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81.
Appropriateness,diagnostic value,and outcomes of repeat testing following index echocardiography 下载免费PDF全文
Alina Hua MBBS Vincent McCaughan MBBS Matthew Wright MBBS Abbas Zaidi MBBS MD Jessica Wright MBBS Aishah Azam MBBS Sujata Bhattacharyya MBBS Lisanne Stock MBBS Guy Lloyd MD FRCP Sanjeev Bhattacharyya MD MRCP FESC 《Echocardiography (Mount Kisco, N.Y.)》2018,35(1):24-29
Aims
Emergency admission to hospital is associated with an economic burden and mortality. Echocardiography is often the first‐line cardiovascular imaging investigation. Repeat testing is common; however, there are sparse data on the prevalence, appropriateness, or outcome of repeat testing.Methods
We performed an electronic database search for patients with emergency admissions to our institution in February 2015. An electronic patient record review of inpatient echocardiograms was undertaken. Indications for echocardiography were classified as appropriate, may be appropriate, or rarely appropriate. One‐year follow‐up for repeat testing and mortality was investigated.Results
A total of 409 of 2306 (17.7%) unplanned/emergency admissions underwent inpatient echocardiography. Abnormalities were identified in 165/409 (40.3%) of these patients; 154 of 409 (37.7%) had a repeat echocardiogram within the next year. Rarely appropriate indications for echocardiography occurred in 51 (33%) of repeat vs 53 (16%) of index echocardiograms, P < .0001. Repeat testing was associated with a change in findings in 17/154 (11%) patients overall. All of whom had an abnormal index echocardiogram and had an appropriate indication. There was no difference in mean survival time between patients who underwent repeat and those who only underwent a single index echocardiogram (310 days vs 327 days), P = .34.Conclusion
Inpatient echocardiography in emergency hospital admissions identifies clinically important pathology. Repeated testing is common within 1 year of hospital admission. New diagnostic findings occurred in 11% of patients and only in patients with appropriate studies and an abnormal index echocardiogram. Identification of methods to reduce repeat testing and implement appropriateness criteria is warranted. 相似文献82.
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Implementation and evaluation of a collaborative clinical pharmacist's medications reconciliation and charting service for admitted medical inpatients in a metropolitan hospital 下载免费PDF全文
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Performance of manual hyperinflation: consistency and modification of the technique by intensive care unit nurses during physiotherapy 下载免费PDF全文
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Robert D. Hinshelwood BSc MBBS DPM 《Medicine, conflict, and survival》2013,29(1):29-38
Society is influenced by the unconcious aspects of the minds of the member individuals. This paper describes a psychoanalytic approach to some aspects of the social processes that give rise to the attitudes in Western society towards nuclear war and the nuclear threat. It is concluded that there are profound hidden factors that work against changing the current views on war and nuclear war, and that some peace groups are inadvertently recruited into maintaining the status quo. 相似文献