Minor head trauma, Amnesia, Neurologic Deficit, Coagulopathy, Vomiting, Headache, suspected head Trauma |
Local best practice |
|
N |
Headache (traumatic and non-traumatic) |
CT |
Head |
Not Specified |
|
|
|
Non-I |
Source Title:
BWH - Minor Head Trauma
Source Type:
Local best practice
Year of Primary Citation:
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Piece of Clinical Logic:
IF ([loss of consciousness] OR [Post-Traumatic Amnesia]) AND NOT ([Focal neurologic deficit] OR [Coagulopathy] OR [Vomiting] OR [Glasgow coma score <15] OR [Severe headache] OR [Physical signs of basal skull fracture] OR [Dangerous mechanism of injury] OR [Trauma >24h ago] OR [Hemodynamically unstable]) AND [Age ≤60] THEN NOT [CT Head]
|
Validating Clinician Name:
Ivan Ip
Curator Name:
David Osterbur
Curator Name:
Julia Whelan
|
Grading Dates:
Mar 4, 2015
Disclaimer:
PMID: 21818031
From the Brigham & Women's Hospital Clinical Decision Support system... "Performing a head CT in this patient does not meet the National Quality Forum (NQF) Imaging Efficiency Quality Measure for Appropriate Head CT Imaging in Adults with Mild Traumatic Brain Injury. This quality measure is based on the New Orleans Criteria and the Canadian CT Head Rule, each of which has been shown to detect more than 99% of intracranial injuries requiring neurosurgical intervention in multiple studies involving thousands of patients." [Harnan, 2011]
SYSTEMATIC LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE. CHANGES AND DIFFERENCES IN THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA, GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
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suspected pediatric appendicitis |
Peer reviewed article |
|
Y |
|
CT |
Abdomen |
Without |
|
|
|
Non-I |
Source Title:
Validation and refinement of a prediction rule to identify children at low risk for acute appendicitis.
Source Type:
Peer reviewed article
Year of Primary Citation:
2012
|
|
Piece of Clinical Logic:
IF ([absolute neutrophil count <=6.75 x 10^3/µL] AND NOT [maximal tenderness in right
lower quadrant]) THEN NOT [CT abdomen with contrast]
|
Validating Clinician Name:
Ali Raja
Curator Name:
David Osterbur
Curator Name:
Paul Bain
|
Grading Dates:
Sep 5, 2015
Disclaimer:
PMID: 22869405 - This is a validation study. It's a single analysis based on multiple centers, rather than independent studies. This rule applies only to pediatric patients.
SYSTEMATIC
LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS
ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED
METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND
A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
CHANGES AND DIFFERENCES IN
THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA,
GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY
AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED
BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF
EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE
MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR
OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|
Blunt trauma |
Peer reviewed article |
|
N |
|
CT |
Chest |
Not Specified |
|
|
|
Non-I |
Source Title:
NEXUS blunt trauma rule
Source Type:
Peer reviewed article
Year of Primary Citation:
2013
|
|
Piece of Clinical Logic:
IF NOT ([age>60] OR [fall >20 feet] OR [motor vehicle
accident >40 mph] OR [chest pain] OR [intoxication] OR [abnormal mental
status] OR [abnormal alertness] OR [distracting painful injury] OR [chest wall
tenderness to palpation]) THEN NOT [CT Chest]
|
Validating Clinician Name:
Ali Raja
Curator Name:
David Osterbur
Curator Name:
Paul Bain
|
Grading Dates:
Sep 5, 2015
Disclaimer:
[inclusion criteria]:
1. Decreased level of consciousness (GCS score <15 or neurologic/behavioral status not age-appropriate) in association with blunt torso trauma (but not isolated head trauma).
OR
2. Blunt traumatic event resulting in paralysis or multiple nonadjacent long bone fractures (eg, tibia fracture, ulna fracture).
OR
3. Blunt traumatic event due to motor vehicle crash >40mph, ejection, rollover, automobile vs. pedestrian, automobile (>=5 mph) vs. bicycle, fall >=20 feet, crush injury to the torso, or physical assault involving the abdomen.
OR
4. Physician concern for abdominal trauma resulting in Abdominal CT or ultrasound (FAST), Laboratory testing to screen for intra-abdominal injury, or chest or pelvic radiography.
[exclusion criteria]:
presenting >24 hours after injury, penetrating trauma, preexisting neurologic disorder preventing reliable examination, pregnancy, transfer from another hospital with previous abdominal CT or peritoneal lavage.
PMID: 23925583 - Validating clinical decision rule in multiple level 1 trauma centers, rather than within one practice group.
SYSTEMATIC LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
CHANGES AND DIFFERENCES IN THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA, GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|
Pulmonary nodule |
Peer reviewed article |
Fleischner Society |
Y |
Cancer of the lung (primary or metastatic, suspected or diagnosed) |
CT |
Chest |
Not Specified |
|
|
|
I |
Source Title:
Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society.
Source Type:
Peer reviewed article
Year of Primary Citation:
2005
|
|
Piece of Clinical Logic:
IF [pulmonary nodule on chest CT] AND [nodule size <= 4mm] AND [low risk] THEN NOT [CT Chest]
|
Validating Clinician Name:
Louise Schneider
Curator Name:
Sowmya Varada
Curator Name:
Fritz Dement
|
Grading Dates:
Jun 13, 2019
Disclaimer:
This recommendation synthesizes data and recommendations from a number of studies and guidelines. A direct citation for this specific rule does not exist so, by definition, it must be graded as expert opinion (5-I).
[inclusion criteria]: age >=35, newly detected incidental nodule (unrelated to known underlying disease), solid nodule
[exclusion criteria]: known or suspected to have underlying malignant disease, age <35, unexplained fever
[low risk] = [minimal or absent history of smoking] OR [minimal or absent exposure to asbestos, uranium, and radon]
[high risk] = [history of smoking] OR [exposure to asbestos, uranium, or radon]
SYSTEMATIC LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
CHANGES AND DIFFERENCES IN THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA, GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|
lung cancer screening |
Professional society guideline |
U.S. Preventive Services Task Force| |
N |
Cancer of the lung (primary or metastatic, suspected or diagnosed) |
CT (low dose) |
Chest |
N/A |
|
|
|
Non-I |
Source Title:
Lung cancer screening
Source Type:
Professional society guideline
Year of Primary Citation:
2013
|
|
Piece of Clinical Logic:
IF [age >=55] AND [age <=80] AND [greater than OR equal to 30
pack years] AND ([current smoker] OR [quit smoking within past 15 years]) THEN [CT lung cancer screening]
|
Validating Clinician Name:
Laila Cochon Coen
Curator Name:
Julia Whelan
Curator Name:
Paul Bain
|
Grading Dates:
May 2, 2017
Disclaimer:
This recommendation is based on an SR with significant heterogeneity but included one good quality RCT (PMID: 21714641, 23697514) with a fairly narrow confidence interval. The rule based upon this study, merits 1b.
SYSTEMATIC LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
CHANGES AND DIFFERENCES IN THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA, GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|
Acute Shoulder Pain |
Professional society guideline |
ACR-American College of Radiology |
N |
Shoulder pain (to include suspected rotator cuff injury) |
MRI |
Shoulder |
Without |
|
|
|
Non-I |
Source Title:
ACR - Acute Shoulder Pain
Source Type:
Professional society guideline
Year of Primary Citation:
2010
|
|
Piece of Clinical Logic:
IF ([Normal radiograph] OR [Radiograph demonstrate coracoacromial arch osteophytes/syndesmophytes]) AND [Suspect rotator cuff tear/impingement] AND [Age >35 years] THEN [MRI shoulder without contrast]
|
Validating Clinician Name:
Ronilda Lacson
Curator Name:
Paul Bain
Curator Name:
Carol Mita
|
Grading Dates:
Mar 5, 2015
Disclaimer:
The narrative doesn't cite direct evidence for the logic. It discusses the value of different views but doesn't address the relative value of radiography or other modes.
SYSTEMATIC LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
CHANGES AND DIFFERENCES IN THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA, GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|
Suspected appendicitis |
Peer reviewed article |
|
N |
|
US |
Abdomen |
N/A |
|
|
|
Non-I |
Source Title:
AIR Score for suspected appendicitis
Source Type:
Peer reviewed article
Year of Primary Citation:
2015
|
|
Piece of Clinical Logic:
IF [AIR SCORE<5] THEN NOT [US abdomen]
AIR score |
Name |
Value |
Vomiting |
1 |
Right iliac fossa pain |
1 |
Rebound tenderness or guarding (light/moderate/strong) |
1 / 2 / 3 |
Temperature >=38.5 C |
1 |
White cell count |
1 / 2 / 3 |
Proportion of PMNs in % (70-84 / >=85) |
1 / 2 |
C-reactive protein in mg/dL (10-49 / >=50) |
1 / 2 |
|
Validating Clinician Name:
Ali Raja
Curator Name:
Sowmya Varada
Curator Name:
Paul Bain
|
Grading Dates:
Sep 5, 2015
Disclaimer:
The Appendicitis Inflammatory Response (AIR) score
- Vomiting - 1
- Right iliac fossa pain - 1
- Rebound tenderness or guarding
- Light - 1
- Moderate - 2
- Strong - 3
- Temperature≥38⋅5°C - 1
- White cell count (×109/l)
- Proportion of PMNs (%)
- C-reactive protein (mg/l)
PMID: 25727811 - Ultrasound performed poorly in low-risk patients.
SYSTEMATIC LITERATURE
REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS ASSESSMENT OF THE
EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED METHODOLOGY FOR
GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND A VALIDATING CLINICIAN
OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
CHANGES AND DIFFERENCES IN THE FORMULATION, APPLICATION OR
INTERPRETATION OF APPROPRIATE USE CRITERIA, GUIDELINES OR DECISION SUPPORT
RULES THAT INCORPORATE MEDICAL EVIDENCE MAY AFFECT THE UTILITY, APPLICABILITY
OR VALIDITY OF THE EVIDENCE SCORING PERFORMED BY THE HARVARD LIBRARY OF
EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE AND HARVARD MEDICAL
SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE MADE BY ANY THIRD PARTY OF THE
CONTENT PROVIDED THROUGH THIS WEBSITE OR OTHERWISE BY THE HARVARD MEDICAL
SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|
Acute ankle injury, ankle pain, ankle tenderness |
Peer reviewed article |
|
Y |
|
Xray |
Ankle |
N/A |
|
|
|
Non-I |
Source Title:
Ottawa Ankle Rule
Source Type:
Peer reviewed article
Year of Primary Citation:
1995
|
|
Piece of Clinical Logic:
IF [any pain in malleolar zone] AND ([Bone tenderness at the posterior edge] OR [bone tenderness at tip of lateral malleolus] OR [Bone tenderness at the posterior edge] OR [bone tenderness at tip of medial malleolus] OR [inability to bear weight both immediately & in the ED]) THEN [Xray Ankle]
|
Validating Clinician Name:
Ivan Ip
Curator Name:
David Osterbur
Curator Name:
Paul Bain
|
Grading Dates:
Mar 5, 2015
Disclaimer:
PMID: 7663253
The rules have been validated at one center by one group (emergency departments of two university hospitals within the same health system). A trial tested effectiveness at reducing radiography at multiple centers with no adverse effects.
"This study has demonstrated that implementation of the Ottawa ankle rules led to significant reductions in the use of ankle and foot radiography, decreased waiting times for patients, decreased medical costs, no apparent dissatisfaction among physicians or patients, and no missed fractures." [Stiell, 1994]
SYSTEMATIC LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE. CHANGES AND DIFFERENCES IN THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA, GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|
Suspected cervical injury, neck pain, trauma |
Peer reviewed article |
|
N |
Cervical or neck pain |
Xray |
Cervical spine |
N/A |
|
|
|
Non-I |
Source Title:
Canadian C-spine rule
Source Type:
Peer reviewed article
Year of Primary Citation:
2011
|
|
Piece of Clinical Logic:
IF NOT ([age >=65] OR [fall >3 feet] OR [axial load to head] OR [motor vehicle accident >100km/hr] OR [vehicle rollover] OR [vehicle ejection] OR [usage of
motorized recreational vehicle] OR [bicycle collision] OR [paresthesias in
extremities]) AND [able to safely assess range of motion] AND [able to rotate neck 45 degrees left and right] THEN NOT [Xray C-spine]
|
Validating Clinician Name:
Ali Raja
Curator Name:
David Osterbur
Curator Name:
Paul Bain
|
Grading Dates:
Aug 29, 2015
Disclaimer:
PMID: 21068171 - Validating study of the Canadian C-Spine Rule in two UK hospitals.
SYSTEMATIC
LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS
ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED
METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND
A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
CHANGES AND DIFFERENCES IN
THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA,
GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY
AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED
BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF
EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE
MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR
OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|
|
Peer reviewed article |
|
N |
Shoulder pain (to include suspected rotator cuff injury) |
Xray |
Shoulder |
N/A |
|
|
|
Non-I |
Source Title:
Quebec decision rule for radiography in shoulder dislocation
Source Type:
Peer reviewed article
Year of Primary Citation:
2009
|
|
Piece of Clinical Logic:
IF [age >=18] AND [age<=39] AND ([motor vehicle collision] OR [assault] OR [sporting injury] OR [fall from greater than patient’s
height]) THEN [Xray shoulder]
|
Validating Clinician Name:
Ali Raja
Curator Name:
Carol Mita
Curator Name:
Margo Coletti
|
Grading Dates:
Aug 29, 2015
Disclaimer:
PMID: 19166638 - Develpment of a clinical decision rule. A prospective derivation cohort study at four university-affiliated emergency departments.
SYSTEMATIC
LITERATURE REVIEW OF THE CLINICAL TOPIC AND RELEVANT STUDIES, AS WELL AS
ASSESSMENT OF THE EVIDENCE USING A FORMAL, PUBLISHED AND WIDELY RECOGNIZED
METHODOLOGY FOR GRADING EVIDENCE WAS COMPLETED BY TWO INDEPENDENT CURATORS AND
A VALIDATING CLINICIAN OF THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE. CHANGES AND DIFFERENCES IN
THE FORMULATION, APPLICATION OR INTERPRETATION OF APPROPRIATE USE CRITERIA,
GUIDELINES OR DECISION SUPPORT RULES THAT INCORPORATE MEDICAL EVIDENCE MAY
AFFECT THE UTILITY, APPLICABILITY OR VALIDITY OF THE EVIDENCE SCORING PERFORMED
BY THE HARVARD LIBRARY OF EVIDENCE. THE HARVARD MEDICAL SCHOOL LIBRARY OF
EVIDENCE AND HARVARD MEDICAL SCHOOL DO NOT ASSUME ANY LIABILITY FOR ANY USE
MADE BY ANY THIRD PARTY OF THE CONTENT PROVIDED THROUGH THIS WEBSITE OR
OTHERWISE BY THE HARVARD MEDICAL SCHOOL LIBRARY OF EVIDENCE.
|
|
|
|