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Thank you to you and the EM:RAP team for reporting this research in such a timely fashion (as usual)! One fact that wasn't mentioned that EM:RAP listeners might find interesting in the realm of Knowledge Translation is that this same manuscript was triple-published in Annals of Emergency Medicine (which you discussed), the Journal of Urology (https://www.auajournals.org/doi/10.1097/JU.0000000000000342), and the Journal of the American College of Radiology (https://www.sciencedirect.com/science/article/pii/S1546144019304247?via%3Dihub). Although editorial boards cannot repeatedly publish the same manuscript in multiple society's journals routinely, occasionally re-publishing research that crosses medical disciplines can accelerate awareness and acceptance in the Knowledge Translation Pipeline. EM:RAP listeners might consider sharing these triple publications with their Urology and Radiology colleagues to promote Knowledge Translation. To the EM:RAP team - keep up the strong work! Chris Carpenter
Thank you for reviewing this paper - as a PGY3 this is something I struggle with how to work up, and will vary widely depending on which attending I am working with. One thing that bugged me about the recommendations in the cases is that the lack of hydronephrosis on US did not really necessitate any further work up. For example, comparing cases 7 and 8, or 10 and 11, or 20 and 21 - the lack of hydronephrosis still results in a recommendation of "no imaging." I'm trying to wrap my head around how that negative finding would be explained in the MDM. Or to play devil's advocate, if the result of the ultrasound isn't going to change management, why do it at all?
What you do matters.