1 / 23

Diagnostics in EM; test thresholds and likelihood ratios

This resource from the CEM FOAMed Network explores the importance of test thresholds and likelihood ratios in emergency medicine diagnostics. It discusses how every patient assessment involves testing, emphasizing the significance of appropriate testing above and below defined thresholds. The content addresses the likelihood of correct diagnoses at various thresholds, the implications of negative and positive likelihood ratios, and the role of factors like cardiac risk in diagnosis. Ultimately, it seeks to improve patient outcomes through informed testing decisions.

teo
Télécharger la présentation

Diagnostics in EM; test thresholds and likelihood ratios

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Diagnostics in EM; test thresholds and likelihood ratios Published courtesy of the CEM FOAMed Network http://www.cemfoamed.co.uk/portfolio/diagnostics-in-em/

  2. Everything we do in a patient assessment is a testIncluding questions we ask

  3. Test thresholds

  4. Within the test thresholds; appropriate testing

  5. Below a test threshold;more likely to harm than help a patient by testing

  6. Above a test threshold; more likely to harm than help a patient by testing

  7. Within a test threshold;appropriate testing

  8. How do we use all of this information?? 100 % Likelihood of diagnosis being correct Diagnosis considered Below test threshold 0%

  9. How do we use all of this information?? 100 % Above test threshold Likelihood of diagnosis being correct Diagnosis considered 0%

  10. How do we use all of this information?? 100 % Above test threshold Appropriate testing Likelihood of diagnosis being correct Diagnosis considered Below test threshold 0%

  11. Likelihood ratios

  12. Positive Likelihood ratio;a high number is powerful>>1

  13. Negative Likelihood ratio;a small number is powerful<< 1

  14. Fagan’s nomogram

  15. Application of serial tests 100 % Finding 3 Above test threshold Finding 2 Likelihood of diagnosis being correct Finding 1 Diagnosis considered Below test threshold 0%

  16. Correct testingCorrect testCorrect circumstanceCorrect patient

  17. Perry et al. Sensitivity of coputed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. BMJ 2011; 343:d4277 doi. 10.1136/bmj.d4277

  18. Han et al., The Role of Cardiac Risk Factor Burden in Diagnosing Acute Coronary Syndromes in the Emergency Department Setting. Ann Emerg Med. 2007; 49

  19. Who not to test 100 % Likelihood of diagnosis being correct Diagnosis considered Below test threshold 0%

  20. Who not to test but to treat 100 % Above test threshold Likelihood of diagnosis being correct Diagnosis considered 0%

  21. Who should be tested 100 % Appropriate testing Likelihood of diagnosis being correct Diagnosis considered 0%

  22. Correct testingCorrect testCorrect circumstanceCorrect patient

More Related