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| Name | Class |
|---|---|
| University of Southern Denmark | OTHER |
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The purpose of this study is to determine whether focused sonography of the heart, lungs and deep veins can increase the number of patients with respiratory symptoms correctly diagnosed in an emergency department.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Focused sonography | Experimental | Intervention group: After the primary evaluation by a physician in the emergency department, focused sonography of the patients heart, lungs and deep veins in the legs are performed. Hereafter the further examinations and treatment are done according to hospital guidelines. |
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| Usual treatment and diagnostic work-up | No Intervention | Control group: After the primary evaluation by a physician in the emergency department. Hereafter the further examinations and treatment are done according to hospital guidelines. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Focused Sonography of the heart, lungs and deep veins | Other | The patient is randomised to either a control group where usual treatment and diagnostic work-up is performed or to an intervention group where usual treatment and diagnostic workup are supplemented by a sonographic examination of the heart, lungs and deep veins are performed within one hour after the primary evaluation. The primary evaluation is defined as the first evaluation of the patient by a physician in the Acute Medical Admission Department. |
| Measure | Description | Time Frame |
|---|---|---|
| The number of patients with a correct presumptive diagnosis within 4 hours after hospital admission. | The 4-hour presumptive diagnosis are compared to the final diagnosis obtained by audit after the patient has been discharged from the hospital (gold standard). | 4 hours after hospital admission |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with a correct presumptive diagnosis after primary evaluation in the control group and after sonography in the intervention group. | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks | |
| Sensitivity, specificity, positive predictive values, negative predictive values and diagnostic accuracy of the primary evaluation and the "4-hour" presumptive diagnosis. |
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Inclusion criteria:
All 4 of the following must be present:
The sonographic examination can be performed before or within 1 hour after the primary evaluation
Patient is 18 years or older
Patient able and willing to give informed consent
One ore more of the following symptoms or clinical findings at admission to the emergency department
Exclusion Criteria:
One of the following:
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| Name | Affiliation | Role |
|---|---|---|
| Christian B Laursen, M.D | Odense University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Odense University Hospital | Odense | Fyn | 5000 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24998674 | Derived | Laursen CB, Sloth E, Lassen AT, Christensen Rd, Lambrechtsen J, Madsen PH, Henriksen DP, Davidsen JR, Rasmussen F. Point-of-care ultrasonography in patients admitted with respiratory symptoms: a single-blind, randomised controlled trial. Lancet Respir Med. 2014 Aug;2(8):638-46. doi: 10.1016/S2213-2600(14)70135-3. Epub 2014 Jul 3. | |
| 22649177 |
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| ID | Term |
|---|---|
| D004417 | Dyspnea |
| D002637 | Chest Pain |
| D003371 | Cough |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
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| Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Number of patients receiving appropriate, inappropriate and no specific treatment 4-hours after admission | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| 30 day mortality | 30 days after the patient has been admitted to the hospital |
| In-hospital mortality | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Number of patients transferred to an intensive care unit | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Number of patients given an appropriate, inappropriate and no specific treatment after primary evaluation in the control group and after sonography in the intervention group | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Time to diagnostic / therapeutic thoracocentesis | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Length of hospital stay | Participants will be followed for the duration of the hospital stay, an expected range of up to 5 weeks |
| Laursen CB, Sloth E, Lassen AT, Christensen RD, Lambrechtsen J, Madsen PH, Henriksen DP, Davidsen JR, Rasmussen F. Focused sonographic examination of the heart, lungs and deep veins in an unselected population of acute admitted patients with respiratory symptoms: a protocol for a prospective, blinded, randomised controlled trial. BMJ Open. 2012 May 30;2(3):e001369. doi: 10.1136/bmjopen-2012-001369. Print 2012. |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |