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Abstract:
STUDY OBJECTIVE:We evaluated a strategy to increase use of the test (Dix-Hallpike's test [DHT]) and treatment (canalith repositioning maneuver [CRM]) for benign paroxysmal positional vertigo in emergency department (ED) dizziness visits. METHODS:We conducted a stepped-wedge randomized trial in 6 EDs. The population was visits with dizziness as a principal reason for the visit. The intervention included educational sessions and decision aid materials. Outcomes were DHT or CRM documentation (primary), head computed tomography (CT) use, length of stay, admission, and 90-day stroke events. The analysis was multilevel logistic regression with intervention, month, and hospital as fixed effects and provider as a random effect. We assessed fidelity with monitoring intervention use and semistructured interviews. RESULTS:We identified 7,635 dizziness visits during 18 months. The DHT or CRM was documented in 1.5% of control visits (45/3,077; 95% confidence interval 1% to 1.9%) and 3.5% of intervention visits (159/4,558; 95% confidence interval 3% to 4%; difference 2%, 95% confidence interval 1.3% to 2.7%). Head CT use was lower in intervention visits compared with control visits (44.0% [1,352/3,077] versus 36.9% [1,682/4,558]). No differences were observed in admission or 90-day subsequent stroke risk. In fidelity evaluations, providers who used the materials typically reported positive clinical experiences but provider engagement was low at facilities without an emergency medicine residency program. CONCLUSION:These findings provide evidence that an implementation strategy of a benign paroxysmal positional vertigo-focused approach to ED dizziness visits can be successful and safe in promoting evidence-based care. Absolute rates of DHT and CRM use, however, were still low, which relates in part to our broad inclusion criteria for dizziness visits.
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最新影响因子:6.762 | 期刊ISSN:0196-0644 | CiteScore:1.51 |
出版周期:Monthly | 是否OA:YES | 出版年份:1980 |
期刊官方网址:http://www.annemergmed.com/
期刊投稿地址:http://www.editorialmanager.com/annemergmed/default.aspx
自引率:10.00% | 研究方向:医学-急救医学 |
出版地区:UNITED STATES |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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Annals of Emergency Medicine is the official publication of the American College of Emergency Physicians and is the specialty's leading peer-reviewed journal. In addition to scientific and clinical articles, Annals presents case reports, editorials, international conference abstracts, and collective reviews of the literature on narrow clinical topics. The journal covers clinical investigations, pediatric emergency care, injury prevention, infectious disease, disaster medicine, toxicology, health policy, and emergency medical services. Read by physicians, researchers, residents, students, paramedics, and EMTs throughout the world, Annals is the only emergency medicine journal recommended for initial purchase in two Brandon-Hill studies, Selected List of Books and Journals for the Small Medical Library (1997/98 Edition) and Selected List of Books and Journals in Allied Health Sciences (1996/97 Edition).
《急诊医学年鉴》是美国急诊医师学院的官方出版物,是该专业领先的同行评议期刊。除了科学和临床文章,年报还提供病例报告、社论、国际会议摘要和对狭窄临床主题的文献的集体评论。该杂志涵盖临床调查、儿科急诊护理、伤害预防、传染病、灾难医学、毒理学、卫生政策和紧急医疗服务。阅读由内科医生、研究人员、居民、学生、护理人员、以及急救医护人员在整个世界,年报是唯一的急诊医学杂志推荐首次购买两个Brandon-Hill研究,选择小医学图书馆的书籍和期刊列表(1997/98版)和选择列表的书籍和期刊在盟军的健康科学(1996/97版)。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
EMERGENCY MEDICINE (急救医学) 2区 |
2/26 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
152 | 139 | 13 |
引文计数(2018)
文献(2015-2017)
1809次引用
1201篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Emergency Medicine
|
#12/77
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研究方向:急救 急性胸痛
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审稿时间: 2个月内 接受率: 比较困难(25%命中)
影响因子:43.474
ISSN:1074-7613
研究方向:医学-免疫学
影响因子:2.957
ISSN:0891-6934
研究方向:医学-免疫学
影响因子:3.152
ISSN:0171-2985
研究方向:医学-免疫学
影响因子:4.04
ISSN:1750-743X
研究方向:医学-免疫学
影响因子:3.594
ISSN:1471-2172
研究方向:医学-免疫学
影响因子:2.211
ISSN:0198-8859
研究方向:医学-免疫学
影响因子:31.25
ISSN:1529-2908
研究方向:医学-免疫学
影响因子:4.23
ISSN:0165-2478
研究方向:医学-免疫学
影响因子:8.701
ISSN:1933-0219
研究方向:医学-免疫学
发表一篇学和医学成像类SCI论文
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