I'm Anton Helman, and I'm Teresa Chinn.

And this is the Journal Jam podcast, where we blend interviews with leading researchers of important emergency medicine journal articles

and the best of crowdsourced social media-based opinions of emergency

medicine providers from around the world.

In this journal jam podcast number three, we have Dr. Michelle Lynn from Academic Life in

EM interviewing two of the authors of the article entitled Ultrasound v. Computed Tomography for Suspected Neproletheysis,

which was published in the New England Journal of Medicine in 2014.

Now, the cool thing about the study is that the authors are from two different specialties.

Dr. Rebecca Smith Bindman from the Department of Radiology at UCSF and Dr. Ralph Wong from the Department of EM also at UCSF.

First off, we'll hear from Dr. Lynn and from Dr. Smith Binman a bit about what the study was trying to answer and how they did the study.

We have two authors of 24 authors, that's impressive, of a multi-center study published in the New England

Journal of Medicine in 2014 talking about what should be the first line imaging modality

for patients with undifferentiated pain who you suspect kidney stones.

And this is a comparative effectiveness study, three arms looking

at ED bedside ultrasound, radiology ultrasound versus CT as the first line imaging modality,

looking at three primary outcomes about missing high-risk diagnoses with complications,

looking at the cumulative radiation dose and looking at cost.

And here's Dr. Smith Bidman describing a bit about how the study was done.

So the study is called a pragmatic trial.

And what that means is you're studying care in actual clinical settings rather than in sort of a more idealized setting.

So in our project, we said, what if patients were randomized to get the first test of one of the three arms you described?

The first test being CT, ultrasound by radiologists or ultrasound by emergency medicine

...