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      European Society of Emergency Radiology: guideline on radiological polytrauma imaging and service (short version)

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          Abstract

          Background

          Although some national recommendations for the role of radiology in a polytrauma service exist, there are no European guidelines to date. Additionally, for many interdisciplinary guidelines, radiology tends to be under-represented. These factors motivated the European Society of Emergency Radiology (ESER) to develop radiologically-centred polytrauma guidelines.

          Results

          Evidence-based decisions were made on 68 individual aspects of polytrauma imaging at two ESER consensus conferences. For severely injured patients, whole-body CT (WBCT) has been shown to significantly reduce mortality when compared to targeted, selective CT. However, this advantage must be balanced against the radiation risk of performing more WBCTs, especially in less severely injured patients. For this reason, we recommend a second lower dose WBCT protocol as an alternative in certain clinical scenarios. The ESER Guideline on Radiological Polytrauma Imaging and Service is published in two versions: a full version (download from the ESER homepage, https://www.eser-society.org) and a short version also covering all recommendations (this article).

          Conclusions

          Once a patient has been accurately classified as polytrauma, each institution should be able to choose from at least two WBCT protocols. One protocol should be optimised regarding time and precision, and is already used by most institutions (variant A). The second protocol should be dose reduced and used for clinically stable and oriented patients who nonetheless require a CT because the history suggests possible serious injury (variant B). Reading, interpretation and communication of the report should be structured clinically following the ABCDE format, i.e. diagnose first what kills first.

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          AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both

          The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality reviews. Many instruments have been designed to evaluate different aspects of reviews, but there are few comprehensive critical appraisal instruments. AMSTAR was developed to evaluate systematic reviews of randomised trials. In this paper, we report on the updating of AMSTAR and its adaptation to enable more detailed assessment of systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. With moves to base more decisions on real world observational evidence we believe that AMSTAR 2 will assist decision makers in the identification of high quality systematic reviews, including those based on non-randomised studies of healthcare interventions.
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            2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)

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              Editor's Choice - Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS).

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                Author and article information

                Contributors
                wirth.online@googlemail.com
                Journal
                Insights Imaging
                Insights Imaging
                Insights into Imaging
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1869-4101
                10 December 2020
                10 December 2020
                December 2020
                : 11
                : 135
                Affiliations
                [1 ]European Society of Emergency Radiology, ESER Office, Am Gestade 1, 1010 Vienna, Austria
                [2 ]GRID grid.411095.8, ISNI 0000 0004 0477 2585, Department of Radiology, , LMU University Hospital, ; Munich, Germany
                [3 ]Department of Radiology and Nuclear Medicine, Schwarzwald-Baar-Hospital, Villingen-Schwenningen, Germany
                [4 ]GRID grid.412451.7, ISNI 0000 0001 2181 4941, Department of Neurosciences, Imaging and Clinical Science, , University of Chieti, ; Chieti, Italy
                [5 ]GRID grid.413104.3, ISNI 0000 0000 9743 1587, Department of Medical Imaging, , Sunnybrook Health Sciences Centre, ; Toronto, ON Canada
                [6 ]GRID grid.411372.2, ISNI 0000 0001 0534 3000, Department of Radiology, , University Hospital JM Morales Meseguer, ; Murcia, Spain
                [7 ]GRID grid.8302.9, ISNI 0000 0001 1092 2592, Department of Radiology, , Ege University Medical Faculty, ; Izmir, Turkey
                [8 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Imperial College NHS Trust, ; St Mary’s Campus, London, UK
                [9 ]Department of Diagnostic and Interventional Radiology, Helios Clinic Munich West, Munich, Germany
                [10 ]Department of Radiology, University Ziekenhuis, Vrije University (VUB), Brussels, Belgium
                [11 ]GRID grid.26597.3f, ISNI 0000 0001 2325 1783, James Cook University Hospital, , Teesside University, ; Middlesbrough, UK
                [12 ]Department of Imaging, Pineta Grande Hospital, Castel Volturno, Italy
                [13 ]Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center, Rostock, Germany
                Author information
                http://orcid.org/0000-0003-4576-3987
                Article
                947
                10.1186/s13244-020-00947-7
                7726597
                33301105
                b0f0c84d-7653-4c2d-8e59-18189713374c
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 14 October 2020
                : 13 November 2020
                Funding
                Funded by: Projekt DEAL
                Categories
                Guideline
                Custom metadata
                © The Author(s) 2020

                Radiology & Imaging
                europe,guideline,radiology,polytrauma,whole-body-ct
                Radiology & Imaging
                europe, guideline, radiology, polytrauma, whole-body-ct

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