TY - JOUR T1 - Highlights from the issue JF - Emergency Medicine Journal JO - Emerg Med J SP - 91 LP - 91 DO - 10.1136/emermed-2014-204595 VL - 32 IS - 2 A2 - Weber, Ellen J Y1 - 2015/02/01 UR - http://emj.bmj.com/content/32/2/91.abstract N2 - As I wrote in my inaugural editorial last January, emergency medicine shares a common set of challenges regardless of where you practice, and ED crowding is one of the biggest. In 2012, a Delphi study of emergency physicians from the USA, Canada, UK, Australia,The Netherlands and Hong Kong led to derivation of the International Crowding Measure in Emergency Departments (ICMED). ICMED defines crowding thresholds for 8 measures routinely measured by EDs. In this issue, Boyle and colleagues report on the first prospective validation of the ICMED in 4 hospitals in England. They compared providers' subjective impressions of crowding and danger with the number of measures that exceeded the threshold. As ‘violations’ increased, so did physicians' concerns; 3 or more violations had PPV+ of 100%, although the NPV was more variable. The AUC for the score was 0.80% somewhat below NEDOCS and EDWIN, both of which are well-validated but have their own limitations. Obviously the next step will be to see if the international score can be validated…internationally. Answer: Boarders. One of the best titles ever for an article about crowding, this quote from a visitor to the ED at Beaumont Hospital in Dublin … ER -