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 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 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 physicistsPhysiciansCareCTIndependent 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 complaintIncidental 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 ResearchMeSH KeywordsAcademic Medical CentersAdultBody Mass IndexEmergency Service, HospitalFemaleHumansMaleMiddle AgedProspective StudiesRadiation DosageTomography, X-Ray ComputedUreterUreteral CalculiConceptsUreteral 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 ResearchMeSH KeywordsClinical CompetenceFemaleHumansHydronephrosisMaleMiddle AgedPoint-of-Care SystemsProspective StudiesRenal ColicSensitivity and SpecificityTomography, X-Ray ComputedUltrasonographyConceptsComputed 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 ResearchMeSH KeywordsAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedProspective StudiesRadiation DosageRegistriesRenal ColicTomography, X-Ray ComputedUnited StatesConceptsDose-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
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
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
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
2008
Prevalence of abnormal CT findings in patients with proven ovarian torsion and a proposed triage schema
Moore C, Meyers AB, Capotasto J, Bokhari J. Prevalence of abnormal CT findings in patients with proven ovarian torsion and a proposed triage schema. Emergency Radiology 2008, 16: 115-120. PMID: 18679730, DOI: 10.1007/s10140-008-0754-x.Peer-Reviewed Original ResearchConceptsOvarian torsionComputed tomographyPelvic painCT findingsAbnormal pelvic findingsAbnormal CT findingsPelvic findingsRetrospective reviewOvarian cystsInvolved ovariesAdnexal massesCT reportsCT scanAvailable CT imagesFurther evaluationRadiologist reviewPatientsWomenPainOvariesTriage schemaCT imagesFindingsReportReview