Evidence map›Paper›PMID 34179874›Full record

ArticleJournal of the American College of Emergency Physicians open2021

What are the clinical effects of the different emergency department imaging options for suspected renal colic? A scoping review.

Erik Doty, Stephen DiGiacomo, Bridget Gunn, Lauren Westafer, Elizabeth Schoenfeld

Abstract readScoping Review
In one paragraph

Article in Journal of the American College of Emergency Physicians open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Renal colic imaging: Are we Choosing Wisely?Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2023
    Article
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Erik DotyDepartment of Emergency Medicine University of Massachusetts Medical School-Baystate Springfield Massachusetts USA.ORCID https://orcid.org/0000-0002-7092-5493
Stephen DiGiacomoDepartment of Emergency Medicine University of Massachusetts Medical School-Baystate Springfield Massachusetts USA.
Bridget GunnInformation and Knowledge Services, Health Sciences Library, Baystate Medical Center Springfield MA USA.
Lauren WestaferDepartment of Emergency Medicine University of Massachusetts Medical School-Baystate Springfield Massachusetts USA.
Elizabeth SchoenfeldDepartment of Emergency Medicine University of Massachusetts Medical School-Baystate Springfield Massachusetts USA.

Funding

K12 Cardiopulmonary Implementation Science Scholars ProgramK12HL138049 · NHLBI · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI LEMON, STEPHENIE C., LINDENAUER, PETER KYLE · 2017 to 2021
$2.7M
AHRQ HHS K08 HS025701NHLBI NIH HHS K12 HL138049
6 · The paper itself

Abstract

objectivesClinicians have minimal guidance regarding the clinical consequences of each radiologic imaging option for suspected renal colic in the emergency department (ED), particularly in relation to patient-centered outcomes. In this scoping review, we sought to identify studies addressing the impact of imaging options on patient-centered aspects of ED renal colic care to help clinicians engage in informed shared decision making. Specifically, we sought to answer questions regarding the effect of obtaining computed tomography (CT; compared with an ultrasound or delayed imaging) on safety outcomes, accuracy, prognosis, and cost (financial and length of stay [LOS]).

methodsWe conducted a comprehensive search using Pubmed, EMBASE, Web of Science conference proceedings index, and Google Scholar, identifying studies pertaining to renal colic, urolithiasis, and ureterolithiasis. In a prior qualitative study, stakeholders identified 14 key questions regarding renal colic care in the domains of safety, accuracy, prognosis, and cost. We systematically screened studies and reviewed the full text of articles based on their ability to address the 14 key questions.

resultsOur search yielded 2570 titles, and 68 met the inclusion criteria. Substantial evidence informed questions regarding test accuracy and radiation exposure, but less evidence was available regarding the effect of imaging modality on patient-oriented outcomes such as cost and prognosis (admissions, ED revisits, and procedures). Reviewed studies demonstrated that both standard renal protocol CT and low-dose CT are highly accurate, with ultrasound having lower accuracy. Several studies found that ureterolithiasis diagnosed by ultrasound was associated with overall reduced radiation exposure. Existing studies did not suggest choice of imaging influences prognosis. Several studies found no substantial differences in monetary cost, but LOS was found to be shorter if a diagnosis was made with point-of-care ultrasound.

conclusionThere is a plethora of data related to imaging accuracy. However, there is minimal data regarding the effect of CT on many patient-centered outcomes. Further research could improve the patient-centeredness of ED care.

Indexed as

computed tomographykidney stonespatient‐centeredrenal colicshared decision‐makingultrasound

Identifiers

PMID34179874
PMCPMC8208654

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.