The content of this month’s journal reflects two major trends in the specialty of Emergency Medicine. First our specialty is an international one—but while the papers this month come from around the world the content of the articles is relevant to us all, wherever we practice. Second our specialty is a diagnostic one—the majority of the original articles this month are not about treatment but are about prediction of outcome and diagnosis. About time too—if we don’t know what we are dealing with then there is very little chance of dealing with it correctly.

PREDICTION

Our paper of the month this month is from Aaron Bernard and colleagues from Cincinnati. This group looked at the emergency department clinical data for 884 visits by 125 patients with potential sickle cell crises. From these data they constructed a risk scoring system (against 96-hour adverse outcome). This simple system, allocating each of nine historical, clinical and laboratory factors a score of 1 if present, is 86% sensitive if 2 …