecutive Examinations
Samim M, Goss S, Luty S, Weinreb J, Moore C. Incidental Findings on CT for Suspected Renal Colic in Emergency Department Patients: Prevalence and Types in 5,383 Consecutive Examinations. Journal Of The American College Of Radiology 2015, 12: 63-69. PMID: 25557571, DOI: 10.1016/j.jacr.2014.07.026.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge DistributionAgedAged, 80 and overComorbidityConnecticutEmergency Medical ServicesEmergency Service, HospitalFemaleHumansIncidental FindingsLung DiseasesMaleMiddle AgedPelvic Inflammatory DiseasePrevalenceRenal ColicRisk AssessmentSex DistributionTomography, X-Ray ComputedUrolithiasisYoung AdultConceptsImportant incidental findingsNon-enhanced CT scansIncidental findingRenal colicEmergency departmentCT scanSuspected Renal ColicEmergency department patientsSubstantial inter-rater agreementSubset of reportsACR White PaperAdult patientsDepartment patientsRetrospective reviewProspective studyHigh prevalenceConsensus recommendationsInter-rater agreementConsecutive examinationsInter-rater variabilityOlder individualsColicPrevalencePatientsScans
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 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
Accuracy of emergency physician-performed limited echocardiography for right ventricular strain
Taylor RA, Moore CL. Accuracy of emergency physician-performed limited echocardiography for right ventricular strain. The American Journal Of Emergency Medicine 2013, 32: 371-374. PMID: 24559906, DOI: 10.1016/j.ajem.2013.12.043.Peer-Reviewed Original ResearchConceptsRight ventricular strainRight ventricular dilationRetrospective cohort studyEcho examinationPulmonary embolismCohort studyVentricular strainVentricular dilationLevel of agreementTest characteristicsCommon emergency department (ED) diagnosisConsecutive ED patientsEmergency department diagnosisChest painED patientsLimited echocardiographyED providersMortality rateLimited echoEfficient careModerate agreementEchocardiographyExaminationFocused examinationDilationPoint-of-Care Focused Cardiac Ultrasound for Prediction of Pulmonary Embolism Adverse Outcomes
Taylor RA, Davis J, Liu R, Gupta V, Dziura J, Moore CL. Point-of-Care Focused Cardiac Ultrasound for Prediction of Pulmonary Embolism Adverse Outcomes. Journal Of Emergency Medicine 2013, 45: 392-399. PMID: 23827166, DOI: 10.1016/j.jemermed.2013.04.014.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overEchocardiographyEmergency Service, HospitalFemaleHemorrhageHospital MortalityHumansMaleMiddle AgedPoint-of-Care SystemsPredictive Value of TestsPrognosisPulmonary EmbolismRecurrenceRespiratory InsufficiencyRetrospective StudiesRisk FactorsShockVenous ThromboembolismVentricular Dysfunction, RightConceptsRight ventricular strainHospital adverse outcomesRetrospective chart reviewPulmonary embolismAdverse outcomesEmergency departmentChart reviewCardiac ultrasoundHighest positive likelihood ratioRecurrent venous thromboembolismLow negative likelihood ratioSignificant predictorsEmergency care practitionersFocused cardiac ultrasoundFOCUS examinationPositive likelihood ratioNegative likelihood ratioMajor bleedingLikelihood ratioRespiratory failureVenous thromboembolismTransthoracic echocardiographyHospital admissionIndependent predictorsVentricular strainPrevalence and Clinical Importance of Alternative Causes of Symptoms Using a Renal Colic Computed Tomography Protocol in Patients With Flank or Back Pain and Absence of Pyuria
Moore CL, Daniels B, Singh D, Luty S, Molinaro A. Prevalence and Clinical Importance of Alternative Causes of Symptoms Using a Renal Colic Computed Tomography Protocol in Patients With Flank or Back Pain and Absence of Pyuria. Academic Emergency Medicine 2013, 20: 470-478. PMID: 23672361, DOI: 10.1111/acem.12127.Peer-Reviewed Original ResearchConceptsCause of symptomsAbsence of pyuriaCause of painBack painUreteral stonesRecord reviewUrine infectionEmergency departmentClinical importanceUnimportant causeKidney stonesAlternative causesRetrospective observational analysisComputed tomography protocolPain protocolAdult patientsPatient's symptomsClassic symptomsCT scanStone diagnosisAlternate causePainPatientsSymptomsPyuria
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
2011
Atraumatic headache in US emergency departments: recent trends in CT/MRI utilisation and factors associated with severe intracranial pathology
Gilbert JW, Johnson KM, Larkin GL, Moore CL. Atraumatic headache in US emergency departments: recent trends in CT/MRI utilisation and factors associated with severe intracranial pathology. Emergency Medicine Journal 2011, 29: 576. PMID: 21856709, DOI: 10.1136/emermed-2011-200088.Peer-Reviewed Original ResearchConceptsAtraumatic headacheCT/MRIIntracranial pathologyBlood pressureNational Hospital Ambulatory Medical Care SurveyAmbulatory Medical Care SurveyHeadache-related visitsPercentage of patientsDiastolic blood pressureEmergency department visitsSystolic blood pressureUS emergency departmentsSignificant intracranial pathologyLength of staySevere intracranial pathologyICP diagnosisClinical decision supportDepartment visitsNeurological weaknessEmergency departmentCare SurveyMotor functionEmergency careHeadachePatients
2010
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
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
Pulseless Electrical Activity, Focused Abdominal Sonography for Trauma, and Cardiac Contractile Activity as Predictors of Survival After Trauma
Schuster KM, Lofthouse R, Moore C, Lui F, Kaplan LJ, Davis KA. Pulseless Electrical Activity, Focused Abdominal Sonography for Trauma, and Cardiac Contractile Activity as Predictors of Survival After Trauma. Journal Of Trauma And Acute Care Surgery 2009, 67: 1154-1157. PMID: 20009660, DOI: 10.1097/ta.0b013e3181c303e8.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal InjuriesAdultAgedAged, 80 and overCardiopulmonary ResuscitationChildFemaleHeart ArrestHumansMaleMiddle AgedPericardial EffusionPredictive Value of TestsPrognosisPulseRetrospective StudiesSensitivity and SpecificityStatistics, NonparametricSurvival RateTrauma Severity IndicesUltrasonographyConceptsPulseless electrical activityCardiac contractile activityFocused abdominal sonographyInitial resuscitationAbdominal sonographyEmergency departmentContractile activityCardiac activityStudy period 25 patientsLevel I trauma centerGrave prognostic indicatorI trauma centerPredictors of survivalMechanism of injuryElectrical activityClosed head injuryPericardial viewTension hemothoraxOngoing resuscitationPericardial effusionBlunt traumaRetrospective reviewTrauma centerPrognostic indicatorHead injury