1
40
23
-
Text
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URL Address
<a href="http://doi.org/10.1097/ACM.0000000000002563" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/ACM.0000000000002563</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
634-639
Issue
5
Volume
94
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Open Access Medical Journals: Promise, Perils, and Pitfalls
Publisher
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Academic Medicine: Journal of the Association of American Medical Colleges
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Creator
An entity primarily responsible for making the resource
Baker Eileen F; Iserson Kenneth V; Aswegan Andrew L; Larkin Gregory L; Derse Arthur R; Kraus Chadd K; of Emergency Physicians Ethics Committee American College
Description
An account of the resource
The number of both print and electronic open access (OA) journals has increased dramatically. Although electronic availability of information on the Internet may offer greater potential for information sharing, it also gives rise to "predatory" journals and deceptive publishers. In this Invited Commentary, the authors describe both the opportunities and potential perils that come with OA publications.Definitions for four models of legitimate OA are provided: the gold model, the green model, the platinum model, and the hybrid model. Benefits and risks of each model are discussed. The authors also distinguish between legitimate OA journals and predatory journals, highlighting several existing tools and resources for distinguishing between the two.Finally, the authors provide a checklist to help authors evaluate the policies and processes of journals and thereby avoid predatory publications.
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An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/ACM.0000000000002563" target="_blank" rel="noreferrer noopener">10.1097/ACM.0000000000002563</a>
2019
Academic Medicine: Journal of the Association of American Medical Colleges
Aswegan Andrew L
Baker Eileen F
Department of Emergency Medicine
Derse Arthur R
Iserson Kenneth V
June 2019 Update
Kraus Chadd K
Larkin Gregory L
NEOMED College of Medicine
of Emergency Physicians Ethics Committee American College
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.annemergmed.2018.10.032" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.annemergmed.2018.10.032</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
274-280
Issue
3
Volume
73
Dublin Core
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Title
A name given to the resource
Comparison of 30-Day Serious Adverse Clinical Events for Elderly Patients Presenting to the Emergency Department With Near-Syncope Versus Syncope.
Publisher
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Annals of emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-03
Creator
An entity primarily responsible for making the resource
Bastani Aveh; Su Erica; Adler David H; Baugh Christopher; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Hollander Judd E; Malveau Susan E; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Yagapen Annick N; Weiss Robert E; Sun Benjamin C
Description
An account of the resource
STUDY OBJECTIVE: Controversy remains in regard to the risk of adverse events for patients presenting with syncope compared with near-syncope. The purpose of our study is to describe the difference in outcomes between these groups in a large multicenter cohort of older emergency department (ED) patients. METHODS: From April 28, 2013, to September 21, 2016, we conducted a prospective, observational study across 11 EDs in adults (>/=60 years) with syncope or near-syncope. A standardized data extraction tool was used to collect information during their index visit and at 30-day follow-up. Our primary outcome was the incidence of
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.annemergmed.2018.10.032" target="_blank" rel="noreferrer noopener">10.1016/j.annemergmed.2018.10.032</a>
2019
Adler David H
Annals of emergency medicine
Bastani Aveh
Baugh Christopher
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Hollander Judd E
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
Sun Benjamin C
Weiss Robert E
Wilber Scott T
Yagapen Annick N
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.ajem.2019.04.029" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2019.04.029</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Dublin Core
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Title
A name given to the resource
Distinct subgroups of emergency department frequent users: A latent class analysis.
Publisher
An entity responsible for making the resource available
The American Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-04
Subject
The topic of the resource
ED frequent user; Emergency department; Health care costs; Health care utilization; Latent class analysis
Creator
An entity primarily responsible for making the resource
Birmingham Lauren E; Cheruvu Vinay K; Frey Jennifer A; Stiffler Kirk A; VanGeest Jonathan
Description
An account of the resource
Background: Emergency department (ED) frequent users have high resource utilization and associated costs. Many interventions have been designed to reduce utilization, but few have proved effective. This may be because this group is more heterogeneous than initially assumed, limiting the effectiveness of targeted interventions. The purpose of this study was to identify and describe distinct subgroups of ED frequent users and to estimate costs to provide hospital-based care to each group.; Methods: Latent class analysis was used to identify homogeneous subgroups of ED frequent users. ED frequent users (n = 5731) from a single urban tertiary hospital-based ED and level 1 trauma center in 2014 were included. Descriptive statistics (counts and percentages) are described to characterize subgroups. A cost analysis was performed to examine differences in direct medical costs between subgroups from the healthcare provider perspective.; Results: Four subgroups were identified and characterized: Short-term ED Frequent Users, Heart-related ED Frequent Users, Long-term ED Frequent Users, and Minor Care ED Frequent Users. The Heart-related group had the largest per person costs and the Long-term group had the largest total group costs.; Conclusion: Distinct subgroups of ED frequent users were identified and described using a statistically objective method. This taxonomy of ED frequent users allows healthcare organizations to tailor interventions to specific subgroups of ED frequent users who can be targeted with tailored interventions. Cost data suggest intervention for long-term ED frequent users offers the greatest cost-avoidance benefit from a hospital perspective.; Copyright © 2019. Published by Elsevier Inc.
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An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.ajem.2019.04.029" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2019.04.029</a>
2019
Birmingham Lauren E
Cheruvu Vinay K
Department of Emergency Medicine
ED frequent user
Emergency department
Frey Jennifer A
Health Care Costs
Health care utilization
June 2019 Update
Latent class analysis
NEOMED College of Medicine
Stiffler Kirk A
The American journal of emergency medicine
VanGeest Jonathan
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.ajem.2018.06.070" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2018.06.070</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
639-644
Issue
4
Volume
37
Dublin Core
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Title
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Clinical differences between visits to adult freestanding and hospital-based emergency departments.
Publisher
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The American journal of emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-04
Creator
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Burke Ryan C; Simon Erin L; Keaton Brian; Kukral Laura; Jouriles Nicholas J
Description
An account of the resource
OBJECTIVE: Compare clinical characteristics for adult visits to freestanding emergency departments (FEDs) and a hospital-based ED (HBED). METHODS: Electronic health records were collected on adult ED visits from 7/1/14 to 6/30/15 from three FEDs and one level 1 trauma tertiary care HBED. RESULTS: There were 55,909 HBED visits; 44,108 FED visits. The FED population was slightly more female (61% vs 57%), younger (48 vs 46years), white (86% vs 60%), and employed (67% vs 49%). A higher percent of FED visits had private insurance (43% vs 20%); a lower percent had Medicaid (25% vs 42%) and Medicare (23% vs 30%). The top three presenting problems were the same at the HBED and FEDs, but the order differed: gastrointestinal (HBED 19% vs FED 18%), cardiorespiratory (18% vs 16%), injury-pain-swelling of extremity (14% vs 17%). Differences were seen in primary ICD9 codes. One quarter of FED visits and only 18% of HBED visits were for injury/poisoning. A higher percent of FED visits were for respiratory diseases (12% vs 9%) but a lower percent were for circulatory system diseases (7% vs 11%) and visits for mental illness (2% vs 6%). Nearly 30% of HBED visits resulted in admission, compared to 8% of FED visits. ESI level differed significantly, with a lower percent of high acuity cases at FEDs (level 1: 0.1% vs 1.6%; level 2: 5% vs 26%). CONCLUSION: Differences were observed in clinical characteristics of adult HBED visits versus FEDs. Results of this study can help communities plan their emergency care system.
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<a href="http://doi.org/10.1016/j.ajem.2018.06.070" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2018.06.070</a>
2019
Burke Ryan C
Department of Emergency Medicine
Jouriles Nicholas J
Keaton Brian
Kukral Laura
NEOMED College of Medicine
Simon Erin L
The American journal of emergency medicine
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.ajem.2018.08.004" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2018.08.004</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
869-872
Issue
5
Volume
37
Dublin Core
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Title
A name given to the resource
Recurrent syncope is not an independent risk predictor for future syncopal events or adverse outcomes
Publisher
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The American Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Creator
An entity primarily responsible for making the resource
Chang Anna Marie; Hollander Judd E; Su Erica; Weiss Robert E; Yagapen Annick N; Malveau Susan E; Adler David H; Bastani Aveh; Baugh Christopher W; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Sun Benjamin C
Description
An account of the resource
Almost 20% of patients with syncope will experience another event. It is unknown whether recurrent syncope is a marker for a higher or lower risk etiology of syncope. The goal of this study is to determine whether older adults with recurrent syncope have a higher likelihood of 30-day serious clinical events than patients experiencing their first episode. METHODS: This study is a pre-specified secondary analysis of a multicenter prospective, observational study conducted at 11 emergency departments in the US. Adults 60 years or older who presented with syncope or near syncope were enrolled. The primary outcome was occurrence of 30-day serious outcome. The secondary outcome was 30-day serious cardiac arrhythmia. In multivariate analysis, we assessed whether prior syncope was an independent predictor of 30-day serious events. RESULTS: The study cohort included 3580 patients: 1281 (35.8%) had prior syncope and 2299 (64.2%) were presenting with first episode of syncope. 498 (13.9%) patients had 1 prior episode while 771 (21.5%) had >1 prior episode. Those with recurrent syncope were more likely to have congestive heart failure, coronary artery disease, previous diagnosis of arrhythmia, and an abnormal ECG. Overall, 657 (18.4%) of the cohort had a serious outcome by 30 days after index ED visit. In multivariate analysis, we found no significant difference in risk of events (adjusted odds ratio 1.09; 95% confidence interval 0.90-1.31; p = 0.387). CONCLUSION: In older adults with syncope, a prior history of syncope within the year does not increase the risk for serious 30-day events.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.ajem.2018.08.004" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2018.08.004</a>
2019
Adler David H
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Chang Anna Marie
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Hollander Judd E
June 2019 Update
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
Sun Benjamin C
The American journal of emergency medicine
Weiss Robert E
Wilber Scott T
Yagapen Annick N
-
Text
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URL Address
<a href="http://doi.org/10.1111/acem.13709" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/acem.13709</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
528-538
Issue
5
Volume
26
Dublin Core
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Title
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Do High-sensitivity Troponin and Natriuretic Peptide Predict Death or Serious Cardiac Outcomes After Syncope?
Publisher
An entity responsible for making the resource available
Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Creator
An entity primarily responsible for making the resource
Clark Carol L; Gibson Thomas A; Weiss Robert E; Yagapen Annick N; Malveau Susan E; Adler David H; Bastani Aveh; Baugh Christopher W; Caterino Jeffrey M; Diercks Deborah B; Hollander Judd E; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Sun Benjamin C
Description
An account of the resource
OBJECTIVES: An estimated 1.2 million annual emergency department (ED) visits for syncope/near syncope occur in the United States. Cardiac biomarkers are frequently obtained during the ED evaluation, but the prognostic value of index high-sensitivity troponin (hscTnT) and natriuretic peptide (NT-proBNP) are unclear. The objective of this study was to determine if hscTnT and NT-proBNP drawn in the ED are independently associated with 30-day death/serious cardiac outcomes in adult patients presenting with syncope. METHODS: A prespecified secondary analysis of a prospective, observational trial enrolling participants ≥ age 60 presenting with syncope, at 11 United States hospitals, was conducted between April 2013 and September 2016. Exclusions included seizure, stroke, transient ischemic attack, trauma, intoxication, hypoglycemia, persistent confusion, mechanical/electrical invention, prior enrollment, or predicted poor follow-up. Within 3 hours of consent, hscTnT and NT-proBNP were collected and later analyzed centrally using Roche Elecsys Gen 5 STAT and 2010 Cobas, respectively. Primary outcome was combined 30-day all-cause mortality and serious cardiac events. Adjusting for illness severity, using multivariate logistic regression analysis, variations between primary outcome and biomarkers were estimated, adjusting absolute risk associated with ranges of biomarkers using Bayesian Markov Chain Monte Carlo methods. RESULTS: The cohort included 3,392 patients; 367 (10.8%) experienced the primary outcome. Adjusted absolute risk for the primary outcome increased with hscTnT and NT-proBNP levels. HscTnT levels ≤ 5 ng/L were associated with a 4% (95% confidence interval [CI] = 3%-5%) outcome risk, and hscTnT > 50 ng/L, a 29% (95% CI = 26%-33%) risk. NT-proBNP levels ≤ 125 ng/L were associated with a 4% (95% CI = 4%-5%) risk, and NT-proBNP > 2,000 ng/L a 29% (95% CI = 25%-32%) risk. Likelihood ratios and predictive values demonstrated similar results. Sensitivity analyses excluding ED index serious outcomes demonstrated similar findings. CONCLUSIONS: hscTnT and NT-proBNP are independent predictors of 30-day death and serious outcomes in older ED patients presenting with syncope.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/acem.13709" target="_blank" rel="noreferrer noopener">10.1111/acem.13709</a>
2019
Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Adler David H
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Gibson Thomas A
Hollander Judd E
June 2019 Update
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Sun Benjamin C
Weiss Robert E
Wilber Scott T
Yagapen Annick N
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1136/bmjstel-2017-000260" target="_blank" rel="noreferrer noopener">http://doi.org/10.1136/bmjstel-2017-000260</a>
Pages
178-179
Issue
3
Volume
5
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Title
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Simulation-based interprofessional conference: a focus on patient handoffs and critical communication
Publisher
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Bmj Simulation & Technology Enhanced Learning
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-07
Subject
The topic of the resource
communication; handoff; interprofessional; simulation
October 2019 Update
Creator
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Gable Brad; Ahmed Rami
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<a href="http://doi.org/10.1136/bmjstel-2017-000260" target="_blank" rel="noreferrer noopener">10.1136/bmjstel-2017-000260</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2019
Ahmed Rami
BMJ simulation & technology enhanced learning
Communication
Department of Emergency Medicine
Gable Brad
handoff
interprofessional
NEOMED College of Medicine
October 2019 Update
simulation
-
Text
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URL Address
<a href="http://doi.org/10.1007/978-3-030-01057-7_22" target="_blank" rel="noreferrer noopener">http://doi.org/10.1007/978-3-030-01057-7_22</a>
Pages
265-285
Volume
869
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<a href="http://neomed.idm.oclc.org/login?url=http://doi.org/10.1007/978-3-030-01057-7_22" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1007/978-3-030-01057-7_22</a>
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Update Year & Number
January 2021 List
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Summa Health Akron City Hospital
Dublin Core
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Title
A name given to the resource
Bivariate markov model based analysis of ecg for accurate identification and classification of premature heartbeats and irregular beat-patterns
Publisher
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Intelligent Systems And Applications, INTELLISYS, Vol 2
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
1905-07
Subject
The topic of the resource
Machine learning; ECG analysis; Intelligent system; Irregular beat pattern; Markov model; Medical diagnosis; Premature beat classification; Real-time system; Signal analysis
Creator
An entity primarily responsible for making the resource
Gawde PR; Bansal AK; Nielson JA; Khan JI
Description
An account of the resource
This paper describes a novel intelligent analysis technique based upon bivariate Markov model that integrates morphological and temporal features with a rule-based interval analysis of ECG signals to localize and accurately classify the premature beats to four major classes: (1) Premature Atrial Complex (PAC), (2) Blocked PAC (B-PAC), (3) Premature Ventricular Complex (PVC), and (4) Premature Junctional Complex (PJC). The paper also describes a beat-pattern classification algorithm to sub classify premature beat-patterns into bigeminy, trigeminy and quadrigeminy. The approach utilizes two phases: (1) a training phase that builds bivariate Markov model from standardized databases of ECG signals, and (2) a dynamic phase that detects embedded P and R waves in T-waves of premature beats using a combination of area subtraction and clinically significant rule-based analysis of R-R intervals. It detects and classifies premature beats using graph matching based upon the forward-backward algorithm and performs a look ahead pattern analysis for the sub-classification of beat-patterns. The algorithms have been presented. The software has been implemented that uses a combination of MATLAB and C++ libraries. Performance results show that processing time is realistic for real-time detection with 98%-99% sensitivity for the premature beat classification and 95%-98% sensitivity for the beat pattern identification.
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<a href="http://doi.org/10.1007/978-3-030-01057-7_22" target="_blank" rel="noreferrer noopener">10.1007/978-3-030-01057-7_22</a>
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journalArticle
2019
Bansal AK
Department of Emergency Medicine
ECG analysis
Gawde PR
Intelligent system
Intelligent Systems And Applications
Intelligent Systems And Applications, INTELLISYS, Vol 2
INTELLISYS
Irregular beat pattern
January 2021 List
journalArticle
Khan JI
Machine learning
Markov model
Medical diagnosis
NEOMED College of Medicine
Nielson JA
Premature beat classification
Real-time system
Signal analysis
Summa Health Akron City Hospital
Vol 2
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1007/978-3-030-02686-8_43" target="_blank" rel="noreferrer noopener">http://doi.org/10.1007/978-3-030-02686-8_43</a>
Pages
569-588
Volume
880
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<a href="http://ezproxy.neomed.idm.oclc.org/login?url=http://doi.org/10.1007/978-3-030-02686-8_43" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1007/978-3-030-02686-8_43</a>
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Update Year & Number
March 2020 Update
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Summa Health Akron
Dublin Core
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Title
A name given to the resource
Integrating Markov Model, Bivariate Gaussian Distribution and GPU Based Parallelization for Accurate Real-Time Diagnosis of Arrhythmia Subclasses
Publisher
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Proceedings of the Future Technologies Conference (ftc) 2018, Vol 1
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
1905-07
Creator
An entity primarily responsible for making the resource
Gawde Purva R; Bansal Arvind K; Nielson Jeffery A
Description
An account of the resource
In this paper, we present the integration of SIMT (Single Instruction Multiple Threads), Markov model and bivariate Gaussian distribution as a general-purpose technique for real-time accurate diagnosis of subclasses of arrhythmia. The model improves the accuracy by integrating both morphological and temporal features of ECG. GPU based implementation exploits concurrent execution of multiple threads at the heart-beat level to improve the execution efficiency. The approach builds a bivariate Gaussian Markov model (BGMM) for each subclass of arrhythmia where each state includes bivariate distribution of temporal and morphological features of each waveform and ISO-lines using ECG records for each subclass from standard databases, and the edge-weights represent the transition probabilities between states. Limited 30-second subsequences of a patient's beats are used to develop bivariate Gaussian transition graphs (BGTG). BGTGs are matched with each of the BGMMs to derive the exact classification of BGTGs. Our approach exploits data-parallelism at the beat level for ECG preprocessing, building BGTGs and matching multiple BGTG-BGMM pairs. SIMT (Single Instruction Multiple Thread) available on CUDA resources in GPU has been utilized to exploit data-parallelism. Algorithms have been presented. The system has been implemented on a machine with NVIDIA CUDA based GPU. Test results on standard MIT- BIH database show that GPU based SIMT improves execution time further by 78% with an overall speedup of 4.5 while retaining the accuracy achieved by the sequential execution of the approach around 98%.
Identifier
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<a href="http://doi.org/10.1007/978-3-030-02686-8_43" target="_blank" rel="noreferrer noopener">10.1007/978-3-030-02686-8_43</a>
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Book Section
2019
Bansal Arvind K
Department of Emergency Medicine
Gawde Purva R
NEOMED College of Medicine
Nielson Jeffery A
Proceedings of the Future Technologies Conference (ftc) 2018
Proceedings of the Future Technologies Conference (ftc) 2018, Vol 1
Summa Health Akron
Vol 1
-
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<a href="http://doi.org/10.1097/ACM.0000000000002820" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/ACM.0000000000002820</a>
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A National Study of Longitudinal Consistency in ACGME Milestone Ratings by Clinical Competency Committees: Exploring an Aspect of Validity in the Assessment of Residents' Competence
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Academic Medicine: Journal of the Association of American Medical Colleges
Date
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2019
2019-06
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Hamstra Stanley J; Yamazaki Kenji; Barton Melissa A; Santen Sally A; Beeson Michael S; Holmboe Eric S
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PURPOSE: To investigate whether clinical competency committees (CCCs) were consistent in applying milestone ratings for first-year residents over time or whether ratings increased or decreased. METHOD: Beginning in December 2013, the ACGME initiated a phased-in requirement for reporting milestones; emergency medicine (EM), diagnostic radiology (DR), and urology (UR) were among the earliest reporting specialties. The authors analyzed CCC milestone ratings of first-year residents from 2013-2016 from all ACGME-accredited EM, DR, and UR programs for which they had data. The number of first-year residents in these programs ranged from 2,838 to 2,928 over this time period. The program-level average milestone rating for each subcompetency was regressed onto the time of observation using a random coefficient multilevel regression model. RESULTS: National average program-level milestone ratings of first-year residents decreased significantly over the observed time period for 32 of the 56 subcompetencies examined. None of the other subcompetencies showed a significant change. National average in-training examination scores for each of the specialties remained essentially unchanged over the time period, suggesting differences between the cohorts was not likely an explanatory factor. CONCLUSIONS: The findings indicate that CCCs tend to become more stringent or maintain consistency in their ratings of beginning residents over time. One explanation for these results is that CCCs may become increasingly comfortable in assigning lower ratings when appropriate. This finding is consistent with an increase in confidence with the milestones rating process and the quality of feedback it provides.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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<a href="http://doi.org/10.1097/ACM.0000000000002820" target="_blank" rel="noreferrer noopener">10.1097/ACM.0000000000002820</a>
2019
Academic Medicine: Journal of the Association of American Medical Colleges
Barton Melissa A
Beeson Michael S
Department of Emergency Medicine
Hamstra Stanley J
Holmboe Eric S
June 2019 Update
NEOMED College of Medicine
Santen Sally A
Yamazaki Kenji
-
Text
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URL Address
<a href="http://doi.org/10.1016/j.jemermed.2019.09.037" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jemermed.2019.09.037</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
ISSN
0736-4679
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Update Year & Number
January 2020 Update
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine; Department of Internal Medicine; NEOMED College of Medicine Student Publications
Affiliated Hospital
Cleveland Clinic Akron General Hospital; Summa Health System Akron City Hospital; Summa Health Akron;
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Title
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Throws of Death: Traumatic Coronary Artery Dissection Resulting From Jiu Jitsu Training
Publisher
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The Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-11-16
Subject
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cardiac arrest; coronary dissection; myocardial infarction; myocardial injury; sports medicine; trauma
Creator
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Haywood Steven T; Patel Kush; Gallo Douglas; Silver Kevin; Jouriles Nicolas
Description
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BACKGROUND: The risk of cardiac injury in blunt thoracic trauma is quite rare, occurring in only 0.1% of patients. The least common cardiac injury is coronary artery dissection. Most cardiac injuries result from high-energy mechanisms such as motor vehicle collisions. Even low-mechanism injuries that have been reported involved rapid deceleration. CASE REPORT: We present a case of traumatic coronary artery dissection that resulted from a low-energy blunt thoracic injury with no rapid deceleration. This patient had no other associated thoracic injuries, such as rib fractures or sternal fracture. Following presentation, our patient twice deteriorated into ventricular fibrillation and was successfully resuscitated each time. The coronary lesion was successfully stented and the patient was eventually discharged home. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case underscores the importance of maintaining a high level of suspicion for coronary artery dissection even in low-energy mechanisms. An electrocardiogram should be obtained early, even in low-energy mechanisms. While patients with traumatic cardiac injuries will commonly present with other injuries, such as rib fractures, the absence of these injuries does not rule out cardiac injury.
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<a href="http://doi.org/10.1016/j.jemermed.2019.09.037" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2019.09.037</a>
PMID: 31744712
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2019
cardiac arrest
Cleveland Clinic Akron General Hospital
coronary dissection
Department of Emergency Medicine
Department of Internal Medicine
Gallo Douglas
Haywood Steven T
January 2020 Update
Jouriles Nicolas
Journal Article
myocardial infarction
myocardial injury
NEOMED College of Medicine
NEOMED College of Medicine Student
NEOMED Student Publications
Patel Kush
Silver Kevin
Sports Medicine
Summa Health Akron
Summa Health System Akron City Hospital
The Journal of emergency medicine
trauma
-
Text
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URL Address
<a href="http://doi.org/10.1016/j.ajem.2019.05.021" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2019.05.021</a>
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Title
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Beyond NIPPV: HVNI Expands Potential Treatment Options For Acute Decompensated Heart Failure
Publisher
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The American Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Subject
The topic of the resource
Acute decompensated heart failure; Critical care; Emergency medicine; High flow nasal cannula; Non-invasive positive-pressure ventilation
Creator
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Haywood Steven T; Volakis Leonithas I; Whittle Jessica S
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<a href="http://doi.org/10.1016/j.ajem.2019.05.021" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2019.05.021</a>
2019
Acute decompensated heart failure
Critical Care
Department of Emergency Medicine
Emergency Medicine
Haywood Steven T
High flow nasal cannula
June 2019 Update
NEOMED College of Medicine
Non-invasive positive-pressure ventilation
The American journal of emergency medicine
Volakis Leonithas I
Whittle Jessica S
-
Text
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URL Address
<a href="https://www.biorxiv.org/content/10.1101/126870v2">https://www.biorxiv.org/content/10.1101/126870v2</a><br /><br /><a href="http://doi.org/10.1055/s-0039-1691842" target="_blank" rel="noreferrer noopener">http://doi.org/10.1055/s-0039-1691842</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
409-420
Issue
3
Volume
10
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Title
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Consensus Development of a Modern Ontology of Emergency Department Presenting Problems-The Hierarchical Presenting Problem Ontology (HaPPy)
Publisher
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Applied Clinical Informatics
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Subject
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care; chief complaint; coded chief complaints; electronic medical-record; emergency; emergency department; Medical Informatics; medicine; ontology; presenting problem; rods; systems; terminologies
Creator
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Horng S; Greenbaum N R; Nathanson L A; McClay J C; Goss F R; Nielson J A
Description
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Objective Numerous attempts have been made to create a standardized "presenting problem" or "chief complaint" list to characterize the nature of an emergency department visit. Previous attempts have failed to gain widespread adoption as they were not freely shareable or did not contain the right level of specificity, structure, and clinical relevance to gain acceptance by the larger emergency medicine community. Using real-world data, we constructed a presenting problem list that addresses these challenges. Materials and Methods We prospectively captured the presenting problems for 180,424 consecutive emergency department patient visits at an urban, academic, Level I trauma center in the Boston metro area. No patients were excluded. We used a consensus process to iteratively derive our system using real-world data. We used the first 70% of consecutive visits to derive our ontology, followed by a 6-month washout period, and the remaining 30% for validation. All concepts were mapped to Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT). Results Our system consists of a polyhierarchical ontology containing 692 unique concepts, 2,118 synonyms, and 30,613 nonvisible descriptions to correct misspellings and nonstandard terminology. Our ontology successfully captured structured data for 95.9% of visits in our validation data set. Discussion and Conclusion We present the HierArchical Presenting Problem ontologY (HaPPy). This ontology was empirically derived and then iteratively validated by an expert consensus panel. HaPPy contains 692 presenting problem concepts, each concept being mapped to SNOMED CT. This freely sharable ontology can help to facilitate presenting problem-based quality metrics, research, and patient care.
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<a href="https://www.biorxiv.org/content/10.1101/126870v2" target="_blank" rel="noreferrer noopener">10.1055/s-0039-1691842</a>
2019
Applied Clinical Informatics
care
chief complaint
coded chief complaints
Department of Emergency Medicine
electronic medical-record
Emergency
Emergency department
Goss F R
Greenbaum N R
Horng S
McClay J C
Medical Informatics
Medicine
Nathanson L A
NEOMED College of Medicine
Nielson J A
ontology
presenting problem
rods
September 2019 Update
systems
terminologies
-
Text
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URL Address
<a href="http://doi.org/10.1007/s40123-019-00217-w" target="_blank" rel="noreferrer noopener">http://doi.org/10.1007/s40123-019-00217-w</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
589-598
Issue
4
Volume
8
ISSN
2193-8245
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<a href="http://ezproxy.neomed.idm.oclc.org/login?url=http://doi.org/10.1007/s40123-019-00217-w" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1007/s40123-019-00217-w</a>
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Title
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Atropine 0.01% Eye Drops for Myopia Control in American Children: A Multiethnic Sample Across Three US Sites
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Ophthalmology And Therapy
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-12
Subject
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Atropine; Childhood myopia; Eye drops; Myopia; Refractive error; Side effects
Creator
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Larkin G Luke; Tahir Alifiya; Epley K David; Beauchamp Cynthia L; Tong John T; Clark Robert A
Description
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INTRODUCTION: Topical atropine eye drops at low concentrations have been shown to slow myopia progression in East Asian studies. This study explored the effect of atropine 0.01% eye drops on controlling myopia progression in a multiethnic cohort of children in the USA. METHODS: A multicenter retrospective case-control study (n = 198) quantified the effect of adding nightly atropine 0.01% eye drops to treatment as usual on the progression of childhood (ages 6-15 years) myopia. Cases included all children treated with atropine for at least 1 year. Controls were matched to cases on both age (± 6 months) and baseline spherical equivalent refraction (SER) (± 0.50 diopters, D) at treatment initiation. The primary endpoint was the average SER myopia progression after 1, 1.5, and 2 years of therapy. A secondary outcome was the percentage of subjects with a clinically significant worsening of myopia, defined as a greater than - 0.75 D SER increase in myopia. RESULTS: The average baseline SERs for the atropine (n = 100) and control (n = 98) groups were similar (- 3.1 ± 1.9 D and - 2.8 ± 1.6 D, respectively) (p = 0.23). The average SER increase from baseline was significantly less for the atropine group than the control group at year 1 (- 0.2 ± 0.8 D compared with - 0.6 ± 0.4 D, p < 0.001) and at year 2 (- 0.3 ± 1.1 D compared with - 1.2 ± 0.7 D, p < 0.001). Secondary analysis at year 2 revealed that 80% of the control group vs. 37% of the atropine group experienced clinically significant worsening myopia of at least - 0.75 D (p < 0.001). There were no major safety issues reported in either group. CONCLUSION: Similar to results reported in Asia, atropine 0.01% eye drops significantly reduced myopia progression in a cohort of US children over 2 years of treatment. FUNDING: Nevakar, Inc. Plain language summary available for this article.
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<a href="http://doi.org/10.1007/s40123-019-00217-w" target="_blank" rel="noreferrer noopener">10.1007/s40123-019-00217-w</a>
PMID: 31602553
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2019
Atropine
Beauchamp Cynthia L
Childhood myopia
Clark Robert A
Department of Emergency Medicine
Epley K David
Eye drops
Journal Article
Larkin G Luke
Myopia
NEOMED College of Medicine
November 2019 Update
Ophthalmology And Therapy
Refractive error
Side effects
Summa Health System Akron City Hospital
Tahir Alifiya
Tong John T
-
Text
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URL Address
<a href="http://doi.org/10.1111/acem.13906" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/acem.13906</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
ISSN
1553-2712
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Update Year & Number
January 2020 Update
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Summa Health Akron
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Frequency of Abnormal and Critical Lab Results in Older Patients Presenting to the Emergency Department with Syncope
Publisher
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Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-12-14
Creator
An entity primarily responsible for making the resource
Moore Andrew B; Su Erica; Weiss Robert E; Yagapen Annick N; Malveau Susan E; Adler David H; Bastani Aveh; Baugh Christopher W; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Hollander Judd E; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Sun Benjamin C
Description
An account of the resource
Syncope is a common and costly chief complaint among patients presenting to the emergency department (ED), accounting for 740,000 ED visits annually with an estimated annual cost of $2.4 billion per year in the United States.1,2 Syncope presents a diagnostic dilemma for clinicians in the ED since differentiating serious and benign causes of syncope can be challenging, particularly in the older adult. Routine laboratory testing with complete blood count (CBC) and basic metabolic panel (BMP) is commonly ordered for patients presenting to the ED with syncope.
Identifier
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<a href="http://doi.org/10.1111/acem.13906" target="_blank" rel="noreferrer noopener">10.1111/acem.13906</a>
PMID: 31837233
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2019
Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Adler David H
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Hollander Judd E
January 2020 Update
Journal Article
Malveau Susan E
Moore Andrew B
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
Summa Health Akron
Sun Benjamin C
Weiss Robert E
Wilber Scott T
Yagapen Annick N
-
Text
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URL Address
https://doi.org/10.1016/j.jamcollsurg.2019.08.696
Pages
524- 541
Volume
73
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Issue
5
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Summa Health Akron
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
American Board of Emergency Medicine Report on Residency and Fellowship Training Information (2018-2019)
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https://orcid.org/0000-0001-9897-1275<a href="https://orcid.org/0000-0001-9897-1275" target="_blank" rel="noreferrer noopener">https://orcid.org/0000-0001-9897-1275</a>
Creator
An entity primarily responsible for making the resource
Nelson LS, Keim SM, <span style="text-decoration:underline;"><strong>Beeson MS</strong></span>, Chudnofsky CR, Gausche-Hill M, Gorgas DL, Goyal DG, Kowalenko T, Muelleman RL; Research Committee, American Board of Emergency Medicine, Joldersma KB, Johnston MM
Publisher
An entity responsible for making the resource available
Annals of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
Subject
The topic of the resource
medical education
Description
An account of the resource
The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine-sponsored residency and fellowship programs, residents and fellows training in those programs, and all fellows for whom ABEM issues subspecialty certifications. We present the 2019 annual report on the status of US emergency medicine training programs.
Identifier
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10.1016/j.annemergmed.2019.03.024
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2019
Annals of emergency medicine
Department of Emergency Medicine
Michael S. Beeson
NEOMED College of Medicine
Summa Health Akron
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.annemergmed.2019.08.429" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.annemergmed.2019.08.429</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
ISSN
1097-6760
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<a href="http://ezproxy.neomed.idm.oclc.org/login?url=http://doi.org/10.1016/j.annemergmed.2019.08.429" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1016/j.annemergmed.2019.08.429</a>
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Title
A name given to the resource
Risk Stratification of Older Adults Who Present to the Emergency Department With Syncope: The FAINT Score
Publisher
An entity responsible for making the resource available
Annals Of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-10-23
Creator
An entity primarily responsible for making the resource
Probst Marc A; Gibson Thomas; Weiss Robert E; Yagapen Annick N; Malveau Susan E; Adler David H; Bastani Aveh; Baugh Christopher W; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Hollander Judd E; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Sun Benjamin C
Description
An account of the resource
STUDY OBJECTIVE: Older adults with syncope are commonly treated in the emergency department (ED). We seek to derive a novel risk-stratification tool to predict 30-day serious cardiac outcomes. METHODS: We performed a prospective, observational study of older adults (≥60 years) with unexplained syncope or near syncope who presented to 11 EDs in the United States. Patients with a serious diagnosis identified in the ED were excluded. We collected clinical and laboratory data on all patients. Our primary outcome was 30-day all-cause mortality or serious cardiac outcome. RESULTS: We enrolled 3,177 older adults with unexplained syncope or near syncope between April 2013 and September 2016. Mean age was 73 years (SD 9.0 years). The incidence of the primary outcome was 5.7% (95% confidence interval [CI] 4.9% to 6.5%). Using Bayesian logistic regression, we derived the FAINT score: history of heart failure, history of cardiac arrhythmia, initial abnormal ECG result, elevated pro B-type natriuretic peptide, and elevated high-sensitivity troponin T. A FAINT score of 0 versus greater than or equal to 1 had sensitivity of 96.7% (95% CI 92.9% to 98.8%) and specificity 22.2% (95% CI 20.7% to 23.8%), respectively. The FAINT score tended to be more accurate than unstructured physician judgment: area under the curve 0.704 (95% CI 0.669 to 0.739) versus 0.630 (95% CI 0.589 to 0.670). CONCLUSION: Among older adults with syncope or near syncope of potential cardiac cause, a FAINT score of zero had a reasonably high sensitivity for excluding death and serious cardiac outcomes at 30 days. If externally validated, this tool could improve resource use for this common condition.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.annemergmed.2019.08.429" target="_blank" rel="noreferrer noopener">10.1016/j.annemergmed.2019.08.429</a>
PMID: 31668571
Format
The file format, physical medium, or dimensions of the resource
Journal Article
2019
Adler David H
Annals of emergency medicine
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Gibson Thomas
Hollander Judd E
Journal Article
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
November 2019 Update
Probst Marc A
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Summa Health System Akron City Hospital
Sun Benjamin C
Weiss Robert E
Wilber Scott T
Yagapen Annick N
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.annemergmed.2019.03.031" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.annemergmed.2019.03.031</a>
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Title
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Clinical Benefit of Hospitalization for Older Adults With Unexplained Syncope: A Propensity-Matched Analysis
Publisher
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Annals of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
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Probst Marc A; Su Erica; Weiss Robert E; Yagapen Annick N; Malveau Susan E; Adler David H; Bastani Aveh; Baugh Christopher W; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Hollander Judd E; Nicks Bret A; Nishijima Daniel K; Shah Manish N; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Sun Benjamin C
Description
An account of the resource
STUDY OBJECTIVE: Many adults with syncope are hospitalized solely for observation and testing. We seek to determine whether hospitalization versus outpatient management for older adults with unexplained syncope is associated with a reduction in postdisposition serious adverse events at 30 days. METHODS: We performed a propensity score analysis using data from a prospective, observational study of older adults with unexplained syncope or near syncope who presented to 11 emergency departments (EDs) in the United States. We enrolled adults (≥60 years) who presented with syncope or near syncope. We excluded patients with a serious diagnosis identified in the ED. Clinical and laboratory data were collected on all patients. The primary outcome was rate of post-ED serious adverse events at 30 days. RESULTS: We enrolled 2,492 older adults with syncope and no serious ED diagnosis from April 2013 to September 2016. Mean age was 73 years (SD 8.9 years), and 51% were women. The incidence of serious adverse events within 30 days after the index visit was 7.4% for hospitalized patients and 3.19% for discharged patients, representing an unadjusted difference of 4.2% (95% confidence interval 2.38% to 6.02%). After propensity score matching on risk of hospitalization, there was no statistically significant difference in serious adverse events at 30 days between the hospitalized group (4.89%) and the discharged group (2.82%) (risk difference 2.07%; 95% confidence interval -0.24% to 4.38%). CONCLUSION: In our propensity-matched sample of older adults with unexplained syncope, for those with clinical characteristics similar to that of the discharged cohort, hospitalization was not associated with improvement in 30-day serious adverse event rates.
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<a href="http://doi.org/10.1016/j.annemergmed.2019.03.031" target="_blank" rel="noreferrer noopener">10.1016/j.annemergmed.2019.03.031</a>
2019
Adler David H
Annals of emergency medicine
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Department of Emergency Medicine
Diercks Deborah B
Hollander Judd E
June 2019 Update
Malveau Susan E
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Probst Marc A
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
Sun Benjamin C
Weiss Robert E
Wilber Scott T
Yagapen Annick N
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.jemermed.2019.03.007" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jemermed.2019.03.007</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
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Title
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Hemorrhagic Soft Tissue Upper Airway Obstruction From Brodifacoum-Contaminated Synthetic Cannabinoid
Publisher
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The Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Subject
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brodifacoum; cannabinoid; coagulopathy; soft tissue hemorrhage; synthetic marijuana
Creator
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Ross Christopher H; Singh Parvinder; Simon Erin L
Description
An account of the resource
BACKGROUND: More than 60 types of cannabinoids are found in nature; the remaining are chemically synthesized analogs of natural cannabinoids. Synthetic cannabinoids were first reported in the United States in 2008. These compounds are usually smoked by users and are sold under various names. Synthesized products have clinical effects that are similar to the effects of cannabis, which include tachycardia, conjunctival injection, nystagmus, vomiting, and ataxia. In cases of acute overdose, hyperthermia, acute kidney injury, seizures, and rhabdomyolysis can occur. CASE REPORT: Deaths and life-threatening coagulopathies caused by brodifacoum (BDF) adulteration of synthetic cannabinoids have been reported in Illinois and other regions of the United States. BDF is a long-acting vitamin K-dependent antagonist that is often used as rat poison and that can cause massive hemorrhage. BDF is sometimes referred to as "superwarfarin" because the anticoagulant effect is 100 times greater than warfarin on a molar basis and its half-life is 20-130 days, which markedly exceeds that of warfarin. The rationale for lacing synthetic cannabinoids with BDF may be associated with attempts to enhance psychoactive effect of the drug, keeping the user high for a longer period of time because of lipid storage, hepatic metabolism, and slow release. We present the case of a healthy 27-year-old man who developed severe soft tissue hemorrhage and airway obstruction after use of a cannabinoid laced with BDF. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: To date there have been no case reports documenting severe soft tissue hemorrhage leading to airway obstruction and respiratory failure from synthetic cannabinoid use, whether or not the synthetic cannabinoid has been adulterated. Severe complications can arise from use, and treatment includes vitamin K and supportive therapy because the resulting coagulopathy can take days to weeks to resolve.
Identifier
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<a href="http://doi.org/10.1016/j.jemermed.2019.03.007" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2019.03.007</a>
2019
brodifacoum
Cannabinoid
coagulopathy
Department of Emergency Medicine
June 2019 Update
NEOMED College of Medicine
Ross Christopher H
Simon Erin L
Singh Parvinder
soft tissue hemorrhage
synthetic marijuana
The Journal of emergency medicine
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.ajem.2019.05.061" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2019.05.061</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
1738-1742
Issue
9
Volume
37
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Title
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Differences in patient population and length of stay between freestanding and hospital-based emergency departments
Publisher
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The American Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-09
Creator
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Simon Erin L; Shakya Sunita; Muir McKinsey; Fertel Baruch S
Description
An account of the resource
BACKGROUND: Freestanding emergency departments (FEDs) represent over 10% of emergency departments (EDs) in the United States. Little is known about differences in encounter characteristics. We compared ED length of stay (LOS) clinical demographics, method of arrival, acuity level, and patient disposition for encounters to FEDs vs. hospital-based EDs (HBEDs). METHODS: A multi-center retrospective analysis was performed. Study sites included 6 FEDs and 13 HBEDs from 10/1/2017 to 9/30/2018. Data was abstracted from ED records and discharge summary within the electronic health record. Descriptive statistics were reported with prevalence (95% Confidence Interval [CI]) for categorical variables and mean (standard deviation [SD]) for continuous variables. Multivariable linear regression assessed the relationship between ED facility (FEDs vs. HBEDs) and ED length of stay (LOS). RESULTS: 1,263,297 encounters were analyzed. Mean ED LOS was shorter at FEDs (146.62 min (±97.04)) vs. HBED (249.70 min (+287.50)). Nine percent of FED encounters arrived via EMS vs. 21% at the HBEDs. FEDs saw 5.47% emergency severity index (ESI) level 2 vs. 13.76% at the HBEDs. Medicaid and Medicare patients were more prevalent in HBEDs (64.2%) than in FEDs (50.6%). FEDs admitted 13% of patients and HBEDs 27%. All results were significant (p < 0.001). After adjusting for potential confounding variables, patients utilizing FEDs had 16.2% shorter ED LOS vs. HBEDs (β = -0.18 [95% CI: -0.18 to -0.17]). CONCLUSION: Overall ED LOS was significantly less for FED vs. HBED patients. Acuity level, insurance status, method of arrival, and patient disposition were significantly different at FEDs vs. HBEDs.
Identifier
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<a href="http://doi.org/10.1016/j.ajem.2019.05.061" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2019.05.061</a>
2019
Department of Emergency Medicine
Fertel Baruch S
Muir McKinsey
NEOMED College of Medicine
September 2019 Update
Shakya Sunita
Simon Erin L
The American journal of emergency medicine
-
Text
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URL Address
<a href="http://doi.org/10.1016/j.jemermed.2019.10.034" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jemermed.2019.10.034</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
ISSN
0736-4679
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<a href="http://ezproxy.neomed.idm.oclc.org/login?url=http://doi.org/10.1016/j.jemermed.2019.10.034" target="_blank" rel="noreferrer noopener">NEOMED Full-text Holding (if available) - Proxy DOI: 10.1016/j.jemermed.2019.10.034</a>
<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Update Year & Number
January 2020 Update
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Emergency Medicine
Affiliated Hospital
Cleveland Clinic Akron General Hospital
Dublin Core
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Title
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Systematic Review: The Role of Intravenous and Oral Contrast in the Computed Tomography Evaluation of Acute Appendicitis
Publisher
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The Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-12-13
Subject
The topic of the resource
acute appendicitis; contrast; CT
Creator
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Soucy Zachary; Cheng David; Vilke Gary M; Childers Richard
Description
An account of the resource
BACKGROUND: This systematic review provides practicing emergency physicians updated information regarding the role of oral and intravenous contrast in the computed tomography (CT) evaluation of acute appendicitis. METHODS: A PubMed literature search was conducted from January 1, 1996 to December 31, 2018 and limited to human clinical trials written in English with relevant keywords. High-quality studies were identified and then underwent a structured review. Recommendations are made based on the literature review. RESULTS: Fifty-seven articles met criteria for rigorous review, of which 14 were appropriate for citation in this review. Excellent evidence shows that oral contrast does not improve the test characteristics of CT with intravenous contrast (IVCT) in the evaluation of adults suspected of having acute appendicitis. Good evidence shows that noncontrast abdominal CTs have excellent test characteristics for this same group of patients. CONCLUSIONS: Considering its downsides and lack of utility, the medical literature does not support using oral contrast in the evaluation of acute appendicitis. There is no direct evidence showing that IVCT is better than a noncontrast CT in the evaluation of acute appendicitis; however, the available literature is consistent with slightly better test characteristics for IVCTs. Still, if IVCT cannot be obtained in a timely manner, noncontrast CTs are extremely accurate in detecting this disease.
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<a href="http://doi.org/10.1016/j.jemermed.2019.10.034" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2019.10.034</a>
PMID: 31843324
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Journal Article
2019
acute appendicitis
Cheng David
Childers Richard
Cleveland Clinic Akron General Hospital
Contrast
ct
Department of Emergency Medicine
January 2020 Update
Journal Article
NEOMED College of Medicine
Soucy Zachary
The Journal of emergency medicine
Vilke Gary M
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.ajem.2018.07.043" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ajem.2018.07.043</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
810-816
Issue
5
Volume
37
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Variation in diagnostic testing for older patients with syncope in the emergency department
Publisher
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American Journal of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Subject
The topic of the resource
Cost; Diagnostic testing; Emergency department; Near syncope; Syncope; Variation; Yield
Creator
An entity primarily responsible for making the resource
Su Erica; Nicks Bret A; Shah Manish N; Adler David H; Bastani Aveh; Caterino Jeffrey M; Clark Carol L; Diercks Deborah B; Hollander Judd E; Malveau Susan E; Nishijima Daniel K; Stiffler Kirk A; Storrow Alan B; Wilber Scott T; Yagapen Annick N; Weiss Robert E; Gibson Thomas A; Baugh Christopher W; Sun Benjamin C
Description
An account of the resource
Background Older adults presenting with syncope often undergo intensive diagnostic testing with unclear benefit. We determined the variation, frequency, yield, and costs of tests obtained to evaluate older persons with syncope.
Identifier
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<a href="http://doi.org/10.1016/j.ajem.2018.07.043" target="_blank" rel="noreferrer noopener">10.1016/j.ajem.2018.07.043</a>
2019
Adler David H
American Journal of Emergency Medicine
Bastani Aveh
Baugh Christopher W
Caterino Jeffrey M
Clark Carol L
Cost
Department of Emergency Medicine
diagnostic testing
Diercks Deborah B
Emergency department
Gibson Thomas A
Hollander Judd E
June 2019 Update
Malveau Susan E
Near syncope
NEOMED College of Medicine
Nicks Bret A
Nishijima Daniel K
Shah Manish N
Stiffler Kirk A
Storrow Alan B
Su Erica
Sun Benjamin C
Syncope
Variation
Weiss Robert E
Wilber Scott T
Yagapen Annick N
Yield
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.annemergmed.2018.12.005" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.annemergmed.2018.12.005</a>
Pages
500–510
Issue
5
Volume
73
ISSN
0196-0644
Search for Full-text
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Title
A name given to the resource
Prevalence of Pulmonary Embolism Among Emergency Department Patients With Syncope: A Multicenter Prospective Cohort Study
Publisher
An entity responsible for making the resource available
Annals of Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Subject
The topic of the resource
Emergency Medicine; guidelines; diagnostic-tests; yield; risk-stratification; short-term
Creator
An entity primarily responsible for making the resource
Thiruganasambandamoorthy V; Sivilotti M L A; Rowe B H; McRae A D; Mukarram M; Malveau S; Yagapen A N; Sun B C; Nemnom M J; Huang L; Taljaard M; Gaudet S; Kim S M; Adler D H; Bastani A; Baugh C W; Caterino J M; Clark C L; Diercks D B; Hollander J E; Nicks B A; Nishijima D K; Shah M N; Stiffler K A; Wilber S T; Storrow A B; North Amer Syncope Consortium
Description
An account of the resource
Study objective: The prevalence of pulmonary embolism among patients with syncope is understudied. In accordance with a recent study with an exceptionally high pulmonary embolism prevalence, some advocate evaluating all syncope patients for pulmonary embolism, including those with another clear cause for their syncope. We seek to evaluate the pulmonary embolism prevalence among emergency department (ED) patients with syncope. Methods: We combined data from 2 large prospective studies enrolling adults with syncope from 17 EDs in Canada and the United States. Each study collected the results of pulmonary embolism-related investigations (ie, D-dimer, ventilation-perfusion scan, or computed tomography [CT] pulmonary angiography) and 30-day adjudicated outcomes: pulmonary embolism or nonpulmonary embolism outcome (arrhythmia, myocardial infarction, serious hemorrhage, and death). Results: Of the 9,374 patients enrolled, 9,091 (97.0%; median age 66 years, 51.9% women) with 30-day follow-up were analyzed: 547 (6.0%) were evaluated for pulmonary embolism (278 [3.1%] had D-dimer, 39 [0.4%] had ventilation-perfusion scan, and 347 [3.8%] had CT pulmonary angiography). Overall, 874 patients (9.6%) experienced 30-day serious outcomes: 818 patients (9.0%) with nonpulmonary embolism serious outcomes and 56 (prevalence 0.6%; 95% confidence interval 0.5% to 0.8%) with pulmonary embolism (including 8 [0.2%] out of 3521 patients diagnosed during the index hospitalization and 7 [0.1%] diagnosed after the index visit). Eighty-six patients (0.9%) died, and 4 deaths (0.04%) were related to pulmonary embolism. Only 11 patients (0.1%) with a nonpulmonary embolism serious condition had a concomitant pulmonary embolism. Conclusion: The prevalence of pulmonary embolism is very low among ED patients with syncope, including those hospitalized after syncope. Although an underlying pulmonary embolism may cause syncope, clinicians should be cautious about indiscriminate investigations for pulmonary embolism.
Identifier
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<a href="http://doi.org/10.1016/j.annemergmed.2018.12.005" target="_blank" rel="noreferrer noopener">10.1016/j.annemergmed.2018.12.005</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2019
Adler D H
Annals of emergency medicine
Bastani A
Baugh C W
Caterino J M
Clark C L
Department of Emergency Medicine
diagnostic-tests
Diercks D B
Emergency Medicine
Gaudet S
guidelines
Hollander J E
Huang L
June 2019 Update
Kim S M
Malveau S
McRae A D
Mukarram M
Nemnom M J
NEOMED College of Medicine
Nicks B A
Nishijima D K
North Amer Syncope Consortium
risk-stratification
Rowe B H
Shah M N
short-term
Sivilotti M L A
Stiffler K A
Storrow A B
Sun B C
Taljaard M
Thiruganasambandamoorthy V
Wilber S T
Yagapen A N
Yield