Inter-rater reliability and prospective validation of a clinical prediction rule for SARS-CoV-2 infection

Objectives Accurate estimation of the risk of SARS-CoV-2 infection based on bedside data alone has importance to Emergency Department (ED) operations and throughput. The 13 item CORC (COVID [or coronavirus] Rule-out Criteria) rule had good overall diagnostic accuracy in retrospective derivation and validation. The objective of this study was to prospectively test the inter-rater-reliability and diagnostic accuracy of the CORC score and rule (score ≤0 negative, >0 positive), and compare the CORC rule performance with physician gestalt. Methods This non-interventional study was conducted at an urban academic ED from February-March 2021. Two practitioners were approached by research coordinators and asked to independently complete a form capturing the CORC criteria for their shared patient, and their gestalt binary prediction of the SARS-CoV-2 test result and confidence (0-100%). The criterion standard for SARS-CoV-2 was from rt-PCR performed on a nasopharyngeal swab. The primary analysis was from weighted Cohen’s K and likelihood ratios (LR). Results For 928 patients, agreement between observers was good for the total CORC score, K = 0.613 (0.579-0.646) and for the CORC rule K = 0.644 (0.591-0.697). The agreement for clinician gestalt binary determination of SARs-CoV-2 status was K = 0.534, (95% CI 0.437-0.632) with median confidence of 76% (1st-3rd quartile: 66-88.5). For 425 patients who had the criterion standard, a negative CORC rule (both observers scored CORC 4, the prevalence of a positive SARS-CoV-2 test was 58% (28-85%) and LR(+) = 13.1 (4.5-37.2). Clinician gestalt demonstrated a sensitivity of 51%, specificity of 86% with a LR(-) = 0.57 (0.39-0.74). Conclusion In this prospective study, the CORC score and rule demonstrated good inter-rater reliability and reproducible diagnostic accuracy for estimating the pretest probability of SARs-CoV-2 infection

Interlaboratory Comparisons in Support of International Comparability and Traceability for Clinical Chemical Measurements

Abstract not availableJRC.D-Institute for Reference Materials and Measurements (Geel

Si-Traceable Values for Inorganic Components in Clinical Samples.

Background and characteristics of the IRMM International Measurement Evaluation Programme (IMEP) are presented. Information and results from previous IMEP-rounds, of special interest for people in laboratory medicine, are given. IMEP-7, trace elements in human serum is briefly outlined.JRC.D-Institute for Reference Materials and Measurements (Geel

The IRMM International Measurement Evaluation Programme (IMEP). IMEP-7 Inorganic Components in Human Serum.

Abstract not availableJRC.D-Institute for Reference Materials and Measurements (Geel

Contemporary neuroscience core curriculum for medical schools

Medical students need to understand core neuroscience principles as a foundation for their required clinical experiences in neurology. In fact, they need a solid neuroscience foundation for their clinical experiences in all other medical disciplines also, because the nervous system plays such a critical role in the function of every organ system. Due to the rapid pace of neuroscience discoveries, it is unrealistic to expect students to master the entire field. It is also unnecessary, as students can expect to have ready access to electronic reference sources no matter where they practice. In the pre-clerkship phase of medical school, the focus should be on providing students with the foundational knowledge to use those resources effectively and interpret them correctly. This article describes an organizational framework for teaching the essential neuroscience background needed by all physicians. This is particularly germane at a time when many medical schools are re-assessing traditional practices and instituting curricular changes such as competency-based approaches, earlier clinical immersion, and increased emphasis on active learning. This article reviews factors that should be considered when developing the pre-clerkship neuroscience curriculum, including goals and objectives for the curriculum, the general topics to include, teaching and assessment methodology, who should direct the course, and the areas of expertise of faculty who might be enlisted as teachers or content experts. These guidelines were developed by a work group of experienced educators appointed by the Undergraduate Education Subcommittee (UES) of the American Academy of Neurology (AAN). They were then successively reviewed, edited, and approved by the entire UES, the AAN Education Committee, and the AAN Board of Directors

Contemporary Neuroscience Core Curriculum for Medical Schools

Medical students need to understand core neuroscience principles as a foundation for their required clinical experiences in neurology. In fact, they need a solid neuroscience foundation for their clinical experiences in all other medical disciplines also, because the nervous system plays such a critical role in the function of every organ system. Due to the rapid pace of neuroscience discoveries, it is unrealistic to expect students to master the entire field. It is also unnecessary, as students can expect to have ready access to electronic reference sources no matter where they practice. In the pre-clerkship phase of medical school, the focus should be on providing students with the foundational knowledge to use those resources effectively and interpret them correctly. This article describes an organizational framework for teaching the essential neuroscience background needed by all physicians. This is particularly germane at a time when many medical schools are re-assessing traditional practices and instituting curricular changes such as competency-based approaches, earlier clinical immersion, and increased emphasis on active learning. This article reviews factors that should be considered when developing the pre-clerkship neuroscience curriculum, including goals and objectives for the curriculum, the general topics to include, teaching and assessment methodology, who should direct the course, and the areas of expertise of faculty who might be enlisted as teachers or content experts. These guidelines were developed by a work group of experienced educators appointed by the Undergraduate Education Subcommittee (UES) of the American Academy of Neurology (AAN). They were then successively reviewed, edited, and approved by the entire UES, the AAN Education Committee, and the AAN Board of Directors

Contemporary neuroscience core curriculum for medical schools

Medical students need to understand core neuroscience principles as a foundation for their required clinical experiences in neurology. In fact, they need a solid neuroscience foundation for their clinical experiences in all other medical disciplines also, because the nervous system plays such a critical role in the function of every organ system. Due to the rapid pace of neuroscience discoveries, it is unrealistic to expect students to master the entire field. It is also unnecessary, as students can expect to have ready access to electronic reference sources no matter where they practice. In the pre-clerkship phase of medical school, the focus should be on providing students with the foundational knowledge to use those resources effectively and interpret them correctly. This article describes an organizational framework for teaching the essential neuroscience background needed by all physicians. This is particularly germane at a time when many medical schools are re-assessing traditional practices and instituting curricular changes such as competency-based approaches, earlier clinical immersion, and increased emphasis on active learning. This article reviews factors that should be considered when developing the pre-clerkship neuroscience curriculum, including goals and objectives for the curriculum, the general topics to include, teaching and assessment methodology, who should direct the course, and the areas of expertise of faculty who might be enlisted as teachers or content experts. These guidelines were developed by a work group of experienced educators appointed by the Undergraduate Education Subcommittee (UES) of the American Academy of Neurology (AAN). They were then successively reviewed, edited, and approved by the entire UES, the AAN Education Committee, and the AAN Board of Directors