Journal Club Summary

Methodology Score: 3/5
Usefulness Score:  3/5 

Marin JR, Dean AJ, Bilker WB, Panebianco NL, Brown NJ, Alpern ER.
Acad Emerg Med. 2013 Jun;20(6):545-53
This prospective single-centre study found that where a clinical question exists regarding the need for drainage of a superficial soft tissue infection in the pediatric population, that the addition of ultrasound to the clinical exam had a theoretical sensitivity of 77.6% (95% CI = 1.2% to 66.6%; difference of 33.9% over clinical exam alone). The group agreed that the overall clinical benefit to patients was uncertain, and that local practice behaviour was unlikely to change as a result of this paper. 
By: Dr. Taylor Lougheed 

Epi lesson: Did Participating Patients Present a Diagnostic Dilemma?

Studies of diagnostic tests or decision rules should enroll patients with a spectrum of disease from mild to severe, including many at intermediate risk. If the patients clearly have or do not have the condition of interest, then we will learn very little about how well the new diagnostic test will perform on our undifferentiated ED patients.  
By: Dr. Ian Stiell