Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-18T19:59:55.714Z Has data issue: false hasContentIssue false
  • English
  • Français

Abdominal pain: a survey of clinically important outcomes for future research

Published online by Cambridge University Press:  21 May 2015

Angela M. Mills ,
Anthony J. Dean ,
Judd E. Hollander  and
Esther H. Chen
Angela M. Mills*
Affiliation:
Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pa.
Anthony J. Dean
Affiliation:
Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pa.
Judd E. Hollander
Affiliation:
Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pa.
Esther H. Chen
Affiliation:
Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pa.
*
Department of Emergency Medicine, University of Pennsylvania, 3400 Spruce St., Philadelphia PA 19104; [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

We aimed to use the consensus opinion of a group of expert emergency physicians to derive a set of emergency diagnoses for acute abdominal pain that might be used as clinically significant outcomes for future research.

Methods:

We conducted a cross-sectional survey of a convenience sample of emergency physicians with expertise in abdominal pain. These experts were authors of textbook chapters, peer-reviewed original research with a focus on abdominal pain or widely published clinical guidelines. Respondents were asked to categorize 50 possible diagnoses of acute abdominal pain into 1 of 3 categories: 1) unacceptable not to diagnose on the first emergency department (ED) visit; 2) although optimal to diagnose on first visit, failure to diagnose would not be expected to have serious adverse consequences provided the patient had follow-up within the next 2–7 days; 3) if not diagnosed during the first visit, unlikely to cause long-term risk to the patient provided the patient had follow-up within the next 1–2 months. Standard descriptive statistical analysis was used to summarize survey data.

Results:

Thirty emergency physicians completed the survey. Of 50 total diagnoses, 16 were categorized as “unacceptable not to diagnose in the ED” with greater than 85% agreement, and 12 were categorized as “acceptable not to diagnose in the ED” with greater than 85% agreement.

Conclusion:

Our study identifies a set of abdominal pain conditions considered by expert emergency physicians to be clinically important to diagnose during the initial ED visit. These diseases may be used as “clinically significant” outcomes for future research on abdominal pain.

Keywords

abdominal painemergency department
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 12 , Issue 6 , September 2010 , pp. 485 - 490
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

References

REFERENCES

1.Pitts, SR, Niska, RW, Xu, J, et al. National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. Natl Health Stat Report 2008;(7):1–38.Google ScholarPubMed
2.Nagurney, JT, Brown, DF, Chang, Y, et al. Use of diagnostic testing in the emergency department forpatients presenting with non-traumatic abdominal pain. J Emerg Med 2003;25:363–71.Google Scholar
3.Clinicalpolicy: critical issues for the initial evaluation and management of patients presenting with a chief complaint of nontraumatic acute abdominal pain. Ann Emerg Med 2000; 36:406–15.Google Scholar
4.Hollander, JE, Blomkalns, AL, Brogan, GX, et al. Standardized reporting guidelines for studies evaluating risk stratification of emergency department patients with potential acute coronary syndromes. Ann Emerg Med 2004;44:589–98.Google Scholar
5.Cannon, CP, Battler, A, Brindis, RG, et al. American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes. A report of the American College of Cardiology Task Force on Clinical Data Standards (Acute Coronary Syndromes Writing Committee). J Am Coll Cardiol 2001;38:2114–30.Google Scholar
6.Stiell, IG, Greenberg, GH, Wells, GA, et al. Derivation of a decision rule for the use of radiography in acute knee injuries. Ann Emerg Med 1995;26:405–13.Google Scholar
7.Stiell, IG, Wells, GA, Vandemheen, KL, et al. The Canadian C-spine Rule for radiography in alert and stable trauma patients. JAMA 2001;286:1841–8.Google Scholar
8.Gerhardt, RT, Nelson, BK, Keenan, S, et al. Derivation of a clinical guideline for the assessment of nonspecific abdominal pain: the Guideline for Abdominal Pain in the ED Setting ((GAPEDS) Phase 1 Study. Am J Emerg Med 2005;23:709–17.Google Scholar