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  1. Article ; Online: Lessons in cognitive unloading, skills mixing, flattened hierarchy and organisational agility from the Nightingale Hospital London during the first wave of the

    Collins, George Benjamin / Ahluwalia, Nikhil / Arrol, Lynne / Forrest, Natalie / McGlennan, Alan / O'Brien, Ben / Proudfoot, Alastair / Trainer, Matthew / Schilling, Richard / Sullivan, Eamonn / Westwood, Mark / Wragg, Andrew / Knight, Charles

    BMJ open quality

    2021  Volume 10, Issue 3

    MeSH term(s) COVID-19/prevention & control ; Capacity Building/organization & administration ; Hospital Administration/methods ; Hospital Design and Construction/methods ; Humans ; Intensive Care Units/organization & administration ; London ; Organizational Innovation ; Personnel Selection/standards ; Personnel, Hospital/standards ; SARS-CoV-2 ; State Medicine ; Surge Capacity/organization & administration
    Language English
    Publishing date 2021-07-21
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2399-6641
    ISSN (online) 2399-6641
    DOI 10.1136/bmjoq-2021-001415
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The accuracy of pre-appendectomy computed tomography with histopathological correlation: a clinical audit, case discussion and evaluation of the literature.

    Collins, George Benjamin / Tan, Tien Jin / Gifford, John / Tan, Andrew

    Emergency radiology

    2014  Volume 21, Issue 6, Page(s) 589–595

    Abstract: The increasing use of computed tomography (CT) in acute appendicitis makes recognising the radiological hallmarks of the condition and its mimics vital. The differential diagnosis includes both appendiceal and nonappendiceal pathologies. The correlation ... ...

    Abstract The increasing use of computed tomography (CT) in acute appendicitis makes recognising the radiological hallmarks of the condition and its mimics vital. The differential diagnosis includes both appendiceal and nonappendiceal pathologies. The correlation between pre-appendectomy CT and post-appendectomy histopathology was audited retrospectively. Cases of clinico-histopathological discrepancy underwent blind peer-review, and possible improvements were discussed in the context of the medical literature. A grade for discrepancy was given based on the RADPEER scoring system, and interesting or discrepant cases were examined more closely to identify targets for education. Of the 199 procedures, 4 appendectomies were negative (histologically normal), 182 were positive (primary appendicitis) and 13 were incidental (another primary process caused inflammation). The positive predictive value for pre-appendectomy CT was 91.5 %, and the negative appendectomy rate was 2 %. There were many secondary pathologies, including neoplasia, tuberculosis and endometriosis. Although no CT reports missed a diagnosis that should be made "almost all of the time" and in 96 % of cases, the second, blinded radiologist agreed with the initial assessment, in 3 cases, a missed diagnosis altered clinical management; 2 were "understandable" misses but 1 was not. In five cases, a discrepancy was "understandable" but clinically insignificant. Overall, in comparison to the medical literature, the degree of clinico-histopathological correlation was good. Although identifying areas for improvement was challenging, after a pictorial review of four cases and a discussion of the medical literature, we present our audit results and some valuable learning points for use in the CT assessment of suspected acute appendicitis.
    MeSH term(s) Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Appendectomy ; Appendicitis/diagnostic imaging ; Appendicitis/pathology ; Clinical Audit ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Preoperative Period ; Tomography, X-Ray Computed
    Language English
    Publishing date 2014-05-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1425144-9
    ISSN 1438-1435 ; 1070-3004
    ISSN (online) 1438-1435
    ISSN 1070-3004
    DOI 10.1007/s10140-014-1243-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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