Should (he) stay or should (he) go now?
Predicting the future is a tough job but emergency physicians are asked to do it all the time. Judging who will need urgent intervention for GI bleeding and who can be seen more electively represents an almost daily exercise in the ER. Experience and medical knowledge help in this decision making, but comorbidities or uncertain histories diminish even the best clinician’s predictive abilities. Risk assessment tools attempt to standardize complex decision making by adding statistical power to what has historically been a subjective gestalt. The high incidence and almost binary natural history of GI bleeding (continue to bleed or stop spontaneously) has made it a popular target for risk stratification tools. In a recent study in Lancet Gastroenterology and Hepatology, Oakland et al. attempt to provide us with a small crystal ball to predict who can safely be discharged from the ER after presenting with a lower GI bleed (1).