Systematic Review and Meta-analysis of Studies on the Use of Shock Index in Emergency Departments
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Questions and Answers

What is the cut-off score on the CBS that suggests severe burden or burnout?

  • 15/30
  • 30/30
  • 20/30
  • 25/30 (correct)
  • Which test was used to compare frequency distributions in the statistical analysis?

  • Shapiro–Wilk test
  • Q–Q plots
  • Mann–Whitney U test
  • Fisher’s exact test (correct)
  • What is the median CFS score at screening for the included patients in this analysis?

  • 3 (2–4)
  • 4 (3–5) (correct)
  • 6 (5–8)
  • 5 (5–7)
  • How was accuracy in predicting outcomes assessed?

    <p>With the area under the curve (AUC) of the receiver operating characteristic (ROC) curve</p> Signup and view all the answers

    What percentage of the sample were classified as frail after the CGA?

    <p>61%</p> Signup and view all the answers

    What is the purpose of using the 'surprise question' (SQ) in the study conducted by Gaffney et al.?

    <p>To predict the need for palliative care</p> Signup and view all the answers

    Which department at the University Hospital Galway was involved in the study?

    <p>Department of Geriatric and Stroke Medicine</p> Signup and view all the answers

    What is the primary focus of the Special Issue to which this article belongs?

    <p>Frailty in the Elderly: Issues and Challenges</p> Signup and view all the answers

    What was the age criterion for the patients included in the prospective study conducted by Gaffney et al.?

    <p>Aged ≥70</p> Signup and view all the answers

    In which country are the University Hospital Galway and Mercy University Hospital located?

    <p>Ireland</p> Signup and view all the answers

    What is the purpose of the 'surprise question' (SQ) mentioned in the text?

    <p>To predict the likelihood of mortality within 12 months</p> Signup and view all the answers

    What is the main finding regarding patients who tested SQ positive in the study?

    <p>They had significantly longer length of stay (LOS)</p> Signup and view all the answers

    What is the relationship between being SQ positive and frailty?

    <p>Being SQ positive was associated with higher odds of frailty</p> Signup and view all the answers

    What aspect of older adults attending ED is emphasized in relation to the SQ?

    <p>Their greater risk of death compared to non-frail patients</p> Signup and view all the answers

    What is the pressing need identified in the text in relation to older people attending ED?

    <p>The need to assess their goals of care on presentation to hospital</p> Signup and view all the answers

    What was the outcome of the diagnostic accuracy of the 'Surprise Question' (SQ) when predicting one-year mortality?

    <p>Low sensitivity and high specificity</p> Signup and view all the answers

    What was the most significant finding regarding patients who were SQ positive according to the study?

    <p>Reduced survival times</p> Signup and view all the answers

    What was the diagnostic accuracy of the 'Surprise Question' (SQ) when predicting admission to the emergency department (ED)?

    <p>Low sensitivity and specificity</p> Signup and view all the answers

    What was the most significant correlation observed with the 'Surprise Question' (SQ)?

    <p>RISC score (r = −0.68)</p> Signup and view all the answers

    What was the median length of stay (LOS) for those admitted to the hospital?

    <p>8 days</p> Signup and view all the answers

    What is the purpose of a comprehensive geriatric assessment (CGA)?

    <p>To assess an older person's medical, functional, and social needs</p> Signup and view all the answers

    What is the FRAIL scale used for in determining frailty status?

    <p>To score the patient's level of frailty from not frail to most frail</p> Signup and view all the answers

    Who conducts the detailed comprehensive geriatric assessment (CGA) in the study?

    <p>Consultant geriatrician blind to the results of the short screens</p> Signup and view all the answers

    What measures are used to determine frailty status in addition to the FRAIL scale and Groningen frailty indicator (GFI)?

    <p>Risk Instrument for Screening in the Community (RISC) mortality sub-score and Euroqol EQ-5D quality of life (QOL)</p> Signup and view all the answers

    Why were patients admitted from nursing homes excluded from the study?

    <p>Due to their high mortality risk and low life expectancy</p> Signup and view all the answers

    What is the main reason for the differences in accuracy between studies of the 'Surprise Question' in different specialties?

    <p>Length of the patient-physician relationship in different specialties</p> Signup and view all the answers

    What does the study suggest about using the 'Surprise Question' as a stand-alone measure of increased risk?

    <p>It should not be used as a surrogate to diagnose frailty</p> Signup and view all the answers

    What is the suggested benefit of using the 'Surprise Question' in a multidisciplinary setting?

    <p>To prompt action on advance care planning</p> Signup and view all the answers

    What is indicated by the correlation between the 'Surprise Question' and higher caregiver burden?

    <p>Caregivers of patients identified as SQ positive are more likely to experience carer burden</p> Signup and view all the answers

    What is highlighted as a limitation of the study?

    <p>Exclusion of patients attending ED but discharged outside of core working hours</p> Signup and view all the answers

    What was a limitation of the study related to the number of patients with specific presenting conditions?

    <p>The number of patients with specific presenting conditions was small, preventing sub-analysis.</p> Signup and view all the answers

    What was the impact of not conducting inter-reliability testing for the SQ?

    <p>It introduced potential bias and limited the reliability of the SQ.</p> Signup and view all the answers

    Why were nursing staff in the ED not scoring the SQ?

    <p>They lacked the necessary training to administer the SQ.</p> Signup and view all the answers

    How did the relatively high prevalence of death in the sample potentially influence the findings of the study?

    <p>It potentially reduced the diagnostic accuracy of the study.</p> Signup and view all the answers

    What effect did being SQ+ have on the patients according to the text?

    <p>They had greater levels of multi-morbidity and were frailer.</p> Signup and view all the answers

    What does it mean when it mentions 'spectrum bias' in relation to the study?

    <p>The study's findings were impacted by certain characteristics of patients included in the sample.</p> Signup and view all the answers

    What aspect of patients was well-matched in terms of age, gender, body mass, and cognition in the study?

    <p>Their age, gender, body mass, and cognition</p> Signup and view all the answers

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