Showing papers by "American College of Chest Physicians published in 2019"
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University of California, San Francisco1, Vanderbilt University Medical Center2, Florida Atlantic University3, Southern Illinois University School of Medicine4, Society of Thoracic Surgeons5, Mayo Clinic6, University of Michigan7, University of Iowa Hospitals and Clinics8, American College of Chest Physicians9, University of Texas Health Science Center at San Antonio10, John H. Stroger, Jr. Hospital of Cook County11, National Institutes of Health12, University of Texas MD Anderson Cancer Center13, University of Wisconsin-Madison14
TL;DR: Evaluation with standard chest radiographs is usually sufficient for the diagnosis of rib fractures, and further imaging is generally not appropriate as there is little data that undiagnosed isolated rib fractures after minor blunt trauma affect management or outcomes.
Abstract: Rib fractures are the most common thoracic injury after minor blunt trauma. Although rib fractures can produce significant morbidity, the diagnosis of injuries to underlying organs is arguably more important as these complications are likely to have the most significant clinical impact. Isolated rib fractures have a relatively low morbidity and mortality and treatment is generally conservative. As such, evaluation with standard chest radiographs is usually sufficient for the diagnosis of rib fractures, and further imaging is generally not appropriate as there is little data that undiagnosed isolated rib fractures after minor blunt trauma affect management or outcomes. Cardiopulmonary resuscitation frequently results in anterior rib fractures and chest radiographs are usually appropriate (and sufficient) as the initial imaging modality in these patients. In patients with suspected pathologic fractures, chest CT or Tc-99m bone scans are usually appropriate and complementary modalities to chest radiography based on the clinical scenario. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
16 citations
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TL;DR: An introduction to implementation science, and its application in dentistry to promote adoption of evidence-based guidelines, is provided.
9 citations