The efficacy and value of emergency medicine: A supportive literature review

Study objectives: The goal of this study was to identify publications in the medical literature that support the efficacy or value of Emergency Medicine (EM) as a medical specialty and of clinical care delivered by trained emergency physicians. In this study we use the term "value" to refer both to the "efficacy of clinical care" in terms of achieving desired patient outcomes, as well as "efficiency" in terms of effective and/or cost-effective utilization ofhealthcare resources in delivering emergency care. A comprehensive listing of publications describing the efficacy or value of EM has not been previously published. It is anticipated that the accumulated reference list generated by this study will serve to help promote awareness of the value of EM as a medical specialty, and acceptance and development of the specialty of EM in countries where EM is new or not yet fully established. Methods: The January 1995 to October 2010 issues of selected journals, including the EM journals with the highest article impact factors, were reviewed to identify articles of studies or commentaries that evaluated efficacy, effectiveness, and/or value related to EM as a specialty or to clinical care delivered by EM practitioners. Articles were included if they found a positive or beneficial effect of EM or of EM physician-provided medical care. Additional articles that had been published prior to 1995 or in other non-EM journals already known to the authors were also included. Results: A total of 282 articles were identified, and each was categorized into one of the following topics: efficacy of EM for critical care and procedures (31 articles), efficacy of EM for efficiency or cost of care (30 articles), efficacy of EM for public health or preventive medicine (34 articles), efficacy of EM for radiology (11 articles), efficacy of EM for trauma or airway management (27 articles), efficacy of EM for using ultrasound (56 articles), efficacy of EM faculty (34 articles), efficacy of EM residencies (24 articles), and overviews and editorials of EM efficacy and value (35 articles). Conclusion: There is extensive medical literature that supports the efficacy and value for both EM as a medical specialty and for emergency patient care delivered by trained EM physicians. © 2011 Yee et al; licensee Springer

Integration of regional to outcrop digital data: 3D visualisation of multi-scale geological models

Multi-scale geological models contain three-dimensional, spatially referenced data, typically spanning at least six orders of magnitude from outcrop to regional scale. A large number of different geological and geophysical data sources can be combined into a single model. Established 3D visualisation methods that are widely used in hydrocarbon exploration and production for sub-surface data have been adapted for onshore surface geology through a combination of methods for digital data acquisition, 3D visualisation, and geospatial analysis. The integration of georeferenced data across a wider than normal range in scale helps to address several of the existing limitations that are inherent in traditional methods of map production and publishing. The primary advantage of a multi-scale approach is that spatial precision and dimensionality (which are generally degraded when data are displayed in 2D at a single scale) can be preserved at all scales. Real-time, immersive, interactive software, based on a “3D geospatial” graphical user interface (GUI), allows complex geological architectures to be depicted, and is more inherently intuitive than software based on a standard “desktop” GUI metaphor. The continuing convergence of different kinds of geo-modelling, GIS, and visualisation software, as well as industry acceptance of standardised middleware, has helped to make multi-scale geological models a practical reality. This is illustrated with two case studies from NE England and NW Scotland

Unlocking the spatial dimension: digital technologies and the future of geoscience fieldwork

The development of affordable digital technologies that allow the collection and analysis of georeferenced field data represents one of the most significant changes in field-based geoscientific study since the invention of the geological map. Digital methods make it easier to re-use pre-existing data (e.g. previous field data, geophysical survey, satellite images) during renewed phases of fieldwork. Increased spatial accuracy from satellite and laser positioning systems provides access to geostatistical and geospatial analyses that can inform hypothesis testing during fieldwork. High-resolution geomatic surveys, including laser scanning methods, allow 3D photorealistic outcrop images to be captured and interpreted using novel visualization and analysis methods. In addition, better data management on projects is possible using geospatially referenced databases that match agreed international data standards. Collectively, the new techniques allow 3D models of geological architectures to be constructed directly from field data in ways that are more robust compared with the abstract models constructed traditionally by geoscientists. This development will permit explicit information on uncertainty to be carried forward from field data to the final product. Current work is focused upon the development and implementation of a more streamlined digital workflow from the initial data acquisition stage to the final project output