An 11-year-old boy presented to the emergency department with sudden-onset, severe, sharp, right upper quadrant abdominal pain and vomiting. On examination, the patient was afebrile, with a pulse rate of 92 beats/min and right upper quadrant tenderness. Laboratory test results were unremarkable, including a WBC count of 9,670/mm 3 without left shift. Radiography of the abdomen revealed no evidence of obstruction. Abdominal point-of-care ultrasonography was performed (Figures 1 and 2, left panel, and Video E1, available online at http://www.annemergmed.com) and the diagnosis was confirmed by contrast-enhanced computed tomography (CT) (Figures 1 and 2, right panel).For the diagnosis and teaching points, see page 468. To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com
INTRODUCTION: Quality of life (QoL) and functional status are important aspects of health especially for older people. Efficient and valid ways of measuring older peoples health is of great importance. AIM: This project aims to establish the reliability of use of (1) a quality of life measure, the WHOQOL-BREF, and (2) a functional measure, the Nottingham Extended Activities of Daily Living scale (NEADL), for use over the telephone. METHODS: With ethical approval, patients over age 75 years (65 years if Maori) have been enrolled in the BRIGHT trial; a randomised controlled trial testing a practice-based screening initiative to prevent disability. Participants with possible disability, defined as being unable to get in and out of the car or take hot drinks from one room to another, completed a telephone interview including the two measures. Seventy participants repeated the two measures during a face-to-face interview within three months. RESULTS: Both WHOQOL-BREF and NEADL scores for the two forms of administration produced high Pearson correlation coefficients. There was good agreement for the WHOQOL-BREF as shown by the Bland-Altman graphs; however there was a tendency of a greater negative difference the greater the average score became (higher level of function) for the NEADL. DISCUSSION: This study shows that telephone interviews can generally provide a valid method to assess the quality of life and function in older people. KEYWORDS: Reliability; Quality of life; WHOQOL-BREF; functional status; NEADL; telephone administration
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