Notice bibliographique
Résumé
ultrasound: ultrasoundFigureWhen I saw the hubbub online regarding the recent statement on POCUS published by the Canadian Association of Radiologists, I thought the publication date must have been a typo: It was listed as August 2019 when surely it must have been August 1999. (Can Assoc Radiol J. 2019;70[3]:219; http://bit.ly/2NiS6Dd.) This paper makes multiple statements that are lacking appropriate references or lacking references altogether. The association stated that “inappropriate use of ultrasound by undertrained physicians has resulted in increased patient harm” with no citation at all. The radiologists also didn't mention hundreds of studies that have demonstrated the benefits of POCUS and the abilities of non-radiologists to use it. The underlying problem of this statement, however, is that an ultrasound is an ultrasound to the association. In other words, POCUS should be viewed as any other ultrasound and subjected to the same standards as radiology-performed scans. This is wishfully simplistic. POCUS cannot be viewed this way, and one only has to look at its history to see why. The earliest application of POCUS was the FAST exam. As anyone old enough to remember the 1990s knows, assessing trauma patients at that time was limited. Diagnostic peritoneal lavage was the best option for a rapid(ish) assessment of intra-abdominal hemorrhage, but there was no quick and easy way to assess for pericardial effusion. No offense to Beck, but everyone's heart tones are muffled in a loud resuscitation room. Thanks to some trauma surgeons and EPs, the FAST was born. As any physician who evaluates patients in real time can appreciate, obtaining the perfect image is irrelevant when someone is crashing in front of you. Figuring out whether he is hemorrhaging is relevant, and is what led to the development of the FAST and what sets it apart from standard imaging. To this day, if I try to order a FAST exam by radiology, it doesn't exist. EPs then started to realize the potential of POCUS to answer other questions at the bedside. The E-FAST was a direct answer to the (many) limitations of the supine chest x-ray. The RUSH protocol combined echo and body imaging to evaluate patients in shock. A lines and B lines exist thanks to POCUS, not to a radiologist. Do we need radiologist-performed ultrasound? Of course, we do. Radiologists are experts in their field, and are invaluable in diagnosis and treatment. But the horse has left the barn when it comes to POCUS. Just like other skills that used to “belong” to other specialties (e.g., intubation), we've demonstrated that we can use it to save lives. Ultrasound at the bedside has become an invaluable tool, and we won't go back. Share this article on Twitter and Facebook. Access the links in EMN by reading this on our website: www.EM-News.com. Comments? Write to us at [email protected]. Dr. Buttsis the director of the division of emergency ultrasound and a clinical assistant professor of emergency medicine at Louisiana State University at New Orleans. Follow her on Twitter@EMNSpeedofSound, and read her past columns athttp://bit.ly/EMN-SpeedofSound.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».