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Evidence-based emergency care: diagnostic testing and clinical decision rules
Edited book

Evidence-based emergency care: diagnostic testing and clinical decision rules

Jesse M. Pines, Fernanda Bellolio, Christopher R. Carpenter and Ali S. Raja
2023
DOI: https://doi.org/10.1002/9781119616870

Abstract

Diagnosis Diagnostic Techniques and Procedures Diseases Emergency medicine -- Decision making Emergency medicine -- Diagnosis Evidence-Based Emergency Medicine Evidence-Based Emergency Medicine -- methods Evidence-based medicine MEDICAL methods
"As emergency department (ED) physicians, we spend a good deal of our time ordering, interpreting, and waiting for the results of diagnostic tests. ED physicians are the experts when it comes to determining who needs a test to rule out a potentially life-threatening condition. There are several reasons for this expertise. First and foremost, we see a lot of patients with undifferentiated symptoms in a decision-dense and time-constrained environment. Especially for those working in busy hospitals, the expectation is to see everyone in a timely way, provide quality care, and ensure patients have a good experience. Some patients and consultants value lab or imaging tests more than the history and physical exam tests that formulate clinical intuition, a phenomenon called "technological tenesmus". However, if we order time-consuming tests on everyone, ED crowding and inefficiency will worsen, costs of care will go up, and patients will experience even longer waits than they already do. In addition, there is increased pressure to carefully choose who needs and who does not need tests in an evidence-based manner, particularly as costs of care have risen so dramatically in recent years particularly in the United States. ,"--

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