62 The Use of Model-Based Iterative Reconstruction to Decrease Radiation Dose Without Increasing Emergency Department Length of Stay

Abstract

of whom also satisfied the NIAID/FAAN criteria. The interrater agreement between allergists was substantial (k ¼ 0.70). Test characteristics of the NIAID/FAAN criteria for the diagnosis of anaphylaxis compared to the reference standard of the allergists' diagnosis are shown in the Table. Conclusion: NIAID/FAAN criteria are very sensitive (93%) when applied to ED patients with allergic symptoms compared to the reference standard of an allergist's diagnosis. However, only about half of patients who met NIAID/FAAN criteria were determined to have anaphylaxis. In the ED setting, high sensitivity is preferred over high specificity to prevent underrecognition and a missed opportunity to provide an epinephrine autoinjector and follow-up referral. Thus, the NIAID/FAAN diagnostic criteria are a useful screening tool in the ED but refinement may be necessary to further improve their clinical utility.