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BackgroundPotassium disturbances are associated with adverse prognosis in patients with chronic conditions. Its prognostic implications in stable patients attending the emergency department (ED) is poorly described.AimsThis study aimed to assess the prevalence of dyskalemia, describe its predisposing factors and prognostic associations in a population presenting the ED without unstable medical illness.MethodsPost-hoc analysis of a prospective, cross-sectional, multicenter study in the ED of 11 French academic hospitals over a period of 8 weeks. All adults presenting to the ED during this period were included, except instances of self-drug poisoning, inability to complete self-medication questionnaire, presence of an unstable medical illness and decline to participate in the study. All-cause hospitalization or deaths were assessed.ResultsA total of 1242 patients were included. The mean age was 57.2±22.3 years, 51% were female. The distribution according to potassium concentrations was: hypokalemia5mmol/L(n = 73, 0,6%). The proportion of patients with a kalemia

Background: The overloading of health care systems is an international problem. In this context, new tools such as symptom checker (SC) are emerging to improve patient orientation and triage. This SC should be rigorously evaluated and we can take a cue from the way we evaluate medical students, using objective structured clinical examinations (OSCE) with simulated patients. Objective: The main objective of this study was to evaluate the efficiency of a symptom checker versus emergency physicians using OSCEs as an assessment method. Methods: We explored a method to evaluate the ability to set a diagnosis and evaluate the emergency of a situation with simulation. A panel of medical experts wrote 220 simulated patients cases. Each situation was played twice by an actor trained to the role: once for the SC, then for an emergency physician. Like a teleconsultation, only the patient's voice was accessible. We performed a prospective non-inferiority study. If primary analysis had failed to detect non-inferiority, we have planned a superiority analysis. Results: The SC established only 30% of the main diagnosis as the emergency physician found 81% of these. The emergency physician was also superior compared to the SC in the suggestion of secondary diagnosis (92% versus 52%). In the matter of patient triage (vital emergency or not), there is still a medical superiority (96% versus 71%). We prove a non-inferiority of the SC compared to the physician in terms of interviewing time. Conclusions and relevance: We should use simulated patients instead of clinical cases in order to evaluate the effectiveness of SCs. [ABSTRACT FROM AUTHOR]