title: Care of acute renal colic: a survey of emergency medicine physicians.
abstract: BACKGROUND
  To determine the contemporary practice patterns of academic emergency department (ED) providers in the United States for an episode of acute renal colic.
  
  
  METHODS
  A 30-question survey was developed to assess ED providers' clinical decision making for an index patient with acute renal colic. The survey population was all attending and resident physicians affiliated with an American emergency medicine residency program with an institutional profile available on the Society for Academic Emergency Medicine (156 programs; 95% of programs in the United States). The survey was conducted in October 2014. A response rate of 8.1% (289/3563) was achieved, which represented 29% (46/156) of the programs.
  
  
  RESULTS
  Only 17% (53/289) of respondents were aware of the American Urological Association (AUA) guidelines on the management and imaging of ureteral calculi. A clinical care pathway was uncommon amongst institutions (6/46; 13%), but desired by providers (193/289; 67%). A low dose non-contrast computed tomography (CT) would be the most preferred initial diagnostic imaging modality (139/289; 48%). Initial imaging choice was not influenced by respondent role, program, census region, practice environment, ED size, ED volume, presence of a clinical care pathway, or knowledge of the AUA guidelines (all p > 0.05).
  
  
  CONCLUSIONS
  In this cross-sectional survey of academic emergency medicine providers, we demonstrated a lack of awareness of quality initiatives and uncommon use of clinical care pathways. We observed that diagnostic imaging modalities with reduced radiation were commonly preferred, and that imaging preference was not associated with several demographic or institutional characteristics.
authors.affiliation: Department of Urology, Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Ziemba
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Sterling
authors.forename: Phillip
authors.initials: P
authors.lastname: Mucksavage
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods; D004635:Emergency Medicine / Q000379:methods / Q000592:standards; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D010346:Patient Care Management / Q000379:methods / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D056844:Renal Colic / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014481:United States; D014514:Ureteral Calculi / Q000150:complications