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Section 1 - Decision-Making

Published online by Cambridge University Press:  14 March 2025

Alex Koyfman
Affiliation:
University of Texas Southwestern Medical Center
Brit Long
Affiliation:
San Antonio Military Medical Center
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Emergency Medicine Thinker
Pearls for the Frontlines
, pp. 3 - 138
Publisher: Cambridge University Press
Print publication year: 2025

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References

Lovell, O. Sweller’s Cognitive Load Theory in Action. Woodbridge: John Catt Educational. 2020.Google Scholar
Duke, A, Sunstein, CR. Freerolls. SSRN. 2020. https://ssrn.com/abstract=3658663.CrossRefGoogle Scholar
Hammond, JS, Keeney, RL, Raffia, H. Even swaps: A rational method for making trade-offs. Harv Bus Rev. 1998. https://hbr.org/1998/03/even-swaps-a-rational-method-for-making-trade-offs.Google Scholar
Hammond, NE, Zampieri, FG, Di Tanna, GL, et al. Balanced crystalloids versus saline in critically ill adults – a systematic review with meta-analysis. NEJM Evid. 2022;1(2). https://evidence.nejm.org/doi/full/10.1056/EVIDoa2100010.CrossRefGoogle ScholarPubMed

References

Definition of Emergency Medicine. Ann Emerg Med. 2016 Jul;68(1):142–3. https://doi.org/10.1016/j.annemergmed.2016.04.040. PMID: 27343657.Google Scholar
Dundes, L, Streiff, MB, Dundes, A. “When you hear hoofbeats, think horses, not zebras”: A folk medical diagnostic proverb. Proverbium. 16(1999): 95104.Google Scholar
Sandberg, S. Best Evidence in Emergency Medicine Conference. 2014.Google Scholar
Cairns, C, Ashman, JJ, Kang, K. Emergency Department visit rates by selected characteristics: United States, 2018. NCHS Data Brief. 2021 Mar;(401):1–8. PMID: 33814037.Google Scholar
Wang, Y, Ruhe, G. The cognitive process of decision making. Int J Cogn Inform Natural Intell. 2007 Apr–Jun;1(2):73+. Gale Academic OneFile. https://go.gale.com/ps/i.do?p=AONE&u=anon~8371a6b5&id=GALE|A172437612&v=2.1&it=r&sid=googleScholar&asid=cf7d4578 (last accessed 11/2/23).CrossRefGoogle Scholar
Kyriacou, DN. Evidence-based medical decision making: deductive versus inductive logical thinking. Acad Emerg Med. 2004 Jun;11(6):670–1. PMID: 15175207.CrossRefGoogle ScholarPubMed
Redinger, JW, Heppe, DB, Albert, TJ, et al. What internal medicine attendings talk about at morning report: A multicenter study. BMC Med Educ. 2023;23:article 84. https://doi.org/10.1186/s12909-023-04057-y.CrossRefGoogle ScholarPubMed
Evans, JS. In two minds: Dual-process accounts of reasoning. Trends Cogn Sci. 2003 Oct;7(10):454–9. https://doi.org/10.1016/j.tics.2003.08.012. PMID: 14550493.CrossRefGoogle ScholarPubMed
Norman, GR, Monteiro, SD, Sherbino, J, et al. The causes of errors in clinical reasoning: Cognitive biases, knowledge deficits, and dual process thinking. Acad Med. 2017 Jan;92(1):2330. https://doi.org/10.1097/ACM.0000000000001421. PMID: 27782919.CrossRefGoogle ScholarPubMed
Pusic, MV, Hall, E, Billings, H, et al. Educating for adaptive expertise: Case examples along the medical education continuum. Adv Health Sci Educ. 2022; 27:1383–400. https://doi-org.laneproxy.stanford.edu/10.1007/s10459-022-10165-z.CrossRefGoogle ScholarPubMed
Dreyfus, SE, Dreyfus, HL. A Five-Stage Model of the Mental Activities Involved in Directed Skill Acquisition. February 1980. Washington, DC: Storming Media. https://apps.dtic.mil/sti/pdfs/ADA084551.pdf (last accessed 11/2/23).CrossRefGoogle Scholar
Accreditation Council for Graduate Medical Education. Clinical Competency Committees: A Guidebook for Programs, 3rd ed. 2020. www.acgme.org/globalassets/acgmeclinicalcompetencycommitteeguidebook.pdf (last accessed 11/2/23).Google Scholar
Branzetti, J, Gisondi, MA, Hopson, LR, Regan, L. Adaptive expertise: The optimal outcome of emergency medicine training. AEM Educ Train. 2022 Apr 1;6(2):e10731. https://doi.org/10.1002/aet2.10731. PMID: 35368500; PMCID: PMC8908303.CrossRefGoogle ScholarPubMed
Branzetti, J, Commissaris, C, Croteau, C, et al. The best laid plans? A qualitative investigation of how resident physicians plan their learning. Acad Med. 2022 Nov 1;97(11):1691–8. https://doi/.org/10.1097/ACM.0000000000004751. Epub 2022 May 24. PMID: 35612927.CrossRefGoogle Scholar
Cutrer, WB, Miller, B, Pusic, MV, et al. Fostering the development of master adaptive learners: A conceptual model to guide skill acquisition in medical education. Acad Med. 2017 Jan;92(1):70–5. https://doi.org/10.1097/ACM.0000000000001323. PMID: 27532867.CrossRefGoogle ScholarPubMed
Branzetti, J, Hopson, L, Gisondi, M, Regan, L. Training for adaptive expertise: Why, what, and how. Acad Med. 2024 Jan;99 (1):121. https://doi.org/10.1097/ACM.0000000000005217.CrossRefGoogle Scholar

References

Cadogan, M, Thoma, B, Chan, TM, Lin, M. Free Open Access Meducation (FOAM): the rise of emergency medicine and critical care blogs and podcasts (2002–2013). Emerg Med J. 2014 Oct;31(e1):e76–7. https://doi.org/10.1136/emermed-2013-203502. Epub 2014 Feb 19. PMID: 24554447.CrossRefGoogle ScholarPubMed
van Oosterhout, REM, de Boer, AR, Maas AHEM, et al. Sex differences in symptom presentation in acute coronary syndromes: a systematic review and meta-analysis. J Am Heart Assoc. 2020 May 5;9(9):e014733. https://doi.org/10.1161/JAHA.119.014733. Epub 2020 May 4. PMID: 32363989; PMCID: PMC7428564.CrossRefGoogle ScholarPubMed
Cole, MA, Maldonado, N. Evidence-based management of suspected appendicitis in the emergency department. Emerg Med Pract. 2011 Oct;13(10):129; quiz 29. PMID: 22164515.Google ScholarPubMed
Howell, JM, Eddy, OL, Lukens, TW, et al. Clinical policy: Critical issues in the evaluation and management of emergency department patients with suspected appendicitis. Ann Emerg Med. 2010 Jan;55(1):71116. https://doi.org/10.1016/j.annemergmed.2009.10.004. PMID: 20116016.CrossRefGoogle ScholarPubMed
Hsiao, CT, Chang, CP, Huang, TY, Chen, YC, Fann, WC. Prospective validation of the laboratory risk indicator for necrotizing fasciitis (LRINEC) score for necrotizing fasciitis of the extremities. PLoS One. 2020 Jan 24;15(1):e0227748. https://doi.org/10.1371/journal.pone.0227748. Erratum in: PLoS One. 2022 Jun 24;17(6):e0270726. PMID: 31978094; PMCID: PMC6980593.CrossRefGoogle ScholarPubMed

References

Cairns, C, Ashman, JJ, Kang, K. Emergency department visit rates by selected characteristics: United States, 2018. NCHS Data Brief. 2021 Mar;(401):18.Google Scholar
Kelen, GD, Wolfe, R, D’Onofrio, G, et al. Emergency department crowding: the canary in the health care system. NEJM Catalyst Innov Care Deliv. 2021;2(5).Google Scholar
Fatovich, DM. The time paradox of emergency medicine: another inverted U curve. Emerg Med Australas. 2017;29(6):730–2.CrossRefGoogle ScholarPubMed
Croskerry, P. A universal model of diagnostic reasoning. Acad Med. 2009 Aug;84(8):1022–8.CrossRefGoogle ScholarPubMed
Kahneman, D. Thinking, Fast and Slow. New York: Farrar, Straus and Giroux. 2011.Google Scholar
De Neys, W. Dual processing in reasoning: two systems but one reasoner. Psychol Sci. 2006 May;17(5):428–33.Google ScholarPubMed
Jones, R. Think twice. Br J Gen Pract. 2017 Dec;67(665):539.CrossRefGoogle ScholarPubMed
Fuks, A, Boudreau, JD, Cassell, EJ. Teaching clinical thinking to first-year medical students. Med Teach. 2009 Feb;31(2):105–11.CrossRefGoogle ScholarPubMed
Daniel, M, Carney, M, Khandelwal, S, et al. Cognitive debiasing strategies: a faculty development workshop for clinical teachers in emergency medicine. MedEdPORTAL. 2017 Oct 23;13:10646.CrossRefGoogle ScholarPubMed
Love, S, Bleacher, J. Crew roles and interactions in scientific space exploration. Acta Astronaut. 2013 Oct;90(2):318–31.CrossRefGoogle Scholar

References

Schreyer, KE, Kuhn, D, Norton, V , American Academy of Emergency Medicine Board of Directors. Physician productivity and supervision. West J Emerg Med. 2023 May 9;24(3):372–6. https://doi.org/10.5811/westjem.60876. PMID: 37278799; PMCID: PMC10284533.CrossRefGoogle ScholarPubMed
Schwartz, X, Porter, B, Gilbert, MP, et al. Emergency department management of uncomplicated hyperglycemia in patients without history of diabetes. J Emerg Med. 2023 Aug;65(2):e8192. https://doiorg/10.1016/j.jemermed.2023.04.018. Epub 2023 Apr 26. PMID: 37474343.CrossRefGoogle ScholarPubMed
Code of Ethics for Emergency Physicians. Ann Emerg Med. 2017 Jul;70(1):e715. https://doi.org/10.1016/j.annemergmed.2017.03.032. PMID: 28645421.CrossRefGoogle Scholar
Murthy, VK, Boscardin, C, Cumbler, E, et al. Learning from the early careers of master clinicians. J Eval Clin Pract. 2024 Feb;30(1):129–36. https://doi.org/10.1111/jep.13906. Epub 2023 Aug 9. PMID: 37555473.CrossRefGoogle ScholarPubMed
Lentz, S, Weisman, A, Ship, J, Siket, MS. A case for lifelong learning in emergency medicine: the perspective from a rural state. AEM Educ Train. 2023 Mar 26;7(2):e10860. https://doi.org/10.1002/aet2.10860. PMID: 36994317; PMCID: PMC10041066.CrossRefGoogle Scholar

References

Ly, DP, Shekelle, PG, Song, Z. Evidence for anchoring bias during physician decision-making. JAMA Intern Med. 2023;183(8):818–23. https://doi.org/10.1001/jamainternmed.2023.2366.CrossRefGoogle ScholarPubMed
Young, JQ, Van Merrienboer, J, Durning, S, Ten Cate, O. Cognitive load theory: implications for medical education: AMEE Guide No. 86.Med Teach. 2014;36(5):371–84. https://doi.org/10.3109/0142159X.2014.889290.CrossRefGoogle Scholar
Newman-Toker, DE, Peterson, SM, Badihian, S, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2022. https://doi.org/10.23970/AHRQEPCCER258.CrossRefGoogle ScholarPubMed
Hartigan, S, Brooks, M, Hartley, S, et al. Review of the basics of cognitive error in emergency medicine: still no easy answers. West J Emerg Med. 2020;21(6). https://doi.org/10.5811/westjem.2020.7.47832.CrossRefGoogle Scholar

References

Rubin, R. The costs of US emergency department visits. JAMA. 2021;325(4):333.Google ScholarPubMed
Smulowitz, PB, Honigman, L, Landon, BE. A novel approach to identifying targets for cost reduction in the emergency department. Ann Emerg Med. 2013;61(3):293300. https://doi.org/10.1016/j.annemergmed.2012.05.042.CrossRefGoogle ScholarPubMed
Fatovich, DM. The time paradox of emergency medicine: another inverted U curve. Emerg Med Australas. 2017;29(6):730–2. https://doi.org/10.1111/1742-6723.12847.CrossRefGoogle ScholarPubMed
Kelen, GD, Wolfe, R, D’Onofrio, G, et al. Emergency department crowding: the canary in the health care system. NEJM Catalyst Innov Care Deliv. 2021;2(5).Google Scholar
Kostopoulou, O, Delaney, BC, Munro, CW. Diagnostic difficulty and error in primary care – a systematic review. Fam Pract. 2008;25(6):400–13. https://doi.org/10.1093/fampra/cmn071.CrossRefGoogle ScholarPubMed
Koslowski, D, Huchinson, M, Hurley, J, Rowley, J, Sutherland, J. The role of emotion in clinical decision making: an integrative literature review. BMC Med Educ. 2017;17:255.CrossRefGoogle Scholar
Ferguson, B, Geralds, J, Petrey, J, Huecker, M. Malpractice in emergency medicine – a review of risk and mitigation practices for the emergency medicine provider. J Emerg Med. 2018;55(5):659–65.CrossRefGoogle Scholar
Gordon, R, Franklin, N. Cognitive underpinnings of diagnostic error. Acad Med. 2003;78:782.CrossRefGoogle ScholarPubMed
Croskerry, P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. 2003;78:775–80.CrossRefGoogle Scholar
Thampy, H, Willert, E, Ramani, S. Assessing clinical reasoning: targeting the higher levels of the pyramid. J Gen Intern Med. 2019;34(8):1631–6.CrossRefGoogle ScholarPubMed
Kupersmith, J. Quality of care in teaching hospitals: a literature review. Acad Med. 2005;80(5):458–66.CrossRefGoogle ScholarPubMed

References

Wolfson, AB, Cloutier, RL, Hendey, GW, et al. (eds.). Harwood-Nuss’ Clinical Practice of Emergency Medicine: Sixth Edition. Philadelphia, PA: Wolters Kluwer Health Adis (ESP), 2014.Google Scholar
Al-Azri, NH. How to think like an emergency care provider: a conceptual mental model for decision making in emergency care. Int J Emerg Med. 2020;13:17.CrossRefGoogle Scholar
Wofford, JL. Clinical inertia. Ann Intern Med. 2002;137:547–8.CrossRefGoogle ScholarPubMed
Phillips, LS Branch, WT, Cook, CB, et al. Clinical inertia. Ann Intern Med. 2001;135:825–34.CrossRefGoogle ScholarPubMed
Owens, P, Elixhauser, A. Hospital Admissions That Began in the Emergency Department, 2003. Statistical Brief #1: February 2006. Rockville, MD: Agency for Healthcare Research and Quality. www.hcup-us.ahrq.gov/reports/statbriefs/sb1.pdf.Google ScholarPubMed
Fernando, SM, Rochwerg, B, Reardon, PM, et al. Emergency Department disposition decisions and associated mortality and costs in ICU patients with suspected infection. Crit Care. 2018;22:172.CrossRefGoogle ScholarPubMed
Dawson, H, Weerasooriya, J, Webster, G. Hospital admissions via the emergency department: implications for planning and patient flow. Healthc Q. 2008;11:20–2.Google ScholarPubMed
Jahan, R, Saver, JL, Schwamm, LH, et al. Association between time to treatment with endovascular reperfusion therapy and outcomes in patients with acute ischemic stroke treated in clinical practice. JAMA. 2019;322:252–63.CrossRefGoogle ScholarPubMed
Mainz, J, Andersen, G, Valentin, JB, et al. Treatment delays and chance of reperfusion therapy in patients with acute stroke: a Danish nationwide study. Cerebrovasc Dis. 2023;52:275–82.CrossRefGoogle ScholarPubMed
Out-of-Hospital Cardiac Arrest Surveillance – Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005–December 31, 2010. www.cdc.gov/mmwr/preview/mmwrhtml/ss6008a1.htm.Google Scholar
Balan, P, Hsi, B, Thangam, M, et al. The cardiac arrest survival score: a predictive algorithm for in-hospital mortality after out-of-hospital cardiac arrest. Resuscitation. 2019;144:4653.CrossRefGoogle Scholar
Chan, PS, Krumholz, HM, Nichol, G, Nallamothu, BK. Delayed time to defibrillation after in-hospital cardiac arrest. N Engl J Med. 2008;358:917.CrossRefGoogle ScholarPubMed
Fatovich, DM. The time paradox of emergency medicine: another inverted U curve. Emerg Med Australas. 2017;29:730–2.CrossRefGoogle ScholarPubMed
Fatovich, DM. The inverted U curve and emergency medicine: overdiagnosis and the law of unintended consequences. Emerg Med Australas. 2016;28:480–2.CrossRefGoogle ScholarPubMed
Center for Health Statistics, N. National Hospital Ambulatory Medical Care Survey: 2021 Emergency Department Summary Tables. (2021). www.cdc.gov/nchs/data/nhamcs/web_tables/2021-nhamcs-ed-web-tables-508.pdf.Google Scholar
Cwinn, MA, Foster, AJ, Cwinn, AA, et al. Prevalence of information gaps for seniors transferred from nursing homes to the emergency department. CJEM. 2009;11:462–72.CrossRefGoogle ScholarPubMed
Stiell, A, Forster, AJ, Stiell, IG, Van Walraven, C. Prevalence of information gaps in the emergency department and the effect on patient outcomes. CMAJ. 2003;169:1023.Google ScholarPubMed
Shah, R, Della Porta, A, Lang, S, et al. A scoping review of current social emergency medicine research. West J Emerg Med. 2021;22:1360–8.CrossRefGoogle ScholarPubMed
Samuels-Kalow, ME, Ciccolo, GE, Lin, MP, Schoenfeld, EM, Camargo, CA. The terminology of social emergency medicine: measuring social determinants of health, social risk, and social need. J Am Coll Emerg Physicians Open. 2020;1:852–6.Google ScholarPubMed
Anderson, ES, Lippert, S, Newberry, J, et al. Addressing social determinants of health from the emergency department through social emergency medicine. West J Emerg Med. 2016;17:487–9.CrossRefGoogle ScholarPubMed
Cornell, PY, Halladay, CW, Ader, J, et al. Embedding social workers in Veterans Health Administration primary care teams reduces emergency department visits. Health Aff (Millwood). 2020;39:603–12.CrossRefGoogle ScholarPubMed
Rehman, T, Pidgeon, H, Chimileski, B, Parker, S, Hsieh, D. Scoping review: medical education interventions optimizing social workers in the emergency department. West J Emerg Med. 2022;24:201–5.CrossRefGoogle ScholarPubMed
Brown, JN, Barnes, CL, Beasley, B, et al. Effect of pharmacists on medication errors in an emergency department. Am J Health Syst Pharm. 2008;65:330–3.CrossRefGoogle ScholarPubMed
Pérez-Moreno, MA, Rodríguez-Camacho, JM, Calderón-Hernanz, B, Comas-Díaz, B, Tarradas-Torras, J. Clinical relevance of pharmacist intervention in an emergency department. Emerg Med J. 2017;34:495501.CrossRefGoogle ScholarPubMed
Weant, KA, Humphries, RL, Hite, K, Armitstead, JA. Effect of emergency medicine pharmacists on medication-error reporting in an emergency department. Am J Health Syst Pharm. 2010;67:1851–5.CrossRefGoogle ScholarPubMed
Abar, B, Holub, A, Hong, S, Aaserude, E, DeRienzo, V. Latent class analysis of barriers to care among emergency department patients. West J Emerg Med. 2019;20:256–61.CrossRefGoogle ScholarPubMed
Naderi, S, Barnett, B, Hoffman, RS, et al. Factors associated with failure to follow-up at a medical clinic after an ED visit. Am J Emerg Med. 2012;30:347–51.CrossRefGoogle Scholar
Taylor, T, Salyakina, D. Health care access barriers bring children to emergency rooms more frequently: a representative survey. Popul Health Manag. 2019;22:262–71.CrossRefGoogle ScholarPubMed
Lin, MP, Burke, RC, Orav, EJ, Friend, TH, Burke, LG. Ambulatory follow-up and outcomes among medicare beneficiaries after emergency department discharge. JAMA Netw Open. 2020;3:e2019878.CrossRefGoogle ScholarPubMed
Rust, G, Ye, J, Baltrus, P, et al. Practical barriers to timely primary care access: impact on adult use of emergency department services. Arch Intern Med. 2008;168:1705–10.CrossRefGoogle ScholarPubMed
Hautz, WE, Sauter, TC, Hautz, SC, et al. What determines diagnostic resource consumption in emergency medicine: patients, physicians or context? Emerg Med J. 2020;37:546–51.CrossRefGoogle ScholarPubMed

References

Fagan, TJ. Letter: Nomogram for Bayes’s theorem. N Engl J Med. 1975;293(5):257. https://doi.org/10.1056/NEJM197507312930513Google ScholarPubMed
Akobeng, AK. Understanding diagnostic tests 2: likelihood ratios, pre- and post-test probabilities and their use in clinical practice. Acta Paediatr. 2007;96(4):487–91. https://doi.org/10.1111/J.1651-2227.2006.00179.X.CrossRefGoogle ScholarPubMed
Doran, FS. The clinical application of Bayes’ theorem. Lancet. 1967;2(7521):887. https://doi.org/10.1016/S0140-6736(67)92614-1.CrossRefGoogle ScholarPubMed
Hall, GH. The clinical application of Bayes’ theorem. Lancet. 1967;2(7515):555–7. https://doi.org/10.1016/S0140-6736(67)90514-4.Google ScholarPubMed
Simel, D, Rennie, D. The Rational Clinical Examination: Evidence-Based Clinical Diagnosis. McGraw Hill; 2009.Google Scholar
Yeh, B. Does This Adult Patient Have Appendicitis? Ann Emerg Med. 2008;52(3):301–3. doi:10.1016/j.annemergmed.2007.10.023.CrossRefGoogle ScholarPubMed

References

Zink, B Anyone, Anything, Anytime: A History of Emergency Medicine. Maryland Heights, MO: Mosby, Inc., 2006.Google Scholar
Newman-Toker, D, Peterson, SM, Bahidian, S, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Comparative Effectiveness Review, No. 258. Rockville, MD: Agency for Healthcare Research and Quality (US). 2022 Dec. Report No.: 22(23)-EHC043.CrossRefGoogle Scholar
Kelen, GD, Kaji, AM, Consortium of Societies of Emergency Medicine. The AHRQ report on diagnostic errors in the emergency department: the wrong answer to the wrong question. Ann Emerg Med. 2023 Sept;82(3):336–40.CrossRefGoogle Scholar
Bosk, CL. Forgive and Remember: Managing Medical Failure. 2nd ed. Chicago, IL: The University of Chicago Press, 2003.CrossRefGoogle Scholar
Hadsall, RS, Sargent, LJ. Disease state management. J Manag Care Spec Pharm 2020 Feb;26(2):8590.Google ScholarPubMed
TriageGO. The use of AI to support better clinical decision-making in emergency medicine. November 9, 2023. www.healthcareitnews.com/news/use-ai-support-better-clinical-decision-making-emergency-medicine.Google Scholar
Wachter, RM, Brynjolfsson, E. Will generative artificial intelligence deliver on its promise in health care. JAMA. 2024;331(1): 65–9.CrossRefGoogle ScholarPubMed

References

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Suspected Non-ST-Elevation Acute Coronary Syndromes; Tomaszewski, CA, Nestler, D, et al. Clinical policy: critical issues in the evaluation and management of emergency department patients with suspected non-ST-elevation acute coronary syndromes. Ann Emerg Med. 2018;72:e65106.CrossRefGoogle ScholarPubMed
Than, MP, Herbert, M, Flaws, D, et al. What is an acceptable risk of major adverse cardiac event in chest pain patients soon after discharge from the Emergency Department? A clinical survey. Int J Cardiol. 2013;166(3):752–4.CrossRefGoogle Scholar
Weinstock, MD, Pallaci, M, Mattu, A, et al. Most clinicians are still not comfortable sending chest pain patients home with a very low risk of 30-day major adverse cardiac event (MACE). J Urgent Care Med. 2021; 15(5):1721.Google Scholar
Kuppermann, N, Holmes, JF, Dayan, PS, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study Lancet. 2009;374(9696):1160–70. https://doi.org/10.1016/S0140-6736(09)61558-0 [published correction appears in Lancet. 2014 Jan 25;383(9914):308].CrossRefGoogle ScholarPubMed
Schonfeld, D, Bressan, S, Da Dalt, L, et al. Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice. Arch Dis Child. 2014;99(5):427–31. https://doi.org/10.1136/archdischild-2013-305004.CrossRefGoogle ScholarPubMed
Kline, JA, Mitchell, AM, Kabrhel, C, Richman, PB, Courtney, DM. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost. 2004;2(8):1247–55. https://doi.org/.10.1111/j.1538-7836.2004.00790.x.CrossRefGoogle ScholarPubMed
Kline, JA, Courtney, DM, Kabrhel, C, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost. 2008;6(5):772–80. https://doi.org/10.1111/j.1538-7836.2008.02944.x.CrossRefGoogle ScholarPubMed
James, JT. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Saf. 2013;9(3):122–8.CrossRefGoogle ScholarPubMed
Ong, S, Nakase, J, Moran, GJ, et al. Antibiotic use for emergency department patients with upper respiratory infections: prescribing practices, patient expectations, and patient satisfaction. Ann Emerg Med. 2007;50(3):213–20. https://doi.org/10.1016/j.annemergmed.2007.03.026.CrossRefGoogle ScholarPubMed
Fenton, JJ, Jerant, AF, Bertakis, KD, Franks, P. The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med. 2012;172(5):405–11. https://doi.org/10.1001/archinternmed.2011.1662.CrossRefGoogle ScholarPubMed
Weinstock, MB, Mattu, A, Hess, EP. How do we balance the long-term health of a patient with the short-term risk to the physician? J Emerg Med. 2017;53(4):583–5. https://doi.org/10.1016/j.jemermed.2017.06.010.CrossRefGoogle ScholarPubMed
Weinstock, MB, Finnerty, NM, Pallaci, M. Time to move on: redefining chest pain outcomes. J Am Heart Assoc. 2019;8(12):e012542. https://doi.org/10.1161/JAHA.119.012542.CrossRefGoogle ScholarPubMed
Alter, SM, Eskin, B, Allegra, JR. Diagnosis of aortic dissection in emergency department patients is rare. West J Emerg Med. 2015;16(5):629–31. https://doi.org/10.5811/westjem.2015.6.25752.CrossRefGoogle ScholarPubMed
Ohle, R, Mc Isaac, S, Perry, JJ. A simple intervention to reduce your chance of missing an acute aortic dissection. CJEM. 2019;21(5):618–21. https://doi.org/10.1017/cem.2019.1.CrossRefGoogle ScholarPubMed
Sakhnini, A, Bisharat, N. Practice behavior of emergency department physicians caring for patients with chest pain. Am J Emerg Med. 2019;37(6):1210–2. https://doi.org/10.1016/j.ajem.2018.11.039.CrossRefGoogle ScholarPubMed
Pines, JM, Isserman, JA, Szyld, D, et al. The effect of physician risk tolerance and the presence of an observation unit on decision making for ED patients with chest pain. Am J Emerg Med. 2010;28(7):771–9. https://doi.org/10.1016/j.ajem.2009.03.019.CrossRefGoogle ScholarPubMed
Mulrow, C, Lucey, C, Farnett, L. Discriminating causes of dyspnea through the clinical examination. J Gen Intern Med. 1993;8:383–92.CrossRefGoogle Scholar
Hickson, GB, Federspiel, CF, Pichert, JW, et al. Patient complaints and malpractice risk. JAMA. 2002;287(22):2951–7. https://doi.org/10.1001/jama.287.22.2951.CrossRefGoogle ScholarPubMed
Lin, GA, Redberg, RF. Addressing overuse of medical services one decision at a time. JAMA Intern Med. 2015;175(7):1092–3. https://doi.org/10.1001/jamainternmed.2015.1693.CrossRefGoogle ScholarPubMed
Jena, AB, Seabury, S, Lakdawalla, D, Chandra, A. Malpractice risk according to physician specialty. N Engl J Med. 2011;365(7):629–36. https://doi.org/10.1056/NEJMsa1012370.CrossRefGoogle ScholarPubMed
Seabury, SA, Chandra, A, Lakdawalla, DN, Jena, AB. On average, physicians spend nearly 11 percent of their 40-year careers with an open, unresolved malpractice claim. Health Aff (Millwood). 2013;32(1):111–9.CrossRefGoogle ScholarPubMed
Carlson, JN, Foster, KM, Pines, JM, et al. Provider and practice factors associated with emergency physicians’ being named in a malpractice claim. Ann Emerg Med. 2018;71(2):157–64. https://doi.org/10.1016/j.annemergmed.2017.06.023 https://doi.org/10.1016/j.annemergmed.2017.06.023.CrossRefGoogle Scholar
Wong, KE, Parikh, PD, Miller, KC, Zonfrillo, MR. Emergency department and urgent care medical malpractice claims 2001–15. West J Emerg Med. 2021;22(2):333–8. https://doi.org/10.5811/westjem.2020.9.48845.CrossRefGoogle ScholarPubMed
Kanzaria, HK, Hoffman, JR, Probst, MA, et al. Emergency physician perceptions of medically unnecessary advanced diagnostic imaging. Acad Emerg Med. 2015;22(4):390–8. https://doi.org/10.1111/acem.12625.CrossRefGoogle ScholarPubMed
Studdert, DM, Mello, MM, Sage, WM, et al. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA. 2005;293(21):2609–17. https://doi.org/10.1001/jama.293.21.2609.CrossRefGoogle Scholar
Wassie, M, Lee, MS, Sun, BC, et al. Single vs serial measurements of cardiac troponin level in the evaluation of patients in the emergency department with suspected acute myocardial infarction. JAMA Netw Open. 2021;4(2):e2037930. https://doi.org/10.1001/jamanetworkopen.2020.37930.CrossRefGoogle ScholarPubMed
Backus, BE, Body, R, Weinstock, MB. Troponin testing in the emergency department – when 2 become 1. JAMA Netw Open. 2021;4(2):e210329. https://doi.org/10.1001/jamanetworkopen.2021.0329.CrossRefGoogle ScholarPubMed
Probst, MA, Kanzaria, HK, Schoenfeld, EM, et al. Shared decision making in the emergency department: a guiding framework for clinicians. Ann Emerg Med. 2017;70(5):688–95. https://doi.org/10.1016/j.annemergmed.2017.03.063.CrossRefGoogle ScholarPubMed

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  • Decision-Making
  • Edited by Alex Koyfman, University of Texas Southwestern Medical Center, Brit Long, San Antonio Military Medical Center
  • Book: Emergency Medicine Thinker
  • Online publication: 14 March 2025
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  • Decision-Making
  • Edited by Alex Koyfman, University of Texas Southwestern Medical Center, Brit Long, San Antonio Military Medical Center
  • Book: Emergency Medicine Thinker
  • Online publication: 14 March 2025
Available formats
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  • Decision-Making
  • Edited by Alex Koyfman, University of Texas Southwestern Medical Center, Brit Long, San Antonio Military Medical Center
  • Book: Emergency Medicine Thinker
  • Online publication: 14 March 2025
Available formats
×