 In order to determine whether any differences observed in guideline adherence were the result of gaming erroneous data entry to either avoid potentially onerous CDS interactions or to enhancing the physicians apparent performance on feedback reports the investigators performed manual chart reviews of 100 randomly chosen charts from each of the two groups. These chart reviews were performed by an attending physician to assess concordance between adherence to EBG calculated from the CDS data, and adherence to EBG calculated from data documented in the ED visit clinical note. The sample size was determined using a baseline concordance of 90 as previously reported, and chosen to detect a difference in concordance of 15 between groups with a power of 80 and an alpha error rate of 5. Demographic data including gender and both age and years since residency training as measured at the beginning of the study period was also captured for all the attending physicians in the study. 