2015
McConnell'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 wall
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 strain
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
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
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