Skip to main content

Christopher Lindsell

Professor of Biostatistics & Bioinformatics
Biostatistics & Bioinformatics, Division of Biostatistics

Selected Publications


Upstrapping to determine futility: predicting future outcomes nonparametrically from past data.

Journal Article Trials · May 9, 2024 BACKGROUND: Clinical trials often involve some form of interim monitoring to determine futility before planned trial completion. While many options for interim monitoring exist (e.g., alpha-spending, conditional power), nonparametric based interim monitori ... Full text Link to item Cite

Association between weight-for-length percentile and ICU length of stay in patients with a single ventricle undergoing bidirectional Glenn repair: A retrospective cohort study.

Journal Article JPEN J Parenter Enteral Nutr · May 2024 BACKGROUND: Poor weight gain has been identified as an independent risk factor for increased surgical morbidity and mortality for patients with single-ventricle physiology undergoing staged surgical palliation. Conversely, excessive weight gain has also em ... Full text Link to item Cite

Efficacy and Safety of Dapagliflozin in Patients With Acute Heart Failure.

Journal Article J Am Coll Cardiol · April 9, 2024 BACKGROUND: The primary goals during acute heart failure (AHF) hospitalization are decongestion and guideline-directed medical therapy (GDMT) optimization. Unlike diuretics or other GDMT, early dapagliflozin initiation could achieve both AHF goals. OBJECTI ... Full text Link to item Cite

Abatacept Pharmacokinetics and Exposure Response in Patients Hospitalized With COVID-19: A Secondary Analysis of the ACTIV-1 IM Randomized Clinical Trial.

Journal Article JAMA Netw Open · April 1, 2024 IMPORTANCE: The pharmacokinetics of abatacept and the association between abatacept exposure and outcomes in patients with severe COVID-19 are unknown. OBJECTIVE: To characterize abatacept pharmacokinetics, relate drug exposure with clinical outcomes, and ... Full text Link to item Cite

Effect of a Co-Located Bridging Recovery Initiative on Hospital Length of Stay Among Patients With Opioid Use Disorder: The BRIDGE Randomized Clinical Trial.

Journal Article JAMA Netw Open · February 5, 2024 IMPORTANCE: Co-located bridge clinics aim to facilitate a timely transition to outpatient care for inpatients with opioid use disorder (OUD); however, their effect on hospital length of stay (LOS) and postdischarge outcomes remains unclear. OBJECTIVE: To e ... Full text Link to item Cite

Robotic versus Electromagnetic bronchoscopy for pulmonary LesIon AssessmeNT: the RELIANT pragmatic randomized trial.

Journal Article Trials · January 19, 2024 BACKGROUND: Robotic-assisted bronchoscopy has recently emerged as an alternative to electromagnetic navigational bronchoscopy for the evaluation of peripheral pulmonary lesions. While robotic-assisted bronchoscopy is proposed to have several advantages, su ... Full text Link to item Cite

Public Perceptions and Informational Needs Regarding Surgical Residents.

Journal Article J Surg Educ · January 2024 OBJECTIVE: Identify what topics are of most interest to patients regarding surgical residents. DESIGN: Survey of general public describing a hypothetical surgery and then assessing comfort level with resident involvement in surgery, reactions to disclosure ... Full text Link to item Cite

Machine learning-driven identification of the gene-expression signature associated with a persistent multiple organ dysfunction trajectory in critical illness.

Journal Article EBioMedicine · January 2024 BACKGROUND: Multiple organ dysfunction syndrome (MODS) disproportionately drives morbidity and mortality among critically ill patients. However, we lack a comprehensive understanding of its pathobiology. Identification of genes associated with a persistent ... Full text Link to item Cite

Peer review of clinical and translational research manuscripts: Perspectives from statistical collaborators.

Journal Article J Clin Transl Sci · 2024 Research articles in the clinical and translational science literature commonly use quantitative data to inform evaluation of interventions, learn about the etiology of disease, or develop methods for diagnostic testing or risk prediction of future events. ... Full text Link to item Cite

Trends in use of composite endpoints in clinical trials: A comparison between acute heart failure trials and COVID-19 trials.

Journal Article J Clin Transl Sci · 2024 Composite endpoints can encode multiple pieces of information and are increasingly adopted in clinical trials. Advocacy for using composite endpoints began decades ago in cardiovascular trials, leading to incorporation of patient-oriented outcomes and cons ... Full text Link to item Cite

Cost-Effectiveness of HIV Screening in Emergency Departments: Results From the Pragmatic Randomized HIV Testing Using Enhanced Screening Techniques in Emergency Departments Trial

Journal Article Annals of Emergency Medicine · January 1, 2024 Study objective: Identification of HIV remains a critical health priority for which emergency departments (EDs) are a central focus. The comparative cost-effectiveness of various HIV screening strategies in EDs remains largely unknown. The goal of this stu ... Full text Cite

Higher-Dose Fluvoxamine and Time to Sustained Recovery in Outpatients With COVID-19: The ACTIV-6 Randomized Clinical Trial.

Journal Article JAMA · December 26, 2023 IMPORTANCE: The effect of higher-dose fluvoxamine in reducing symptom duration among outpatients with mild to moderate COVID-19 remains uncertain. OBJECTIVE: To assess the effectiveness of fluvoxamine, 100 mg twice daily, compared with placebo, for treatin ... Full text Link to item Cite

Pharmacist Review of Chronic Inhaler Therapy Appropriateness for Hospitalized Patients with COPD or Asthma.

Journal Article J Am Coll Clin Pharm · December 2023 INTRODUCTION: Patients with asthma and chronic obstructive pulmonary disease rely on inhaler therapy to reduce disease progression and exacerbation risk. Patients admitted to the hospital are at an increased risk for exacerbations and readmission if their ... Full text Link to item Cite

Pediatric Persistent Inflammation, Immunosuppression, and Catabolism Syndrome Prevalence in Sepsis-Related Mortalities: A 23-Year Institutional History.

Journal Article Chest · November 2023 BACKGROUND: Delayed mortality in sepsis often is linked to a lack of resolution in the inflammatory cascade termed persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Limited research exists on PICS in pediatric patients with sepsis ... Full text Link to item Cite

The Association of Organizational Readiness With Lung Cancer Screening Utilization.

Journal Article Am J Prev Med · November 2023 INTRODUCTION: Lung cancer screening is widely underutilized. Organizational factors, such as readiness for change and belief in the value of change (change valence), may contribute to underutilization. The aim of this study was to evaluate the association ... Full text Link to item Cite

Inhaled Fluticasone Furoate for Outpatient Treatment of Covid-19.

Journal Article N Engl J Med · September 21, 2023 BACKGROUND: The effectiveness of inhaled glucocorticoids in shortening the time to symptom resolution or preventing hospitalization or death among outpatients with mild-to-moderate coronavirus disease 2019 (Covid-19) is unclear. METHODS: We conducted a dec ... Full text Link to item Cite

Blood Pressure Management After Endovascular Therapy for Acute Ischemic Stroke: The BEST-II Randomized Clinical Trial.

Journal Article JAMA · September 5, 2023 IMPORTANCE: The effects of moderate systolic blood pressure (SBP) lowering after successful recanalization with endovascular therapy for acute ischemic stroke are uncertain. OBJECTIVE: To determine the futility of lower SBP targets after endovascular thera ... Full text Link to item Cite

Upstrapping to determine futility: predicting future outcomes nonparametrically from past data.

Journal Article Trials · May 9, 2024 BACKGROUND: Clinical trials often involve some form of interim monitoring to determine futility before planned trial completion. While many options for interim monitoring exist (e.g., alpha-spending, conditional power), nonparametric based interim monitori ... Full text Link to item Cite

Association between weight-for-length percentile and ICU length of stay in patients with a single ventricle undergoing bidirectional Glenn repair: A retrospective cohort study.

Journal Article JPEN J Parenter Enteral Nutr · May 2024 BACKGROUND: Poor weight gain has been identified as an independent risk factor for increased surgical morbidity and mortality for patients with single-ventricle physiology undergoing staged surgical palliation. Conversely, excessive weight gain has also em ... Full text Link to item Cite

Efficacy and Safety of Dapagliflozin in Patients With Acute Heart Failure.

Journal Article J Am Coll Cardiol · April 9, 2024 BACKGROUND: The primary goals during acute heart failure (AHF) hospitalization are decongestion and guideline-directed medical therapy (GDMT) optimization. Unlike diuretics or other GDMT, early dapagliflozin initiation could achieve both AHF goals. OBJECTI ... Full text Link to item Cite

Abatacept Pharmacokinetics and Exposure Response in Patients Hospitalized With COVID-19: A Secondary Analysis of the ACTIV-1 IM Randomized Clinical Trial.

Journal Article JAMA Netw Open · April 1, 2024 IMPORTANCE: The pharmacokinetics of abatacept and the association between abatacept exposure and outcomes in patients with severe COVID-19 are unknown. OBJECTIVE: To characterize abatacept pharmacokinetics, relate drug exposure with clinical outcomes, and ... Full text Link to item Cite

Effect of a Co-Located Bridging Recovery Initiative on Hospital Length of Stay Among Patients With Opioid Use Disorder: The BRIDGE Randomized Clinical Trial.

Journal Article JAMA Netw Open · February 5, 2024 IMPORTANCE: Co-located bridge clinics aim to facilitate a timely transition to outpatient care for inpatients with opioid use disorder (OUD); however, their effect on hospital length of stay (LOS) and postdischarge outcomes remains unclear. OBJECTIVE: To e ... Full text Link to item Cite

Robotic versus Electromagnetic bronchoscopy for pulmonary LesIon AssessmeNT: the RELIANT pragmatic randomized trial.

Journal Article Trials · January 19, 2024 BACKGROUND: Robotic-assisted bronchoscopy has recently emerged as an alternative to electromagnetic navigational bronchoscopy for the evaluation of peripheral pulmonary lesions. While robotic-assisted bronchoscopy is proposed to have several advantages, su ... Full text Link to item Cite

Public Perceptions and Informational Needs Regarding Surgical Residents.

Journal Article J Surg Educ · January 2024 OBJECTIVE: Identify what topics are of most interest to patients regarding surgical residents. DESIGN: Survey of general public describing a hypothetical surgery and then assessing comfort level with resident involvement in surgery, reactions to disclosure ... Full text Link to item Cite

Machine learning-driven identification of the gene-expression signature associated with a persistent multiple organ dysfunction trajectory in critical illness.

Journal Article EBioMedicine · January 2024 BACKGROUND: Multiple organ dysfunction syndrome (MODS) disproportionately drives morbidity and mortality among critically ill patients. However, we lack a comprehensive understanding of its pathobiology. Identification of genes associated with a persistent ... Full text Link to item Cite

Peer review of clinical and translational research manuscripts: Perspectives from statistical collaborators.

Journal Article J Clin Transl Sci · 2024 Research articles in the clinical and translational science literature commonly use quantitative data to inform evaluation of interventions, learn about the etiology of disease, or develop methods for diagnostic testing or risk prediction of future events. ... Full text Link to item Cite

Trends in use of composite endpoints in clinical trials: A comparison between acute heart failure trials and COVID-19 trials.

Journal Article J Clin Transl Sci · 2024 Composite endpoints can encode multiple pieces of information and are increasingly adopted in clinical trials. Advocacy for using composite endpoints began decades ago in cardiovascular trials, leading to incorporation of patient-oriented outcomes and cons ... Full text Link to item Cite

Cost-Effectiveness of HIV Screening in Emergency Departments: Results From the Pragmatic Randomized HIV Testing Using Enhanced Screening Techniques in Emergency Departments Trial

Journal Article Annals of Emergency Medicine · January 1, 2024 Study objective: Identification of HIV remains a critical health priority for which emergency departments (EDs) are a central focus. The comparative cost-effectiveness of various HIV screening strategies in EDs remains largely unknown. The goal of this stu ... Full text Cite

Higher-Dose Fluvoxamine and Time to Sustained Recovery in Outpatients With COVID-19: The ACTIV-6 Randomized Clinical Trial.

Journal Article JAMA · December 26, 2023 IMPORTANCE: The effect of higher-dose fluvoxamine in reducing symptom duration among outpatients with mild to moderate COVID-19 remains uncertain. OBJECTIVE: To assess the effectiveness of fluvoxamine, 100 mg twice daily, compared with placebo, for treatin ... Full text Link to item Cite

Pharmacist Review of Chronic Inhaler Therapy Appropriateness for Hospitalized Patients with COPD or Asthma.

Journal Article J Am Coll Clin Pharm · December 2023 INTRODUCTION: Patients with asthma and chronic obstructive pulmonary disease rely on inhaler therapy to reduce disease progression and exacerbation risk. Patients admitted to the hospital are at an increased risk for exacerbations and readmission if their ... Full text Link to item Cite

Pediatric Persistent Inflammation, Immunosuppression, and Catabolism Syndrome Prevalence in Sepsis-Related Mortalities: A 23-Year Institutional History.

Journal Article Chest · November 2023 BACKGROUND: Delayed mortality in sepsis often is linked to a lack of resolution in the inflammatory cascade termed persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Limited research exists on PICS in pediatric patients with sepsis ... Full text Link to item Cite

The Association of Organizational Readiness With Lung Cancer Screening Utilization.

Journal Article Am J Prev Med · November 2023 INTRODUCTION: Lung cancer screening is widely underutilized. Organizational factors, such as readiness for change and belief in the value of change (change valence), may contribute to underutilization. The aim of this study was to evaluate the association ... Full text Link to item Cite

Inhaled Fluticasone Furoate for Outpatient Treatment of Covid-19.

Journal Article N Engl J Med · September 21, 2023 BACKGROUND: The effectiveness of inhaled glucocorticoids in shortening the time to symptom resolution or preventing hospitalization or death among outpatients with mild-to-moderate coronavirus disease 2019 (Covid-19) is unclear. METHODS: We conducted a dec ... Full text Link to item Cite

Blood Pressure Management After Endovascular Therapy for Acute Ischemic Stroke: The BEST-II Randomized Clinical Trial.

Journal Article JAMA · September 5, 2023 IMPORTANCE: The effects of moderate systolic blood pressure (SBP) lowering after successful recanalization with endovascular therapy for acute ischemic stroke are uncertain. OBJECTIVE: To determine the futility of lower SBP targets after endovascular thera ... Full text Link to item Cite

Modifiable in-hospital factors for 12-month global cognition, post-traumatic stress disorder symptoms, and depression symptoms in adults hospitalized with COVID-19.

Journal Article Influenza Other Respir Viruses · September 2023 BACKGROUND: We sought to identify potentially modifiable in-hospital factors associated with global cognition, post-traumatic stress disorder (PTSD) symptoms, and depression symptoms at 12 months. METHODS: This was a multi-center prospective cohort study i ... Full text Link to item Cite

Incorrect Nonauthor Collaborator Name.

Journal Article JAMA · August 15, 2023 Full text Link to item Cite

Life After Mild Traumatic Brain Injury: Widespread Structural Brain Changes Associated With Psychological Distress Revealed With Multimodal Magnetic Resonance Imaging.

Journal Article Biol Psychiatry Glob Open Sci · July 2023 BACKGROUND: Traumatic brain injury (TBI) can alter brain structure and lead to onset of persistent neuropsychological symptoms. This study investigates the relationship between brain injury and psychological distress after mild TBI using multimodal magneti ... Full text Link to item Cite

The IMpact of PerioperAtive KeTamine on Enhanced Recovery after Abdominal Surgery (IMPAKT ERAS): protocol for a pragmatic, randomized, double-blinded, placebo-controlled trial.

Journal Article BMC Anesthesiol · June 30, 2023 BACKGROUND: Multimodal analgesic strategies that reduce perioperative opioid consumption are well-supported in Enhanced Recovery After Surgery (ERAS) literature. However, the optimal analgesic regimen has not been established, as the contributions of each ... Full text Link to item Cite

Early Serial Echocardiographic and Ultrasonographic Findings in Critically Ill Patients With COVID-19.

Journal Article CHEST Crit Care · June 2023 BACKGROUND: Cardiac function of critically ill patients with COVID-19 generally has been reported from clinically obtained data. Echocardiographic deformation imaging can identify ventricular dysfunction missed by traditional echocardiographic assessment. ... Full text Link to item Cite

The importance of appropriate selection of clinical endpoints in outpatient COVID-19 clinical trials.

Journal Article Commun Med (Lond) · April 17, 2023 Clinical trial endpoints must be carefully and intentionally selected so that the results of the trial can be used to inform policy- and decision-making. The relative importance of potential endpoints often depends on the stakeholder, with patients having ... Full text Link to item Cite

Walk before you run: Feasibility challenges and lessons learned from the PROCLAIM study, a multicenter randomized controlled trial of misoprostol for prevention of recurrent Clostridioides difficile during COVID-19.

Journal Article Anaerobe · April 2023 We analyzed our challenging experience with a randomized controlled trial of misoprostol for prevention of recurrent C. difficile. Despite careful prescreening and thoughtful protocol modifications to facilitate enrollment, we closed the study early after ... Full text Link to item Cite

Effect of Higher-Dose Ivermectin for 6 Days vs Placebo on Time to Sustained Recovery in Outpatients With COVID-19: A Randomized Clinical Trial.

Journal Article JAMA · March 21, 2023 IMPORTANCE: It is unknown whether ivermectin, with a maximum targeted dose of 600 μg/kg, shortens symptom duration or prevents hospitalization among outpatients with mild to moderate COVID-19. OBJECTIVE: To evaluate the effectiveness of ivermectin at a max ... Full text Link to item Cite

Vaccine Effectiveness Against Influenza A(H3N2)-Associated Hospitalized Illness: United States, 2022.

Journal Article Clin Infect Dis · March 21, 2023 BACKGROUND: The COVID-19 pandemic was associated with historically low influenza circulation during the 2020-2021 season, followed by an increase in influenza circulation during the 2021-2022 US season. The 2a.2 subgroup of the influenza A(H3N2) 3C.2a1b su ... Full text Link to item Cite

Lopinavir/ritonavir for treatment of non-hospitalized patients with COVID-19: a randomized clinical trial.

Journal Article Int J Infect Dis · March 2023 OBJECTIVES: Effective and widely available therapies are still needed for outpatients with COVID-19. We aimed to evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) for early treatment of non-hospitalized individuals diagnosed with COVID-19. ME ... Full text Link to item Cite

Household Transmission of Influenza A Viruses in 2021-2022.

Journal Article JAMA · February 14, 2023 IMPORTANCE: Influenza virus infections declined globally during the COVID-19 pandemic. Loss of natural immunity from lower rates of influenza infection and documented antigenic changes in circulating viruses may have resulted in increased susceptibility to ... Full text Link to item Cite

Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States.

Journal Article Clin Infect Dis · February 8, 2023 BACKGROUND: Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding ex ... Full text Link to item Cite

Association of Vitamin C, Thiamine, and Hydrocortisone Infusion With Long-term Cognitive, Psychological, and Functional Outcomes in Sepsis Survivors: A Secondary Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis Randomized Clinical Trial.

Journal Article JAMA Netw Open · February 1, 2023 IMPORTANCE: Sepsis is associated with long-term cognitive impairment and worse psychological and functional outcomes. Potential mechanisms include intracerebral oxidative stress and inflammation, yet little is known about the effects of early antioxidant a ... Full text Link to item Cite

Effect of Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial.

Journal Article JAMA · January 24, 2023 IMPORTANCE: The effectiveness of fluvoxamine to shorten symptom duration or prevent hospitalization among outpatients with mild to moderate symptomatic COVID-19 is unclear. OBJECTIVE: To evaluate the efficacy of low-dose fluvoxamine (50 mg twice daily) for ... Full text Link to item Cite

Using the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to study adaptations in lung cancer screening delivery in the Veterans Health Administration: a cohort study.

Journal Article Implement Sci Commun · January 12, 2023 BACKGROUND: Lung cancer screening is a complex clinical process that includes identification of eligible individuals, shared decision-making, tobacco cessation, and management of screening results. Adaptations to the delivery process for lung cancer screen ... Full text Link to item Cite

Incorrect Author Name.

Journal Article JAMA · January 10, 2023 Full text Link to item Cite

Evaluating automated electronic case report form data entry from electronic health records.

Journal Article J Clin Transl Sci · 2023 BACKGROUND: Many clinical trials leverage real-world data. Typically, these data are manually abstracted from electronic health records (EHRs) and entered into electronic case report forms (CRFs), a time and labor-intensive process that is also error-prone ... Full text Link to item Cite

ACTIV-6: Operationalizing a decentralized, outpatient randomized platform trial to evaluate efficacy of repurposed medicines for COVID-19.

Journal Article J Clin Transl Sci · 2023 Despite the availability of vaccinations, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to cause Coronavirus Disease 2019 (COVID-19) infection with a spectrum of disease in the acute setting. Transmission, infection, and severe dis ... Full text Link to item Cite

Rural barriers and facilitators of lung cancer screening program implementation in the veterans health administration: a qualitative study.

Journal Article Front Health Serv · 2023 INTRODUCTION: To assess healthcare professionals' perceptions of rural barriers and facilitators of lung cancer screening program implementation in a Veterans Health Administration (VHA) setting through a series of one-on-one interviews with healthcare tea ... Full text Link to item Cite

Effect of Ivermectin 600 μg/kg for 6 days vs Placebo on Time to Sustained Recovery in Outpatients with Mild to Moderate COVID-19: A Randomized Clinical Trial.

Journal Article medRxiv · December 15, 2022 BACKGROUND: Whether ivermectin, with a maximum targeted dose of 600 μg/kg, shortens symptom duration or prevents hospitalization among outpatients with mild to moderate coronavirus disease 2019 (COVID-19) remains unknown. Our objective was to evaluate the ... Full text Link to item Cite

Reliability of the Behaviorally Anchored Rating Scale (BARS) for assessing non-technical skills of medical students in simulated scenarios.

Journal Article Med Educ Online · December 2022 PURPOSE: Caring for critically ill patients requires non-technical skills such as teamwork, communication, and task management. The Behaviorally Anchored Rating Scale (BARS) is a brief tool used to assess non-technical skills. The investigators determined ... Full text Link to item Cite

Comparison of test-negative and syndrome-negative controls in SARS-CoV-2 vaccine effectiveness evaluations for preventing COVID-19 hospitalizations in the United States.

Journal Article Vaccine · November 15, 2022 BACKGROUND: Test-negative design (TND) studies have produced validated estimates of vaccine effectiveness (VE) for influenza vaccine studies. However, syndrome-negative controls have been proposed for differentiating bias and true estimates in VE evaluatio ... Full text Link to item Cite

Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation.

Journal Article N Engl J Med · November 10, 2022 BACKGROUND: Invasive mechanical ventilation in critically ill adults involves adjusting the fraction of inspired oxygen to maintain arterial oxygen saturation. The oxygen-saturation target that will optimize clinical outcomes in this patient population rem ... Full text Link to item Cite

Fluvoxamine for Outpatient Treatment of COVID-19: A Decentralized, Placebo-controlled, Randomized, Platform Clinical Trial.

Journal Article medRxiv · November 1, 2022 BACKGROUND: The effectiveness of fluvoxamine to shorten symptom duration or prevent hospitalization among outpatients in the US with mild to moderate symptomatic coronavirus disease 2019 (COVID-19) is unclear. DESIGN: ACTIV-6 is an ongoing, decentralized, ... Full text Link to item Cite

Cognitive Outcomes in the Pragmatic Investigation of optimaL Oxygen Targets (CO-PILOT) trial: protocol and statistical analysis plan.

Journal Article BMJ Open · November 1, 2022 INTRODUCTION: Long-term cognitive impairment is one of the most common complications of critical illness among survivors who receive mechanical ventilation. Recommended oxygen targets during mechanical ventilation vary among international guidelines. Diffe ... Full text Link to item Cite

Neutralizing COVID-19 Convalescent Plasma in Adults Hospitalized With COVID-19: A Blinded, Randomized, Placebo-Controlled Trial.

Journal Article Chest · November 2022 BACKGROUND: Convalescent plasma has been one of the most common treatments for COVID-19, but most clinical trial data to date have not supported its efficacy. RESEARCH QUESTION: Is rigorously selected COVID-19 convalescent plasma with neutralizing anti-SAR ... Full text Link to item Cite

Ascertainment of vaccination status by self-report versus source documentation: Impact on measuring COVID-19 vaccine effectiveness.

Journal Article Influenza Other Respir Viruses · November 2022 BACKGROUND: During the COVID-19 pandemic, self-reported COVID-19 vaccination might facilitate rapid evaluations of vaccine effectiveness (VE) when source documentation (e.g., immunization information systems [IIS]) is not readily available. We evaluated th ... Full text Link to item Cite

Vaccine effectiveness of primary series and booster doses against covid-19 associated hospital admissions in the United States: living test negative design study.

Journal Article BMJ · October 11, 2022 OBJECTIVE: To compare the effectiveness of a primary covid-19 vaccine series plus booster doses with a primary series alone for the prevention of hospital admission with omicron related covid-19 in the United States. DESIGN: Multicenter observational case- ... Full text Link to item Cite

Effectiveness of the Ad26.COV2.S (Johnson & Johnson) Coronavirus Disease 2019 (COVID-19) Vaccine for Preventing COVID-19 Hospitalizations and Progression to High Disease Severity in the United States.

Journal Article Clin Infect Dis · October 3, 2022 Background . Adults in the United States (US) began receiving the adenovirus vector coronavirus disease 2019 (COVID-19) vaccine, Ad26.COV2.S (Johnson & Johnson [Janssen]), in February 2021. We evaluated Ad26.COV2.S vaccine effectiveness (VE) against COVID- ... Full text Link to item Cite

Effect of Ivermectin vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial.

Journal Article JAMA · October 2022 ImportanceThe effectiveness of ivermectin to shorten symptom duration or prevent hospitalization among outpatients in the US with mild to moderate symptomatic COVID-19 is unknown.ObjectiveTo evaluate the efficacy of ivermectin, 400 μg/kg, ... Full text Cite

Oxygen-Free Days as an Outcome Measure in Clinical Trials of Therapies for COVID-19 and Other Causes of New-Onset Hypoxemia.

Journal Article Chest · October 2022 Mortality historically has been the primary outcome of choice for acute and critical care clinical trials. However, undue reliance on mortality can limit the scope of trials that can be performed. Large sample sizes are usually needed for trials powered fo ... Full text Link to item Cite

mRNA Vaccine Effectiveness Against Coronavirus Disease 2019 Hospitalization Among Solid Organ Transplant Recipients.

Journal Article J Infect Dis · September 13, 2022 BACKGROUND: The study objective was to evaluate 2- and 3-dose coronavirus disease 2019 (COVID-19) mRNA vaccine effectiveness (VE) in preventing COVID-19 hospitalization among adult solid organ transplant (SOT) recipients. METHODS: We conducted a 21-site ca ... Full text Link to item Cite

Balanced Crystalloid versus Saline in Adults with Traumatic Brain Injury: Secondary Analysis of a Clinical Trial.

Journal Article J Neurotrauma · September 2022 Balanced crystalloids may improve outcomes compared with saline for some critically ill adults. Lower tonicity of balanced crystalloids could worsen cerebral edema in patients with intracranial pathology. The effect of balanced crystalloids versus saline o ... Full text Link to item Cite

Multicenter International Cohort Validation of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-sedation Scale.

Journal Article Ann Surg · August 1, 2022 OBJECTIVE: In a multicenter, international cohort, we aimed to validate a modified Sequential Organ Failure Assessment (mSOFA) using the Richmond Agitation-Sedation Scale, hypothesized as comparable to the Glasgow Coma Scale (GCS)-based Sequential Organ Fa ... Full text Link to item Cite

Effect of Fluid Bolus Administration on Cardiovascular Collapse Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial.

Journal Article JAMA · July 19, 2022 IMPORTANCE: Hypotension is common during tracheal intubation of critically ill adults and increases the risk of cardiac arrest and death. Whether administering an intravenous fluid bolus to critically ill adults undergoing tracheal intubation prevents seve ... Full text Link to item Cite

Integrated PERSEVERE and endothelial biomarker risk model predicts death and persistent MODS in pediatric septic shock: a secondary analysis of a prospective observational study.

Journal Article Crit Care · July 11, 2022 BACKGROUND: Multiple organ dysfunction syndrome (MODS) is a critical driver of sepsis morbidity and mortality in children. Early identification of those at risk of death and persistent organ dysfunctions is necessary to enrich patients for future trials of ... Full text Link to item Cite

Effect of Smartphone App-Based Education on Clinician Prescribing Habits in a Learning Health Care System: A Randomized Cluster Crossover Trial.

Journal Article JAMA Netw Open · July 1, 2022 IMPORTANCE: Effective methods for engaging clinicians in continuing education for learning-based practice improvement remain unknown. OBJECTIVE: To determine whether a smartphone-based app using spaced education with retrieval practice is an effective meth ... Full text Link to item Cite

Associations between persistent symptoms after mild COVID-19 and long-term health status, quality of life, and psychological distress.

Journal Article Influenza Other Respir Viruses · July 2022 BACKGROUND: We sought to assess whether persistent COVID-19 symptoms beyond 6 months (Long-COVID) among patients with mild COVID-19 is associated with poorer health status, quality of life, and psychological distress. METHODS: This was a multicenter prospe ... Full text Link to item Cite

Assessment of Awake Prone Positioning in Hospitalized Adults With COVID-19: A Nonrandomized Controlled Trial.

Journal Article JAMA Intern Med · June 1, 2022 IMPORTANCE: Awake prone positioning may improve hypoxemia among patients with COVID-19, but whether it is associated with improved clinical outcomes remains unknown. OBJECTIVE: To determine whether the recommendation of awake prone positioning is associate ... Full text Link to item Cite

Effectiveness of mRNA Vaccines Against COVID-19 Hospitalization by Age and Chronic Medical Conditions Burden Among Immunocompetent US Adults, March-August 2021.

Journal Article J Infect Dis · May 16, 2022 Vaccine effectiveness (VE) against COVID-19 hospitalization was evaluated among immunocompetent adults (≥18 years) during March-August 2021 using a case-control design. Among 1669 hospitalized COVID-19 cases (11% fully vaccinated) and 1950 RT-PCR-negative ... Full text Link to item Cite

Effectiveness of Severe Acute Respiratory Syndrome Coronavirus 2 Messenger RNA Vaccines for Preventing Coronavirus Disease 2019 Hospitalizations in the United States.

Journal Article Clin Infect Dis · May 3, 2022 BACKGROUND: As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination coverage increases in the United States, there is a need to understand the real-world effectiveness against severe coronavirus disease 2019 (COVID-19) and among people ... Full text Link to item Cite

Trial of Early Antiviral Therapies during Non-hospitalized Outpatient Window (TREAT NOW) for COVID-19: a summary of the protocol and analysis plan for a decentralized randomized controlled trial.

Journal Article Trials · April 8, 2022 BACKGROUND: Coronavirus disease 2019 (COVID-19) has a heterogeneous outcome in individuals from remaining asymptomatic to death. In a majority of cases, mild symptoms are present that do not require hospitalization and can be successfully treated in the ou ... Full text Link to item Cite

Effectiveness of mRNA Vaccination in Preventing COVID-19-Associated Invasive Mechanical Ventilation and Death - United States, March 2021-January 2022.

Journal Article MMWR Morb Mortal Wkly Rep · March 25, 2022 COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) are effective at preventing COVID-19-associated hospitalization (1-3). However, how well mRNA vaccines protect against the most severe outcomes of these hospitalizations, including ... Full text Link to item Cite

Clinical severity of, and effectiveness of mRNA vaccines against, covid-19 from omicron, delta, and alpha SARS-CoV-2 variants in the United States: prospective observational study.

Journal Article BMJ · March 9, 2022 OBJECTIVES: To characterize the clinical severity of covid-19 associated with the alpha, delta, and omicron SARS-CoV-2 variants among adults admitted to hospital and to compare the effectiveness of mRNA vaccines to prevent hospital admissions related to ea ... Full text Link to item Cite

Promoting patient and nurse safety: testing a behavioural health intervention in a learning healthcare system: results of the DEMEANOR pragmatic, cluster, cross-over trial.

Journal Article BMJ Open Qual · February 2022 BACKGROUND: Based on clinical staff safety within a learning healthcare system, the purpose of this study was to test an innovative model of care for addressing disruptive behaviour in hospitalised patients to determine whether it should be scaled up at th ... Full text Link to item Cite

Effectiveness of a Third Dose of Pfizer-BioNTech and Moderna Vaccines in Preventing COVID-19 Hospitalization Among Immunocompetent and Immunocompromised Adults - United States, August-December 2021.

Journal Article MMWR Morb Mortal Wkly Rep · January 28, 2022 COVID-19 mRNA vaccines (BNT162b2 [Pfizer-BioNTech] and mRNA-1273 [Moderna]) provide protection against infection with SARS-CoV-2, the virus that causes COVID-19, and are highly effective against COVID-19-associated hospitalization among eligible persons wh ... Full text Link to item Cite

Securely sharing DSMB reports to speed decision making from multiple, concurrent, independent studies of similar treatments in COVID-19.

Journal Article J Clin Transl Sci · 2022 INTRODUCTION: As clinical trials were rapidly initiated in response to the COVID-19 pandemic, Data and Safety Monitoring Boards (DSMBs) faced unique challenges overseeing trials of therapies never tested in a disease not yet characterized. Traditionally, i ... Full text Link to item Cite

Sharing data among clinical trials of therapeutics in COVID-19: Barriers and facilitators to collaborating in a crisis.

Journal Article J Clin Transl Sci · 2022 BACKGROUND: The Clinical and Translational Science Award Program (CTSA) Trial Innovation Network (TIN) was launched in 2016 to increase the efficiency and effectiveness of multisite trials by supporting the development of national infrastructure. With the ... Full text Link to item Cite

Modeling clinical trajectory status of critically ill COVID-19 patients over time: A method for analyzing discrete longitudinal and ordinal outcomes.

Journal Article J Clin Transl Sci · 2022 Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event a ... Full text Link to item Cite

We know what we want, it's just not there.

Journal Article J Clin Transl Sci · 2022 Full text Link to item Cite

Noninvasive Thalamotomy for Refractory Tremor by Frameless Radiosurgery.

Journal Article Int J Radiat Oncol Biol Phys · January 1, 2022 PURPOSE: We sought to determine whether a more widely accessible, noninvasive, frameless approach to radiosurgical thalamotomy would improve objective measures of refractory essential or parkinsonian tremor without added toxicity compared with reports of f ... Full text Link to item Cite

Development and implementation of the National Heart, Lung, and Blood Institute COVID-19 common data elements.

Journal Article J Clin Transl Sci · 2022 BACKGROUND: Coronavirus Disease 2019 (COVID-19) instigated a flurry of clinical research activity. The unprecedented pace with which trials were launched left an early void in data standardization, limiting the potential for subsequent data pooling. To fac ... Full text Link to item Cite

Serial Thromboelastography and the Development of Venous Thromboembolism in Critically Ill Patients With COVID-19.

Journal Article Crit Care Explor · January 2022 UNLABELLED: To test the hypothesis that relatively lower clot strength on thromboelastography maximum amplitude (MA) is associated with development of venous thromboembolism (VTE) in critically ill patients with COVID-19. DESIGN: Prospective, observational ... Full text Link to item Cite

Effect of Use of a Bougie vs Endotracheal Tube With Stylet on Successful Intubation on the First Attempt Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial.

Journal Article JAMA · December 28, 2021 IMPORTANCE: For critically ill adults undergoing emergency tracheal intubation, failure to intubate the trachea on the first attempt occurs in up to 20% of cases and is associated with severe hypoxemia and cardiac arrest. Whether using a tracheal tube intr ... Full text Link to item Cite

Modeling the Impacts of Clinical Influenza Testing on Influenza Vaccine Effectiveness Estimates.

Journal Article J Infect Dis · December 15, 2021 BACKGROUND: Test-negative design studies for evaluating influenza vaccine effectiveness (VE) enroll patients with acute respiratory infection. Enrollment typically occurs before influenza status is determined, resulting in over-enrollment of influenza-nega ... Full text Link to item Cite

Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity.

Journal Article JAMA · November 23, 2021 IMPORTANCE: A comprehensive understanding of the benefits of COVID-19 vaccination requires consideration of disease attenuation, determined as whether people who develop COVID-19 despite vaccination have lower disease severity than unvaccinated people. OBJ ... Full text Link to item Cite

Interruption of initial patient assessment in the emergency department and its effect on patient perception of care quality.

Journal Article Int J Qual Health Care · November 20, 2021 BACKGROUND: Triage is a critical first step in appropriately caring for patients in the emergency department (ED). Patients' assumptions of the care they will receive can be established in triage. Interruptions to this process can disrupt patient flow, cau ... Full text Link to item Cite

A multicenter cluster randomized, stepped wedge implementation trial for targeted normoxia in critically ill trauma patients: study protocol and statistical analysis plan for the Strategy to Avoid Excessive Oxygen (SAVE-O2) trial.

Journal Article Trials · November 8, 2021 BACKGROUND: Targeted normoxia (SpO2 90-96% or PaO2 60-100 mmHg) may help to conserve oxygen and improve outcomes in critically ill patients by avoiding potentially harmful hyperoxia. However, the role of normoxia for critically ill trauma patients remains ... Full text Link to item Cite

Bridging Recovery Initiative Despite Gaps in Entry (BRIDGE): study protocol for a randomized controlled trial of a bridge clinic compared with usual care for patients with opioid use disorder.

Journal Article Trials · October 30, 2021 BACKGROUND: Patients with substance use disorders are overrepresented among general hospital inpatients, and their admissions are associated with longer lengths of stay and increased readmission rates. Amid the national opioid crisis, increased attention h ... Full text Link to item Cite

Protocol and statistical analysis plan for the Pragmatic Investigation of optimaL Oxygen Targets (PILOT) clinical trial.

Journal Article BMJ Open · October 28, 2021 INTRODUCTION: Mechanical ventilation of intensive care unit (ICU) patients universally involves titration of the fraction of inspired oxygen to maintain arterial oxygen saturation (SpO2). However, the optimal SpO2 target remains unknown. METHODS AND ANALYS ... Full text Link to item Cite

Influenza Vaccine Effectiveness for Prevention of Severe Influenza-Associated Illness Among Adults in the United States, 2019-2020: A Test-Negative Study.

Journal Article Clin Infect Dis · October 20, 2021 BACKGROUND: Influenza vaccine effectiveness (VE) against a spectrum of severe disease, including critical illness and death, remains poorly characterized. METHODS: We conducted a test-negative study in an intensive care unit (ICU) network at 10 US hospital ... Full text Link to item Cite

Prognostic Value of Hemorrhagic Brainstem Injury on Early Computed Tomography: A TRACK-TBI Study.

Journal Article Neurocrit Care · October 2021 BACKGROUND: Traumatic brainstem injury has yet to be incorporated into widely used imaging classification systems for traumatic brain injury (TBI), and questions remain regarding prognostic implications for this TBI subgroup. To address this, retrospective ... Full text Link to item Cite

Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations Among Adults Without Immunocompromising Conditions - United States, March-August 2021.

Journal Article MMWR Morb Mortal Wkly Rep · September 24, 2021 Three COVID-19 vaccines are authorized or approved for use among adults in the United States (1,2). Two 2-dose mRNA vaccines, mRNA-1273 from Moderna and BNT162b2 from Pfizer-BioNTech, received Emergency Use Authorization (EUA) by the Food and Drug Administ ... Full text Link to item Cite

Biomarkers for Traumatic Brain Injury: Data Standards and Statistical Considerations.

Journal Article J Neurotrauma · September 15, 2021 Recent biomarker innovations hold potential for transforming diagnosis, prognostic modeling, and precision therapeutic targeting of traumatic brain injury (TBI). However, many biomarkers, including brain imaging, genomics, and proteomics, involve vast quan ... Full text Link to item Cite

Embedding Learning in a Learning Health Care System to Improve Clinical Practice.

Journal Article Acad Med · September 1, 2021 PROBLEM: In an ideal learning health care system (LHS), clinicians learn from what they do and do what they learn, closing the evidence-to-practice gap. In operationalizing an LHS, great strides have been made in knowledge generation. Yet, considerable cha ... Full text Link to item Cite

Learning From What We Do, and Doing What We Learn: A Learning Health Care System in Action.

Journal Article Acad Med · September 1, 2021 Different models of learning health systems are emerging. At Vanderbilt University Medical Center, the Learning Health Care System (LHS) Platform was established with the goal of creating generalizable knowledge. This differentiates the LHS Platform from o ... Full text Link to item Cite

Utilization of ICU Rehabilitation Services in Pediatric Patients With a Prolonged ICU Stay.

Journal Article Crit Care Med · September 1, 2021 OBJECTIVES: To describe rehabilitation practice patterns among critically ill children with prolonged ICU stays and explore the association between institution-level utilization of rehabilitative services and patient outcomes. DESIGN: Retrospective cohort ... Full text Link to item Cite

Invariance of the Bifactor Structure of Mild Traumatic Brain Injury (mTBI) Symptoms on the Rivermead Postconcussion Symptoms Questionnaire Across Time, Demographic Characteristics, and Clinical Groups: A TRACK-TBI Study.

Journal Article Assessment · September 2021 This study aimed to elucidate the structure of the Rivermead Postconcussion Symptoms Questionnaire (RPQ) and evaluate its longitudinal and group variance. Factor structures were developed and compared in 1,011 patients with mild traumatic brain injury (mTB ... Full text Link to item Cite

Pathological Computed Tomography Features Associated With Adverse Outcomes After Mild Traumatic Brain Injury: A TRACK-TBI Study With External Validation in CENTER-TBI.

Journal Article JAMA Neurol · September 1, 2021 IMPORTANCE: A head computed tomography (CT) with positive results for acute intracranial hemorrhage is the gold-standard diagnostic biomarker for acute traumatic brain injury (TBI). In moderate to severe TBI (Glasgow Coma Scale [GCS] scores 3-12), some CT ... Full text Link to item Cite

Influenza vaccine acceptance and hesitancy among adults hospitalized with severe acute respiratory illnesses, United States 2019-2020.

Journal Article Vaccine · August 31, 2021 INTRODUCTION: Understanding patient factors associated with not being vaccinated is essential for successful implementation of influenza vaccination programs. METHODS: We enrolled adults hospitalized with severe acute respiratory illness at 10 United State ... Full text Link to item Cite

Sustained Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Associated Hospitalizations Among Adults - United States, March-July 2021.

Journal Article MMWR Morb Mortal Wkly Rep · August 27, 2021 Real-world evaluations have demonstrated high effectiveness of vaccines against COVID-19-associated hospitalizations (1-4) measured shortly after vaccination; longer follow-up is needed to assess durability of protection. In an evaluation at 21 hospitals i ... Full text Link to item Cite

Protocolized Postextubation Respiratory Support to Prevent Reintubation: A Randomized Clinical Trial.

Journal Article Am J Respir Crit Care Med · August 1, 2021 Rationale: Respiratory support (noninvasive ventilation or high-flow nasal cannula) applied at the time of extubation has been reported to reduce reintubation rates, but concerns regarding effectiveness have limited uptake into practice.Objectives: To dete ... Full text Link to item Cite

Functional Outcomes Over the First Year After Moderate to Severe Traumatic Brain Injury in the Prospective, Longitudinal TRACK-TBI Study.

Journal Article JAMA Neurol · August 1, 2021 IMPORTANCE: Moderate to severe traumatic brain injury (msTBI) is a major cause of death and disability in the US and worldwide. Few studies have enabled prospective, longitudinal outcome data collection from the acute to chronic phases of recovery after ms ... Full text Link to item Cite

Adults Hospitalized With Coronavirus Disease 2019 (COVID-19)-United States, March-June and October-December 2020: Implications for the Potential Effects of COVID-19 Tier-1 Vaccination on Future Hospitalizations and Outcomes.

Journal Article Clin Infect Dis · July 15, 2021 BACKGROUND: Because of the increased risk for severe coronavirus disease 2019 (COVID-19), the Advisory Committee on Immunization Practices (ACIP) initially prioritized COVID-19 vaccination for persons in long-term care facilities (LTCF), persons aged ≥65 y ... Full text Link to item Cite

Effectiveness of SARS-CoV-2 mRNA Vaccines for Preventing Covid-19 Hospitalizations in the United States.

Journal Article medRxiv · July 8, 2021 BACKGROUND: As SARS-CoV-2 vaccination coverage increases in the United States (US), there is a need to understand the real-world effectiveness against severe Covid-19 and among people at increased risk for poor outcomes. METHODS: In a multicenter case-cont ... Full text Link to item Cite

Intermittent Theta Burst Stimulation (iTBS) for Treatment of Chronic Post-Stroke Aphasia: Results of a Pilot Randomized, Double-Blind, Sham-Controlled Trial.

Journal Article Med Sci Monit · June 29, 2021 BACKGROUND Research indicates intermittent theta burst stimulation (iTBS) is a potential treatment of post-stroke aphasia. MATERIAL AND METHODS In this double-blind, sham-controlled trial (NCT01512264) participants were randomized to receive 3 weeks of sha ... Full text Link to item Cite

BOugie or stylet in patients UnderGoing Intubation Emergently (BOUGIE): protocol and statistical analysis plan for a randomised clinical trial.

Journal Article BMJ Open · May 25, 2021 INTRODUCTION: Intubation-related complications are less frequent when intubation is successful on the first attempt. The rate of first attempt success in the emergency department (ED) and intensive care unit (ICU) is typically less than 90%. The bougie, a ... Full text Link to item Cite

Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Among Hospitalized Adults Aged ≥65 Years - United States, January-March 2021.

Journal Article MMWR Morb Mortal Wkly Rep · May 7, 2021 Adults aged ≥65 years are at increased risk for severe outcomes from COVID-19 and were identified as a priority group to receive the first COVID-19 vaccines approved for use under an Emergency Use Authorization (EUA) in the United States (1-3). In an evalu ... Full text Link to item Cite

Incorporating Real-time Influenza Detection Into the Test-negative Design for Estimating Influenza Vaccine Effectiveness: The Real-time Test-negative Design (rtTND).

Journal Article Clin Infect Dis · May 4, 2021 With rapid and accurate molecular influenza testing now widely available in clinical settings, influenza vaccine effectiveness (VE) studies can prospectively select participants for enrollment based on real-time results rather than enrolling all eligible p ... Full text Link to item Cite

Seroprevalence of SARS-CoV-2 Among Frontline Healthcare Personnel During the First Month of Caring for Patients With COVID-19-Nashville, Tennessee.

Journal Article Clin Infect Dis · May 4, 2021 Among 249 healthcare personnel who worked in hospital units with COVID-19 patients for 1 month, 19 (7.6%) tested positive for SARS-CoV-2 antibodies. Only 11 (57.9%) of the 19 personnel with positive serology reported symptoms of a prior illness, suggesting ... Full text Link to item Cite

Sepsis Subclasses: A Framework for Development and Interpretation.

Journal Article Crit Care Med · May 1, 2021 Sepsis is defined as a dysregulated host response to infection that leads to life-threatening acute organ dysfunction. It afflicts approximately 50 million people worldwide annually and is often deadly, even when evidence-based guidelines are applied promp ... Full text Open Access Link to item Cite

Protocol to evaluate an enterprise-wide initiative to increase access to lung cancer screening in the Veterans Health Administration.

Journal Article Clin Imaging · May 2021 INTRODUCTION: The Veterans Affairs Partnership to increase Access to Lung Screening (VA-PALS) is an enterprise-wide initiative to implement lung cancer screening programs at VA medical centers (VAMCs). VA-PALS will be using implementation strategies that i ... Full text Link to item Cite

Symptoms and recovery among adult outpatients with and without COVID-19 at 11 healthcare facilities-July 2020, United States.

Journal Article Influenza Other Respir Viruses · May 2021 BACKGROUND: Symptoms of mild COVID-19 illness are non-specific and may persist for prolonged periods. Effects on quality of life of persistent poor physical or mental health associated with COVID-19 are not well understood. METHODS: Adults aged ≥18 years w ... Full text Link to item Cite

Association of Sex and Age With Mild Traumatic Brain Injury-Related Symptoms: A TRACK-TBI Study.

Journal Article JAMA Netw Open · April 1, 2021 IMPORTANCE: Knowledge of differences in mild traumatic brain injury (mTBI) recovery by sex and age may inform individualized treatment of these patients. OBJECTIVE: To identify sex-related differences in symptom recovery from mTBI; secondarily, to explore ... Full text Link to item Cite

Passive Immunity Trial for Our Nation (PassITON): study protocol for a randomized placebo-control clinical trial evaluating COVID-19 convalescent plasma in hospitalized adults.

Journal Article Trials · March 20, 2021 BACKGROUND: Convalescent plasma is being used widely as a treatment for coronavirus disease 2019 (COVID-19). However, the clinical efficacy of COVID-19 convalescent plasma is unclear. METHODS: The Passive Immunity Trial for Our Nation (PassITON) is a multi ... Full text Link to item Cite

Latent Profile Analysis of Neuropsychiatric Symptoms and Cognitive Function of Adults 2 Weeks After Traumatic Brain Injury: Findings From the TRACK-TBI Study.

Journal Article JAMA Netw Open · March 1, 2021 IMPORTANCE: Heterogeneity across patients with traumatic brain injury (TBI) presents challenges for clinical care and intervention design. Identifying distinct clinical phenotypes of TBI soon after injury may inform patient selection for precision medicine ... Full text Link to item Cite

Smaller Regional Brain Volumes Predict Posttraumatic Stress Disorder at 3 Months After Mild Traumatic Brain Injury.

Journal Article Biol Psychiatry Cogn Neurosci Neuroimaging · March 2021 BACKGROUND: Brain volumes in regions such as the hippocampus and amygdala have been associated with risk for the development of posttraumatic stress disorder (PTSD). The objective of this study was to determine whether a set of regional brain volumes, meas ... Full text Link to item Cite

ICU Bed Utilization During the Coronavirus Disease 2019 Pandemic in a Multistate Analysis-March to June 2020.

Journal Article Crit Care Explor · March 2021 OBJECTIVES: Given finite ICU bed capacity, knowledge of ICU bed utilization during the coronavirus disease 2019 pandemic is critical to ensure future strategies for resource allocation and utilization. We sought to examine ICU census trends in relation to ... Full text Link to item Cite

Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis: The VICTAS Randomized Clinical Trial.

Journal Article JAMA · February 23, 2021 IMPORTANCE: Sepsis is a common syndrome with substantial morbidity and mortality. A combination of vitamin C, thiamine, and corticosteroids has been proposed as a potential treatment for patients with sepsis. OBJECTIVE: To determine whether a combination o ... Full text Link to item Cite

Effect of balanced crystalloids versus saline on urinary biomarkers of acute kidney injury in critically ill adults.

Journal Article BMC Nephrol · February 5, 2021 BACKGROUND: Recent trials have suggested use of balanced crystalloids may decrease the incidence of major adverse kidney events compared to saline in critically ill adults. The effect of crystalloid composition on biomarkers of early acute kidney injury re ... Full text Link to item Cite

Efficacy and safety of dapagliflozin in acute heart failure: Rationale and design of the DICTATE-AHF trial.

Journal Article Am Heart J · February 2021 BACKGROUND: Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, reduces cardiovascular death and worsening heart failure in patients with chronic heart failure and reduced ejection fraction. Early initiation during an acute heart failure (AHF) hospi ... Full text Link to item Cite

Understanding timely STEMI treatment performance: A 3-year retrospective cohort study using diagnosis-to-balloon-time and care subintervals.

Journal Article J Am Coll Emerg Physicians Open · February 2021 OBJECTIVE: From the perspective of percutaneous coronary intervention (PCI) centers, locations of ST-segment elevation myocardial infarction (STEMI) diagnosis can include a referring facility, emergency medical services (EMS) transporting to a PCI center, ... Full text Link to item Cite

Guidance for biostatisticians on their essential contributions to clinical and translational research protocol review.

Journal Article J Clin Transl Sci · 2021 Rigorous scientific review of research protocols is critical to making funding decisions, and to the protection of both human and non-human research participants. Given the increasing complexity of research designs and data analysis methods, quantitative e ... Full text Link to item Cite

Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey.

Journal Article Front Neurol · 2021 Background: It is unclear what factors clinicians consider when deciding about endovascular thrombectomy (EVT) in acute ischemic stroke patients with a pre-existing disability. We aimed to explore international practice patterns and preferences for EVT in ... Full text Link to item Cite

Human and Machine Intelligence Together Drive Drug Repurposing in Rare Diseases.

Journal Article Front Genet · 2021 Repurposing is an increasingly attractive method within the field of drug development for its efficiency at identifying new therapeutic opportunities among approved drugs at greatly reduced cost and time of more traditional methods. Repurposing has generat ... Full text Link to item Cite

Delirium as a predictor of mortality and disability among hospitalized patients in Zambia.

Journal Article PLoS One · 2021 OBJECTIVE: To study the epidemiology and outcomes of delirium among hospitalized patients in Zambia. METHODS: We conducted a prospective cohort study at the University Teaching Hospital in Lusaka, Zambia, from October 2017 to April 2018. The primary exposu ... Full text Link to item Cite

External Corroboration That Corticosteroids May Be Harmful to Septic Shock Endotype A Patients.

Journal Article Crit Care Med · January 1, 2021 OBJECTIVES: We previously reported gene expression-based endotypes of pediatric septic shock, endotypes A and B, and that corticosteroid exposure was independently associated with increased mortality among pediatric endotype A patients. The Vasopressin vs ... Full text Link to item Cite

Food and Drug Administration and Institutional Review Board Approval of a Novel Prehospital Informed Consent Process for Emergency Research.

Journal Article Prehosp Emerg Care · 2021 Research on the management of acute pain in the prehospital setting is fraught with challenges. The prehospital setting is complex due to constrained time, resources, and training. Research activities must not interfere with the underlying clinical priorit ... Full text Link to item Cite

Intranasal Ketamine as an Adjunct to Fentanyl for the Prehospital Treatment of Acute Traumatic Pain: Design and Rationale of a Randomized Controlled Trial.

Journal Article Prehosp Emerg Care · 2021 Objective: Acute pain management is fundamental in prehospital trauma care. Early pain control may decrease the risk of developing post-traumatic stress disorder (PTSD) and chronic pain. Fentanyl and ketamine are frequently used off-label, but there is a p ... Full text Link to item Cite

Equipoise and research in the current COVID-19 pandemic

Journal Article Journal of Clinical and Translational Science · January 1, 2021 Full text Cite

Effect of Hydroxychloroquine on Clinical Status at 14 Days in Hospitalized Patients With COVID-19: A Randomized Clinical Trial.

Journal Article JAMA · December 1, 2020 IMPORTANCE: Data on the efficacy of hydroxychloroquine for the treatment of coronavirus disease 2019 (COVID-19) are needed. OBJECTIVE: To determine whether hydroxychloroquine is an efficacious treatment for adults hospitalized with COVID-19. DESIGN, SETTIN ... Full text Link to item Cite

Decline in SARS-CoV-2 Antibodies After Mild Infection Among Frontline Health Care Personnel in a Multistate Hospital Network - 12 States, April-August 2020.

Journal Article MMWR Morb Mortal Wkly Rep · November 27, 2020 Most persons infected with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), develop virus-specific antibodies within several weeks, but antibody titers might decline over time. Understanding the timeline of antibody decline is importa ... Full text Link to item Cite

Telework Before Illness Onset Among Symptomatic Adults Aged ≥18 Years With and Without COVID-19 in 11 Outpatient Health Care Facilities - United States, July 2020.

Journal Article MMWR Morb Mortal Wkly Rep · November 6, 2020 Since March 2020, large-scale efforts to reduce transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), have continued. Mitigation measures to reduce workplace exposures have included work site policies to support flexible wo ... Full text Link to item Cite

Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials.

Journal Article JAMA Netw Open · November 2, 2020 IMPORTANCE: Saline (0.9% sodium chloride), the fluid most commonly used to treat diabetic ketoacidosis (DKA), can cause hyperchloremic metabolic acidosis. Balanced crystalloids, an alternative class of fluids for volume expansion, do not cause acidosis and ... Full text Link to item Cite

Socioeconomic Factors and Intensive Care Unit-Related Cognitive Impairment.

Journal Article Ann Surg · October 2020 OBJECTIVE: We aimed to identify socioeconomic and clinical risk factors for post-intensive care unit (ICU)-related long-term cognitive impairment (LTCI). SUMMARY BACKGROUND DATA: After delirium during ICU stay, LTCI has been increasingly recognized, but wi ... Full text Link to item Cite

Protocol and statistical analysis plan for the PREventing cardiovascular collaPse with Administration of fluid REsuscitation during Induction and Intubation (PREPARE II) randomised clinical trial.

Journal Article BMJ Open · September 18, 2020 INTRODUCTION: Cardiovascular collapse is a common complication during tracheal intubation of critically ill adults. Whether administration of an intravenous fluid bolus prevents cardiovascular collapse during tracheal intubation remains uncertain. A prior ... Full text Link to item Cite

Community and Close Contact Exposures Associated with COVID-19 Among Symptomatic Adults ≥18 Years in 11 Outpatient Health Care Facilities - United States, July 2020.

Journal Article MMWR Morb Mortal Wkly Rep · September 11, 2020 Community and close contact exposures continue to drive the coronavirus disease 2019 (COVID-19) pandemic. CDC and other public health authorities recommend community mitigation strategies to reduce transmission of SARS-CoV-2, the virus that causes COVID-19 ... Full text Link to item Cite

Seroprevalence of SARS-CoV-2 Among Frontline Health Care Personnel in a Multistate Hospital Network - 13 Academic Medical Centers, April-June 2020.

Journal Article MMWR Morb Mortal Wkly Rep · September 4, 2020 Health care personnel (HCP) caring for patients with coronavirus disease 2019 (COVID-19) might be at high risk for contracting SARS-CoV-2, the virus that causes COVID-19. Understanding the prevalence of and factors associated with SARS-CoV-2 infection amon ... Full text Link to item Cite

Rationale and Design of ORCHID: A Randomized Placebo-controlled Clinical Trial of Hydroxychloroquine for Adults Hospitalized with COVID-19.

Journal Article Ann Am Thorac Soc · September 2020 The ORCHID (Outcomes Related to COVID-19 treated with Hydroxychloroquine among In-patients with symptomatic Disease) trial is a multicenter, blinded, randomized trial of hydroxychloroquine versus placebo for the treatment of adults hospitalized with corona ... Full text Link to item Cite

Impact of a Follow-up Telephone Call Program on 30-Day Readmissions (FUTR-30): A Pragmatic Randomized Controlled Real-world Effectiveness Trial.

Journal Article Med Care · September 2020 BACKGROUND: Telephone call programs are a common intervention used to improve patients' transition to outpatient care after hospital discharge. OBJECTIVE: To examine the impact of a follow-up telephone call program as a readmission reduction initiative. RE ... Full text Link to item Cite

Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network - United States, March-June 2020.

Journal Article MMWR Morb Mortal Wkly Rep · July 31, 2020 Prolonged symptom duration and disability are common in adults hospitalized with severe coronavirus disease 2019 (COVID-19). Characterizing return to baseline health among outpatients with milder COVID-19 illness is important for understanding the full spe ... Full text Link to item Cite

Characteristics of Adult Outpatients and Inpatients with COVID-19 - 11 Academic Medical Centers, United States, March-May 2020.

Journal Article MMWR Morb Mortal Wkly Rep · July 3, 2020 Descriptions of coronavirus disease 2019 (COVID-19) in the United States have focused primarily on hospitalized patients. Reports documenting exposures to SARS-CoV-2, the virus that causes COVID-19, have generally been described within congregate settings, ... Full text Link to item Cite

Learning gaps among statistical competencies for clinical and translational science learners.

Journal Article J Clin Transl Sci · June 19, 2020 INTRODUCTION: Statistical literacy is essential in clinical and translational science (CTS). Statistical competencies have been published to guide coursework design and selection for graduate students in CTS. Here, we describe common elements of graduate c ... Full text Link to item Cite

The Disruptive bEhavior manageMEnt ANd prevention in hospitalized patients using a behaviORal intervention team (DEMEANOR) study protocol: a pragmatic, cluster, crossover trial.

Journal Article Trials · May 24, 2020 BACKGROUND: Disruptive behavior in hospitalized patients has become a priority area of safety concern for clinical staff, and also has consequences for patient management and hospital course. Proactive screening and intervention of patients with behavioral ... Full text Link to item Cite

In response: Letter on update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) protocol.

Journal Article Trials · April 22, 2020 ClinicalTrials.gov: NCT03509350. Registered on 26 April 2018. ... Full text Link to item Cite

Acute care research competencies for clinical research professionals.

Journal Article J Clin Transl Sci · April 13, 2020 INTRODUCTION: Acute care research (ACR) is uniquely challenged by the constraints of recruiting participants and conducting research procedures within minutes to hours of an unscheduled critical illness or injury. Existing competencies for clinical researc ... Full text Link to item Cite

Global Differences in Characteristics, Precipitants, and Initial Management of Patients Presenting With Acute Heart Failure.

Journal Article JAMA Cardiol · April 1, 2020 IMPORTANCE: Acute heart failure (AHF) precipitates millions of hospital admissions worldwide, but previous registries have been country or region specific. OBJECTIVE: To conduct a prospective contemporaneous comparison of AHF presentations, etiologic facto ... Full text Link to item Cite

Impact of Operative Management on Recurrence of Adhesive Small Bowel Obstruction: A Longitudinal Analysis of a Statewide Database.

Conference J Am Coll Surg · April 2020 BACKGROUND: Recurrence of adhesive small bowel obstruction (ASBO) can lead to multiple admissions. There is limited knowledge of the role of operative and nonoperative treatment in the long-term recurrence risk for ASBO. We sought to determine the effect o ... Full text Link to item Cite

Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting.

Journal Article Air Med J · 2020 OBJECTIVE: Suboptimal ventilation may impact outcomes in patients with traumatic brain injury (TBI). This study compares the incidence of eucapnia between manually and mechanically ventilated patients with severe TBI during helicopter transport. METHODS: T ... Full text Link to item Cite

The Experience of Caregivers Following a Moderate to Severe Traumatic Brain Injury Requiring ICU Admission.

Journal Article J Head Trauma Rehabil · 2020 OBJECTIVES: Survivors of moderate and severe traumatic brain injury (TBI) require substantial care, much of which is ultimately provided by friends and family. We sought to describe the unmet needs of informal caregivers. DESIGN: Qualitative, semistructure ... Full text Link to item Cite

Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) protocol: statistical analysis plan for a prospective, multicenter, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

Journal Article Trials · December 4, 2019 BACKGROUND: Observational research suggests that combined therapy with Vitamin C, thiamine and hydrocortisone may reduce mortality in patients with septic shock. METHODS AND DESIGN: The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) trial is a multice ... Full text Link to item Cite

Prospective clinical testing and experimental validation of the Pediatric Sepsis Biomarker Risk Model.

Journal Article Sci Transl Med · November 13, 2019 Sepsis remains a major public health problem with no major therapeutic advances over the last several decades. The clinical and biological heterogeneity of sepsis have limited success of potential new therapies. Accordingly, there is considerable interest ... Full text Link to item Cite

Evaluation of Hypoglossal Nerve Stimulation Treatment in Obstructive Sleep Apnea.

Journal Article JAMA Otolaryngol Head Neck Surg · November 1, 2019 IMPORTANCE: Hypoglossal nerve stimulation is a treatment option for patients with obstructive sleep apnea unable to tolerate continuous positive airway pressure. This study evaluates demographic factors that may be associated with greater improvements in p ... Full text Link to item Cite

COMPASS: A Pilot Trial of an Early Palliative Care Intervention for Patients With End-Stage Liver Disease.

Journal Article J Pain Symptom Manage · October 2019 CONTEXT: Palliative care interventions have shown promise in improving quality of life and reducing health-care utilization among patients with chronic organ failure. OBJECTIVES: To evaluate the effect of a palliative care intervention for adults with end- ... Full text Link to item Cite

Association between plasma GFAP concentrations and MRI abnormalities in patients with CT-negative traumatic brain injury in the TRACK-TBI cohort: a prospective multicentre study.

Journal Article Lancet Neurol · October 2019 BACKGROUND: After traumatic brain injury (TBI), plasma concentration of glial fibrillary acidic protein (GFAP) correlates with intracranial injury visible on CT scan. Some patients with suspected TBI with normal CT findings show pathology on MRI. We assess ... Full text Link to item Cite

Recovery After Mild Traumatic Brain Injury in Patients Presenting to US Level I Trauma Centers: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Study.

Journal Article JAMA Neurol · September 1, 2019 IMPORTANCE: Most traumatic brain injuries (TBIs) are classified as mild (mTBI) based on admission Glasgow Coma Scale (GCS) scores of 13 to 15. The prevalence of persistent functional limitations for these patients is unclear. OBJECTIVES: To characterize th ... Full text Link to item Cite

Protocolized Post-Extubation Respiratory Support to prevent reintubation: protocol and statistical analysis plan for a clinical trial.

Journal Article BMJ Open · August 2, 2019 INTRODUCTION: Following extubation from invasive mechanical ventilation, nearly one in seven critically ill adults requires reintubation. Reintubation is independently associated with increased mortality. Postextubation respiratory support (non-invasive ve ... Full text Link to item Cite

Intravenous fluid resuscitation is associated with septic endothelial glycocalyx degradation.

Journal Article Crit Care · July 23, 2019 BACKGROUND: Intravenous fluids, an essential component of sepsis resuscitation, may paradoxically worsen outcomes by exacerbating endothelial injury. Preclinical models suggest that fluid resuscitation degrades the endothelial glycocalyx, a heparan sulfate ... Full text Link to item Cite

The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) Protocol: a prospective, multi-center, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

Journal Article Trials · April 5, 2019 BACKGROUND: Sepsis accounts for 30% to 50% of all in-hospital deaths in the United States. Other than antibiotics and source control, management strategies are largely supportive with fluid resuscitation and respiratory, renal, and circulatory support. Int ... Full text Link to item Cite

Risk of Posttraumatic Stress Disorder and Major Depression in Civilian Patients After Mild Traumatic Brain Injury: A TRACK-TBI Study.

Journal Article JAMA Psychiatry · March 1, 2019 IMPORTANCE: Traumatic brain injury (TBI) has been associated with adverse mental health outcomes, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), but little is known about factors that modify risk for these psychiatric seq ... Full text Link to item Cite

Use of a tablet computer application to engage patients in updating their medication list.

Journal Article Am J Health Syst Pharm · February 9, 2019 PURPOSE: Failure to obtain an accurate medication history can adversely affect patient care in the emergency department (ED) and propagate errors into the inpatient and outpatient settings. Obtaining an accurate medication history in the ED is challenging, ... Full text Link to item Cite

Timing of Advanced Airway Placement after Witnessed Out-of-Hospital Cardiac Arrest.

Journal Article Prehosp Emerg Care · 2019 Background: Advanced airways (endotracheal tubes, supraglottic airways) are frequently placed by Emergency Medical Services (EMS) in patients with out-of-hospital cardiac arrest (OHCA). However, if an airway is to be placed, it is unknown whether this shou ... Full text Link to item Cite

Rehabilitation Practices in Patients With Moderate and Severe Traumatic Brain Injury.

Conference J Head Trauma Rehabil · 2019 OBJECTIVE: To characterize the indications, timing, barriers, and perceived value of rehabilitation currently provided for individuals with moderate or severe traumatic brain injury (TBI) admitted to the intensive care unit (ICU) based on the perspectives ... Full text Link to item Cite

A Comparison of Satisfaction With Life and the Glasgow Outcome Scale-Extended After Traumatic Brain Injury: An Analysis of the TRACK-TBI Pilot Study.

Journal Article J Head Trauma Rehabil · 2019 OBJECTIVE: To evaluate the relationship between satisfaction with life (SWL) and functional outcome after traumatic brain injury (TBI). SETTING AND PARTICIPANTS: The Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study (TRACK- ... Full text Link to item Cite

A randomized controlled field trial of iBsafe-a novel child safety game app.

Journal Article Mhealth · 2019 BACKGROUND: Injury is a leading cause of child morbidity and mortality worldwide. Delivering injury prevention programs via mobile platforms, such as applications (apps), may reduce risky behaviors. iBsafe is an "interactive Bike and Bite safety" mobile ga ... Full text Link to item Cite

Hypertensive ED patients: Missed opportunities for addressing hypertension and facilitating outpatient follow-up.

Journal Article Am J Emerg Med · December 2018 OBJECTIVES: Hypertension is a leading cause of morbidity and mortality. The emergency department (ED) frequently serves populations with unmet health needs and could have a greater and more systematic role in secondary prevention for hypertension. This stu ... Full text Link to item Cite

Impact of a low intensity and broadly inclusive ED care coordination intervention on linkage to primary care and ED utilization.

Journal Article Am J Emerg Med · December 2018 OBJECTIVE: We aim to evaluate the effectiveness of a broadly inclusive, comparatively low intensity intervention linking ED patients to a primary care home. METHODS: This retrospective cohort study evaluated ED patients referred for primary care linkage in ... Full text Link to item Cite

Quality and Efficiency of the Clinical Decision-Making Process: Information Overload and Emphasis Framing

Journal Article Production and Operations Management · December 1, 2018 The healthcare industry has invested heavily in electronic health records and other clinical information systems in order to improve caregivers' access to information and ability to share information with other care providers. It has been shown that these ... Full text Cite

Assessment of Follow-up Care After Emergency Department Presentation for Mild Traumatic Brain Injury and Concussion: Results From the TRACK-TBI Study.

Journal Article JAMA Netw Open · May 18, 2018 IMPORTANCE: Mild traumatic brain injury (mTBI) affects millions of Americans each year. Lack of consistent clinical practice raises concern that many patients with mTBI may not receive adequate follow-up care. OBJECTIVE: To characterize the provision of fo ... Full text Link to item Cite

Endotype Transitions During the Acute Phase of Pediatric Septic Shock Reflect Changing Risk and Treatment Response.

Journal Article Crit Care Med · March 2018 OBJECTIVE: We previously identified septic shock endotypes A and B based on 100 genes reflecting adaptive immunity and glucocorticoid receptor signaling. The endotypes differ with respect to outcome and corticosteroid responsiveness. We determined whether ... Full text Link to item Cite

Balanced Crystalloids versus Saline in Noncritically Ill Adults.

Journal Article N Engl J Med · March 1, 2018 BACKGROUND: Comparative clinical effects of balanced crystalloids and saline are uncertain, particularly in noncritically ill patients cared for outside an intensive care unit (ICU). METHODS: We conducted a single-center, pragmatic, multiple-crossover tria ... Full text Link to item Cite

Longitudinal fMRI study of language recovery after a left hemispheric ischemic stroke.

Journal Article Restor Neurol Neurosci · 2018 BACKGROUND: Recovery from stroke-induced aphasia is typically protracted and involves complex functional reorganization. The relative contributions of the lesioned and non-lesioned hemispheres to this process have been examined in several cross-sectional s ... Full text Link to item Cite

Pediatric Sepsis Endotypes Among Adults With Sepsis.

Journal Article Crit Care Med · December 2017 OBJECTIVES: Recent transcriptomic studies describe two subgroups of adults with sepsis differentiated by a sepsis response signature. The implied biology and related clinical associations are comparable with recently reported pediatric sepsis endotypes, la ... Full text Link to item Cite

Pilot Integration of HIV Screening and Healthcare Settings with Multi- Component Social Network and Partner Testing for HIV Detection.

Journal Article Curr HIV Res · November 23, 2017 BACKGROUND: Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing ("Transmission Network Targeting (TNT)") to select high-risk individuals based on their contacts. HIV screening and TNT systems are not in ... Full text Link to item Cite

Improved Risk Stratification in Pediatric Septic Shock Using Both Protein and mRNA Biomarkers. PERSEVERE-XP.

Journal Article Am J Respir Crit Care Med · August 15, 2017 RATIONALE: We previously derived and validated the Pediatric Sepsis Biomarker Risk Model (PERSEVERE) to estimate baseline mortality risk in children with septic shock. The PERSEVERE biomarkers are serum proteins selected from among the proteins directly re ... Full text Link to item Cite

Statistical competencies for medical research learners: What is fundamental?

Journal Article J Clin Transl Sci · June 2017 INTRODUCTION: It is increasingly essential for medical researchers to be literate in statistics, but the requisite degree of literacy is not the same for every statistical competency in translational research. Statistical competency can range from 'fundame ... Full text Open Access Link to item Cite

Passive ultra-brief video training improves performance of compression-only cardiopulmonary resuscitation.

Journal Article Resuscitation · June 2017 BACKGROUND: Bystander compression-only cardiopulmonary resuscitation (CPR) improves survival after out-of-hospital cardiac arrest. To broaden CPR training, 1-2min ultra-brief videos have been disseminated via the Internet and television. Our objective was ... Full text Link to item Cite

Factors associated with adverse outcomes in patients with traumatic intracranial hemorrhage and Glasgow Coma Scale of 15.

Journal Article Am J Emerg Med · June 2017 Patients with mild traumatic brain injury (mTBI) with associated intracranial injury, or complicated mTBI, are at risk of deterioration. Clinical management differs within and between institutions. We conducted an exploratory analysis to determine which of ... Full text Link to item Cite

Developing a standardized measurement of alcohol intoxication.

Journal Article Am J Emerg Med · May 2017 INTRODUCTION: We assessed multiple examinations and assessment tools to develop a standardized measurement of alcohol intoxication to aid medical decision making in the Emergency Department. METHODS: Volunteers underwent an alcohol challenge. Pre- and post ... Full text Link to item Cite

Characteristics of Biostatistics, Epidemiology, and Research Design Programs in Institutions With Clinical and Translational Science Awards.

Journal Article Acad Med · February 2017 PURPOSE: To learn the size, composition, and scholarly output of biostatistics, epidemiology, and research design (BERD) units in U.S. academic health centers (AHCs). METHOD: Each year for four years, the authors surveyed all BERD units in U.S. AHCs that w ... Full text Link to item Cite

Reducing Door-in Door-out Intervals in Helicopter ST-segment Elevation Myocardial Infarction Interhospital Transfers.

Conference Air Med J · 2017 BACKGROUND: Many health systems rely on helicopter EMS (HEMS) to transfer ST-elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI) to a hospital with a catheterization laboratory. Mortality rates increase with the ti ... Full text Link to item Cite

Uncovering precision phenotype-biomarker associations in traumatic brain injury using topological data analysis.

Journal Article PLoS One · 2017 BACKGROUND: Traumatic brain injury (TBI) is a complex disorder that is traditionally stratified based on clinical signs and symptoms. Recent imaging and molecular biomarker innovations provide unprecedented opportunities for improved TBI precision medicine ... Full text Link to item Cite

Biochemical surrogate markers of hemolysis do not correlate with directly measured erythrocyte survival in sickle cell anemia.

Journal Article Am J Hematol · December 2016 Hemolysis is a key feature of sickle cell anemia (HbSS). Direct quantitation of hemolysis could be used as an objective outcome in clinical trials of new therapeutics for HbSS and would also enable better human studies of the pathogenesis of complications ... Full text Link to item Cite

An Enrichment Strategy For Sepsis Clinical Trials.

Journal Article Shock · December 2016 INTRODUCTION: Selecting participants for research based on their risk is an enrichment strategy with potential for enhancing clinical trials in sepsis. Adult Septic Shock Information and Stratification (ASSIST) is a tool for estimating mortality risk that ... Full text Link to item Cite

Pediatric Sepsis Biomarker Risk Model-II: Redefining the Pediatric Sepsis Biomarker Risk Model With Septic Shock Phenotype.

Journal Article Crit Care Med · November 2016 OBJECTIVE: The Pediatric Sepsis Biomarker Risk Model (PERSEVERE), a pediatric sepsis risk model, uses biomarkers to estimate baseline mortality risk for pediatric septic shock. It is unknown how PERSEVERE performs within distinct septic shock phenotypes. W ... Full text Link to item Cite

Combining Prognostic and Predictive Enrichment Strategies to Identify Children With Septic Shock Responsive to Corticosteroids.

Journal Article Crit Care Med · October 2016 OBJECTIVES: Prognostic and predictive enrichment strategies are fundamental tools of precision medicine. Identifying children with septic shock who may benefit from corticosteroids remains a challenge. We combined prognostic and predictive strategies to id ... Full text Link to item Cite

Shorter times to packed red blood cell transfusion are associated with decreased risk of death in traumatically injured patients.

Journal Article J Trauma Acute Care Surg · September 2016 BACKGROUND: Hemorrhage is a leading cause of death in traumatically injured patients. Currently, the importance of earlier administration of packed red blood cells (pRBC) to improve outcomes is limited. We evaluated the association of earlier pRBC administ ... Full text Link to item Cite

Supplemental Oxygen Requirements of Critically Injured Adults: An Observational Trial.

Journal Article Mil Med · August 2016 OBJECTIVES: The optimal amount of oxygen to deploy with pararescue personnel for combat casualty care is currently unknown. The purpose of this prospective observational trial was to determine the proportion of trauma patients requiring supplemental oxygen ... Full text Link to item Cite

Emergency Department Prescription Opioids as an Initial Exposure Preceding Addiction.

Conference Ann Emerg Med · August 2016 STUDY OBJECTIVE: Opioid abuse and overdose constitute an ongoing health emergency. Many presume opioids have little potential for iatrogenic addiction when used as directed, particularly in short courses, as is typical of the emergency department (ED) sett ... Full text Link to item Cite

Association of Early Stress Testing with Outcomes for Emergency Department Evaluation of Suspected Acute Coronary Syndrome.

Journal Article Crit Pathw Cardiol · June 2016 BACKGROUND: Professional society guidelines suggest early stress testing (within 72 hours) after an emergency department (ED) evaluation for suspected acute coronary syndrome (ACS). However, there is increasing concern that current practice results in over ... Full text Link to item Cite

Emergency Medicine Resources Within the Clinical Translational Science Institutes: A Cross-sectional Study.

Journal Article Acad Emerg Med · June 2016 BACKGROUND: The Clinical and Translational Science Award (CTSA) program aims to strengthen and support translational research by accelerating the process of translating laboratory discoveries into treatments for patients, training a new generation of clini ... Full text Link to item Cite

Apolipoprotein A-I and Paraoxonase-1 Are Potential Blood Biomarkers for Ischemic Stroke Diagnosis.

Journal Article J Stroke Cerebrovasc Dis · June 2016 BACKGROUND: Blood biomarkers for ischemic and hemorrhagic stroke diagnosis remain elusive. Recent investigations suggested that apolipoprotein (Apo), matrix metalloproteinase (MMP), and paraoxonase-1 may be associated with stroke. We hypothesized that Apo ... Full text Link to item Cite

A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow-up?

Journal Article Acad Emerg Med · April 2016 OBJECTIVES: Postconcussion symptoms (PCS) are a common complication of mild traumatic brain injury (TBI). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop PCS. The purpose ... Full text Link to item Cite

Comparison of the HEART and TIMI Risk Scores for Suspected Acute Coronary Syndrome in the Emergency Department.

Journal Article Crit Pathw Cardiol · March 2016 OBJECTIVES: The emergency department evaluation for suspected acute coronary syndrome (ACS) is common, costly, and challenging. Risk scores may help standardize clinical care and screening for research studies. The Thrombolysis in Myocardial Infarction (TI ... Full text Link to item Cite

Best Practices for Biostatistical Consultation and Collaboration in Academic Health Centers.

Journal Article Am Stat · 2016 Given the increasing level and scope of biostatistics expertise needed at academic health centers today, we developed best practices guidelines for biostatistics units to be more effective in providing biostatistical support to their institutions, and in f ... Full text Link to item Cite

Monte Carlo Simulation Modeling of a Regional Stroke Team's Use of Telemedicine.

Journal Article Acad Emerg Med · January 2016 OBJECTIVES: The objective of this study was to evaluate operational policies that may improve the proportion of eligible stroke patients within a population who would receive intravenous recombinant tissue plasminogen activator (rt-PA) and minimize time to ... Full text Link to item Cite

Prospective Testing and Redesign of a Temporal Biomarker Based Risk Model for Patients With Septic Shock: Implications for Septic Shock Biology.

Journal Article EBioMedicine · December 2015 The temporal version of the pediatric sepsis biomarker risk model (tPERSEVERE) estimates the risk of a complicated course in children with septic shock based on biomarker changes from days 1 to 3 of septic shock. We validated tPERSEVERE performance in a pr ... Full text Link to item Cite

Levels of Alternatively Spliced Tissue Factor in the Plasma of Patients with Pancreatic Cancer May Help Predict Aggressive Tumor Phenotype.

Journal Article Ann Surg Oncol · December 2015 BACKGROUND: Circulating ('blood-borne') tissue factor (TF) is implicated in the pathogenesis of several chronic conditions, most notably cardiovascular disease, diabetes, and cancer. Full-length TF is an integral membrane protein, while alternatively splic ... Full text Link to item Cite

Randomized Controlled Noninferiority Trial Comparing Daptomycin to Vancomycin for the Treatment of Complicated Skin and Skin Structure Infections in an Observation Unit.

Journal Article J Emerg Med · December 2015 BACKGROUND: Incidence of methicillin-resistant Staphylococcus aureus (MRSA) is increasing in complicated skin and skin structure infection (cSSSI) presenting to emergency departments (EDs). Treatment is heterogeneous and can require inpatient admission to ... Full text Link to item Cite

Evaluating Academic Scientists Collaborating in Team-Based Research: A Proposed Framework.

Journal Article Acad Med · October 2015 Criteria for evaluating faculty are traditionally based on a triad of scholarship, teaching, and service. Research scholarship is often measured by first or senior authorship on peer-reviewed scientific publications and being principal investigator on extr ... Full text Link to item Cite

Identification of Emergency Department Patients With Acute Heart Failure at Low Risk for 30-Day Adverse Events: The STRATIFY Decision Tool.

Journal Article JACC Heart Fail · October 2015 OBJECTIVES: No prospectively derived or validated decision tools identify emergency department (ED) patients with acute heart failure (AHF) at low risk for 30-day adverse events who are thus potential candidates for safe ED discharge. This study sought to ... Full text Link to item Cite

Constraint-Induced Aphasia Therapy for Treatment of Chronic Post-Stroke Aphasia: A Randomized, Blinded, Controlled Pilot Trial.

Journal Article Med Sci Monit · September 24, 2015 BACKGROUND: To provide a preliminary estimate of efficacy of constraint-induced aphasia therapy (CIAT) when compared to no-intervention in patients with chronic (>1 year) post-stroke aphasia in order to plan an appropriately powered randomized controlled t ... Full text Link to item Cite

Serum Cardiac Troponin I in the Evaluation of Nonaccidental Trauma.

Journal Article J Pediatr · September 2015 OBJECTIVE: To determine if troponin I is more often elevated in children with suspected nonaccidental trauma (NAT) compared with uninjured children of similar age, and describe associations between troponin I elevation and NAT injuries. STUDY DESIGN: Prosp ... Full text Link to item Cite

Weighted multiple testing correction for correlated endpoints in survival data

Chapter · August 31, 2015 Multiple correlated time-to-event endpoints often occur in clinical trials and some time-to-event endpoints are more important than others. Most weighted multiple testing adjustment methods have been proposed to control family-wise type I error rates eithe ... Full text Cite

A Multibiomarker-Based Model for Estimating the Risk of Septic Acute Kidney Injury.

Journal Article Crit Care Med · August 2015 OBJECTIVE: The development of acute kidney injury in patients with sepsis is associated with worse outcomes. Identifying those at risk for septic acute kidney injury could help to inform clinical decision making. We derived and tested a multibiomarker-base ... Full text Link to item Cite

Opportunities for earlier HIV diagnosis in a pediatric ED.

Journal Article Am J Emerg Med · July 2015 OBJECTIVES: Emergency department (ED) HIV screening is recommended but challenging to implement and of uncertain effectiveness in pediatric EDs (PEDs). We sought to determine whether there were opportunities for earlier HIV diagnosis in the PED for a cohor ... Full text Link to item Cite

Patient flow analysis in resource-limited settings: a practical tutorial and case study.

Journal Article Glob Health Sci Pract · March 2015 Patient flow analysis (PFA), a simple quality improvement tool to identify patient flow patterns, can be used in resource-limited settings to inform service delivery improvements. A PFA at a Ghanaian hospital found that personnel constraints and a mismatch ... Full text Link to item Cite

Comparing the prognostic performance of ASSIST to interleukin-6 and procalcitonin in patients with severe sepsis or septic shock.

Journal Article Biomarkers · March 2015 CONTEXT: We recently derived and validated a multi-biomarker-based model (ASSIST) to stratify patients with sepsis based on initial mortality risk. OBJECTIVE: The objective of this study was to compare the performance of ASSIST to interleukin-6 (IL6) and p ... Full text Link to item Cite

Randomized controlled trial of a scoring aid to improve Glasgow Coma Scale scoring by emergency medical services providers.

Journal Article Ann Emerg Med · March 2015 STUDY OBJECTIVE: Emergency medical services (EMS) personnel frequently use the Glasgow Coma Scale (GCS) to assess injured and critically ill patients. This study assesses the accuracy of EMS providers' GCS scoring, as well as the improvement in GCS score a ... Full text Link to item Cite

Patients who use multiple EDs: quantifying the degree of overlap between ED populations.

Journal Article West J Emerg Med · March 2015 INTRODUCTION: The degree to which individual patients use multiple emergency departments (EDs) is not well-characterized. We determined the degree of overlap in ED population between three geographically proximate hospitals. METHODS: This retrospective coh ... Full text Link to item Cite

Effectiveness of ecallantide in treating angiotensin-converting enzyme inhibitor-induced angioedema in the emergency department.

Journal Article Ann Allergy Asthma Immunol · March 2015 BACKGROUND: Angiotensin-converting enzyme inhibitor-induced angioedema (ACEI-AE) is mediated by bradykinin. There remains an unmet treatment need because these patients, when presenting to the emergency department (ED), do not respond to conventional thera ... Full text Link to item Cite

Assessing statistical competencies in clinical and translational science education: one size does not fit all.

Journal Article Clin Transl Sci · February 2015 INTRODUCTION: Statistics is an essential training component for a career in clinical and translational science (CTS). Given the increasing complexity of statistics, learners may have difficulty selecting appropriate courses. Our question was: what depth of ... Full text Link to item Cite

Developing a clinically feasible personalized medicine approach to pediatric septic shock.

Journal Article Am J Respir Crit Care Med · February 1, 2015 RATIONALE: Using microarray data, we previously identified gene expression-based subclasses of septic shock with important phenotypic differences. The subclass-defining genes correspond to adaptive immunity and glucocorticoid receptor signaling. Identifyin ... Full text Link to item Cite

Use of an oral stable isotope label to confirm variation in red blood cell mean age that influences HbA1c interpretation.

Journal Article Am J Hematol · January 2015 HbA1c is commonly used to monitor glycemic control. However, there is growing evidence that the relationship between HbA1c and mean blood glucose (MBG) is influenced by variation in red blood cell (RBC) lifespan in hematologically normal individuals. Corre ... Full text Link to item Cite

Electroencephalography findings in patients presenting to the ED for evaluation of seizures.

Journal Article Am J Emerg Med · January 2015 BACKGROUND: Status epilepticus is a life-threatening, time-sensitive emergency. Acquiring an electroencephalogram (EEG) in the emergency department (ED) could impact therapeutic and disposition decisions for patients with suspected status epilepticus. OBJE ... Full text Link to item Cite

The flex track: flexible partitioning between low- and high-acuity areas of an emergency department.

Journal Article Ann Emerg Med · December 2014 STUDY OBJECTIVE: Emergency departments (EDs) with both low- and high-acuity treatment areas often have fixed allocation of resources, regardless of demand. We demonstrate the utility of discrete-event simulation to evaluate flexible partitioning between lo ... Full text Link to item Cite

Repeat neuroimaging of mild traumatic brain-injured patients with acute traumatic intracranial hemorrhage: clinical outcomes and radiographic features.

Journal Article Acad Emerg Med · October 2014 OBJECTIVES: Emergency department (ED) management of mild traumatic brain injury (TBI) patients with any form of traumatic intracranial hemorrhage (ICH) is variable. Since 2000, our center's standard practice has been to obtain a repeat head computed tomogr ... Full text Link to item Cite

Prevalence of undiagnosed acute and chronic HIV in a lower-prevalence urban emergency department.

Journal Article Am J Public Health · September 2014 OBJECTIVES: We estimated the seroprevalence of both acute and chronic HIV infection by using a random sample of emergency department (ED) patients from a region of the United States with low-to-moderate HIV prevalence. METHODS: This cross-sectional seropre ... Full text Link to item Cite

ED disposition of the Glasgow Coma Scale 13 to 15 traumatic brain injury patient: analysis of the Transforming Research and Clinical Knowledge in TBI study.

Journal Article Am J Emerg Med · August 2014 OBJECTIVE: Mild traumatic brain injury (mTBI) patients are frequently admitted to high levels of care despite limited evidence suggesting benefit. Such decisions may contribute to the significant cost of caring for mTBI patients. Understanding the factors ... Full text Link to item Cite

Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital.

Journal Article Am J Emerg Med · August 2014 OBJECTIVES: Crowding and limited resources have increased the strain on acute care facilities and emergency departments worldwide. These problems are particularly prevalent in developing countries. Discrete event simulation is a computer-based tool that ca ... Full text Link to item Cite

Measurement of posttransfusion red cell survival with the biotin label.

Journal Article Transfus Med Rev · July 2014 The goal of this review is to summarize and critically assess information concerning the biotin method to label red blood cells (RBC) for use in studies of RBC and transfusion biology-information that will prove useful to a broad audience of clinicians and ... Full text Link to item Cite

The pediatric sepsis biomarker risk model: potential implications for sepsis therapy and biology.

Journal Article Expert Rev Anti Infect Ther · July 2014 Sepsis remains a major cause of morbidity and mortality in adult and pediatric intensive care units. Heterogeneity of demographics, comorbidities, biological mechanisms, and severity of illness leads to difficulty in determining which patients are at highe ... Full text Link to item Cite

A multibiomarker-based outcome risk stratification model for adult septic shock*.

Journal Article Crit Care Med · April 2014 OBJECTIVES: Clinical trials in septic shock continue to fail due, in part, to inequitable and sometimes unknown distribution of baseline mortality risk between study arms. Investigators advocate that interventional trials in septic shock require effective ... Full text Link to item Cite

A consensus parameter for the evaluation and management of angioedema in the emergency department.

Journal Article Acad Emerg Med · April 2014 Despite its relatively common occurrence and life-threatening potential, the management of angioedema in the emergency department (ED) is lacking in terms of a structured approach. It is paramount to distinguish the different etiologies of angioedema from ... Full text Link to item Cite

Transient and sustained changes in operational performance, patient evaluation, and medication administration during electronic health record implementation in the emergency department.

Journal Article Ann Emerg Med · March 2014 STUDY OBJECTIVE: Little is known about the transient and sustained operational effects of electronic health records on emergency department (ED) performance. We quantify how the implementation of a comprehensive electronic health record was associated with ... Full text Link to item Cite

Post-ICU admission fluid balance and pediatric septic shock outcomes: a risk-stratified analysis.

Journal Article Crit Care Med · February 2014 OBJECTIVE: Observed associations between fluid balance and septic shock outcomes are likely confounded by initial mortality risk. We conducted a risk-stratified analysis of the association between post-ICU admission fluid balance and pediatric septic shock ... Full text Link to item Cite

Testing the prognostic accuracy of the updated pediatric sepsis biomarker risk model.

Journal Article PLoS One · 2014 BACKGROUND: We previously derived and validated a risk model to estimate mortality probability in children with septic shock (PERSEVERE; PEdiatRic SEpsis biomarkEr Risk modEl). PERSEVERE uses five biomarkers and age to estimate mortality probability. After ... Full text Link to item Cite

Patient perception of whether an HIV test was provided during the emergency department encounter.

Journal Article J Int Assoc Provid AIDS Care · 2014 This cross-sectional study approached emergency department (ED) patients after the treating physician's disposition decision to measure patient understanding of whether or not they had received an HIV test during their ED encounter. Of the 300 respondents, ... Full text Link to item Cite

Corticosteroids and pediatric septic shock outcomes: a risk stratified analysis.

Journal Article PLoS One · 2014 BACKGROUND: The potential benefits of corticosteroids for septic shock may depend on initial mortality risk. OBJECTIVE: We determined associations between corticosteroids and outcomes in children with septic shock who were stratified by initial mortality r ... Full text Link to item Cite

The adverse effect of spasticity on 3-month poststroke outcome using a population-based model.

Journal Article Stroke Res Treat · 2014 Several devices and medications have been used to address poststroke spasticity. Yet, spasticity's impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regress ... Full text Link to item Cite

The temporal version of the pediatric sepsis biomarker risk model.

Journal Article PLoS One · 2014 BACKGROUND: PERSEVERE is a risk model for estimating mortality probability in pediatric septic shock, using five biomarkers measured within 24 hours of clinical presentation. OBJECTIVE: Here, we derive and test a temporal version of PERSEVERE (tPERSEVERE) ... Full text Link to item Cite

Antihypertensives are administered selectively in emergency department patients with subarachnoid hemorrhage.

Journal Article J Stroke Cerebrovasc Dis · November 2013 Elevated blood pressure is common in patients with acute subarachnoid hemorrhage (SAH). American Heart Association guidelines do not specify a blood pressure target, but limited data suggest that systolic blood pressure (SBP)≥160 mmHg is associated with in ... Full text Link to item Cite

ST2 in emergency department patients with noncardiac dyspnea.

Journal Article Acad Emerg Med · November 2013 OBJECTIVES: Serum levels of soluble ST2, a member of the interleukin-1 receptor family, predict mortality in emergency department (ED) patients with dyspnea secondary to acute heart failure and acute coronary syndrome. Elevated levels of ST2 have also been ... Full text Link to item Cite

Interleukin 27 as a sepsis diagnostic biomarker in critically ill adults.

Journal Article Shock · November 2013 PURPOSE: We previously identified interleukin 27 (IL-27) as a sepsis diagnostic biomarker in critically ill children. The current study tested the performance of IL-27 alone and in combination with procalcitonin (PCT) for diagnosing sepsis in critically il ... Full text Link to item Cite

Randomized comparison of universal and targeted HIV screening in the emergency department.

Journal Article J Acquir Immune Defic Syndr · November 1, 2013 OBJECTIVE: Universal HIV screening is recommended but challenging to implement. Selectively targeting those at risk is thought to miss cases, but previous studies are limited by narrow risk criteria, incomplete implementation, and absence of direct compari ... Full text Link to item Cite

Prevalence of prehospital hypoxemia and oxygen use in trauma patients.

Journal Article Mil Med · October 2013 OBJECTIVE: This study estimates the prevalence of injured patients requiring prehospital supplemental oxygen based on existing recommendations, and determines whether actual use exceeds those recommendations. PATIENTS AND METHODS: Prehospital oxygen use an ... Full text Link to item Cite

An evaluation of a dog bite prevention intervention in the pediatric emergency department.

Journal Article J Trauma Acute Care Surg · October 2013 BACKGROUND: This study aimed to determine the efficacy of a video-based dog bite prevention intervention at increasing child knowledge and describe any associated factors and to assess the acceptability of providing this intervention in a pediatric emergen ... Full text Link to item Cite

The incidence of seizures in patients undergoing therapeutic hypothermia after resuscitation from cardiac arrest.

Journal Article Epilepsy Res · October 2013 STUDY OBJECTIVE: Non-convulsive seizures/status epilepticus occur in approximately 20% of comatose, non-cardiac arrest intensive care unit (ICU) patients, and are associated with increased mortality. The prevalence and clinical significance of seizures in ... Full text Link to item Cite

Performance of a multi-disciplinary emergency department observation protocol for acetaminophen overdose.

Journal Article J Med Toxicol · September 2013 The availability of 20-h N-acetylcysteine (NAC) infusion for low-risk acetaminophen (APAP) overdose enabled our center to implement an Emergency Department observation unit (OU) protocol as an alternative to hospitalization. Our objective was to evaluate o ... Full text Link to item Cite

Operational data integrity during electronic health record implementation in the ED.

Journal Article Am J Emerg Med · July 2013 OBJECTIVE: Operational data are often used to make systems changes in real time. Inaccurate data, however, transiently, can result in inappropriate operational decision making. Implementing electronic health records (EHRs) is fraught with the possibility o ... Full text Link to item Cite

Individual lytic efficacy of recombinant tissue plasminogen activator in an in vitro human clot model: rate of "nonresponse".

Journal Article Acad Emerg Med · May 2013 OBJECTIVES: Recombinant tissue plasminogen activator (rt-PA) is a lytic medication widely used in the emergency department to treat acute thrombotic disorders such as ischemic stroke and myocardial infarction. It is known in the clinical use of this drug t ... Full text Link to item Cite

Strategies for developing biostatistics resources in an academic health center.

Journal Article Acad Med · April 2013 Biostatistics--the application of statistics to understanding health and biology-provides powerful tools for developing research questions, designing studies, refining measurements, analyzing data, and interpreting findings. Biostatistics plays an importan ... Full text Link to item Cite

Factors associated with hospitalization of patients with angiotensin-converting enzyme inhibitor-induced angioedema.

Conference Allergy Asthma Proc · 2013 Angiotensin-converting enzyme inhibitor (ACE-I)-induced angioedema can be life-threatening without emergent intervention. The putative mediator is believed to be bradykinin, similar to hereditary angioedema, so these patients respond poorly to corticostero ... Full text Link to item Cite

Factors that Affect Integrity of Authorship of Scientific Meeting Abstracts.

Journal Article AJOB Prim Res · 2013 BACKGROUND: Strict criteria for manuscript authorship exist to guide decisions on who should be considered an author. Less is known about how authorship for scientific meetings is determined. Our goal was to explore factors that influence decisions about a ... Full text Link to item Cite

Toward understanding the difference between using patients or encounters in the accounting of emergency department utilization.

Journal Article Ann Emerg Med · December 2012 STUDY OBJECTIVE: Descriptions of emergency department (ED) census often do not differentiate between patients and encounters, and there is no guidance about which unit of analysis is most appropriate. We explore differences between patient- and encounter-l ... Full text Link to item Cite

Risk stratification in acute heart failure: rationale and design of the STRATIFY and DECIDE studies.

Journal Article Am Heart J · December 2012 BACKGROUND: A critical challenge for physicians facing patients presenting with signs and symptoms of acute heart failure (AHF) is how and where to best manage them. Currently, most patients evaluated for AHF are admitted to the hospital, yet not all warra ... Full text Link to item Cite

Galectin 3 complements BNP in risk stratification in acute heart failure.

Journal Article Biomarkers · December 2012 BACKGROUND: Galectin 3 (G3) is a mediator of fibrosis and remodeling in heart failure. METHODS: Patients diagnosed with and treated for Acute Heart Failure Syndromes were prospectively enrolled in the Decision Making in Acute Decompensated Heart Failure mu ... Full text Link to item Cite

The effects of linguistic relationships among paired associates on verbal self-generation and recognition memory.

Journal Article Brain Behav · November 2012 Previous studies have shown that self-generated information is better remembered than information that has been read passively. To further examine this subsequent memory effect, we investigated the effect of five different linguistic relationships on memor ... Full text Link to item Cite

The pediatric sepsis biomarker risk model.

Journal Article Crit Care · October 1, 2012 INTRODUCTION: The intrinsic heterogeneity of clinical septic shock is a major challenge. For clinical trials, individual patient management, and quality improvement efforts, it is unclear which patients are least likely to survive and thus benefit from alt ... Full text Link to item Cite

Relationship between prostate-specific antigen, age, and body mass index in a prostate cancer screening population.

Journal Article Am J Clin Oncol · October 2012 BACKGROUND: Recent studies questioning the benefit of prostate-specific antigen (PSA) screening have increased the need for evaluating factors contributing to variance in levels and their clinical relevance. An inverse relationship between body mass index ... Full text Link to item Cite

Females and males are highly similar in language performance and cortical activation patterns during verb generation.

Journal Article Cortex · October 2012 OBJECTIVE: To test the existence of sex differences in cortical activation during verb generation when performance is controlled for. METHODS: Twenty male and 20 female healthy adults underwent functional magnetic resonance imaging (fMRI) using a covert bl ... Full text Link to item Cite

Temperature affects thrombolytic efficacy using rt-PA and eptifibatide, an in vitro study.

Journal Article Ther Hypothermia Temp Manag · September 2012 The potential for hypothermia as a neuroprotectant during stroke has led to its increase in clinical use. At the same time, combination pharmaceutical therapies for ischemic stroke using recombinant tissue plasminogen activator (rt-PA), and GP IIb-IIIa inh ... Full text Link to item Cite

Elevated urinary neutrophil gelatinase-associated lipocalcin after acute heart failure treatment is associated with worsening renal function and adverse events.

Journal Article Eur J Heart Fail · September 2012 AIMS: Reliable detectors of worsening renal function (WRF) in Emergency Department (ED) patients with acute heart failure (AHF) are limited. We hypothesized that initial urinary neutrophil gelatinase-associated lipocalcin (NGAL) levels, and changes in urin ... Full text Link to item Cite

Standardized reporting criteria for studies evaluating suspected acute heart failure syndromes in the emergency department.

Journal Article J Am Coll Cardiol · August 28, 2012 Heart failure requiring urgent therapy represents a burgeoning health care burden. Although acute heart failure syndromes are commonly defined as a change in chronic heart failure signs and symptoms requiring urgent therapy, the presentation, development, ... Full text Link to item Cite

Short-term high-dose effect of lovastatin on thrombolysis by rt-PA in a human whole-blood in vitro clot model.

Journal Article Curr Neurovasc Res · August 2012 High-dose hydroxymethylglutaryl coenzyme. A reductase inhibitor (statin) administration reduces neuronal injury and improves outcomes in experimental models of acute ischemic stroke, and has been shown to be safe in a phase 1 dose-escalation study using lo ... Full text Link to item Cite

Bayesian adaptive trial design in acute heart failure syndromes: moving beyond the mega trial.

Journal Article Am Heart J · August 2012 Over the last 2 decades, early treatment for patients presenting with acute heart failure syndromes (AHFS) has changed very little. Despite strikingly different underlying disease pathophysiology, presenting signs and symptoms, and precipitants of AHFS, mo ... Full text Link to item Cite

Patients living in impoverished areas have more severe ischemic strokes.

Journal Article Stroke · August 2012 BACKGROUND AND PURPOSE: Initial stroke severity is one of the strongest predictors of eventual stroke outcome. However, predictors of initial stroke severity have not been well-described within a population. We hypothesized that poorer patients would have ... Full text Link to item Cite

An automated dispensing system for improving medication timing in the emergency department.

Journal Article World J Emerg Med · June 12, 2012 BACKGROUND: Numerous medical conditions require timely medication administration in the emergency department (ED). Automated dispensing systems (ADSs) store premixed common doses at the point-of-care to minimize time to administration, but the use of such ... Full text Link to item Cite

A time-and-motion study of the processes required to obtain cardiac biomarker assays using central laboratory, near-patient testing, and bedside point-of-care testing

Journal Article Point of Care · June 1, 2012 Background: Point-of-care (POC) testing can reduce cardiac biomarker assay turnaround time for patients with suspected acute coronary syndromes (ACSs). However, equivalent reductions in patient throughput have not been realized. To better understand how PO ... Full text Cite

Vereckei criteria used as a diagnostic tool by emergency medicine residents to distinguish between ventricular tachycardia and supra-ventricular tachycardia with aberrancy.

Journal Article J Cardiol · May 2012 BACKGROUND: Accurate electrocardiographic (ECG) differentiation of ventricular tachycardia (VT) from supraventricular tachycardia with aberrancy (SVT-A) on ECG is key to therapeutic decision-making in the emergency department (ED) setting. OBJECTIVE: The g ... Full text Link to item Cite

Early changes in clinical characteristics after emergency department therapy for acute heart failure syndromes: identifying patients who do not respond to standard therapy.

Journal Article Heart Fail Rev · May 2012 Clinical trials for acute heart failure syndromes (AHFS) have traditionally enrolled patients well after emergency department (ED) presentation. We hypothesized a large proportion of patients would undergo changes in clinical profiles during the first 24 h ... Full text Link to item Cite

Derivation and validation of the Denver Human Immunodeficiency Virus (HIV) risk score for targeted HIV screening.

Journal Article Am J Epidemiol · April 15, 2012 Targeted screening remains an important approach to human immunodeficiency virus (HIV) testing. The authors aimed to derive and validate an instrument to accurately identify patients at risk for HIV infection, using patient data from a metropolitan sexuall ... Full text Link to item Cite

Initial EEG predicts outcomes in a trial of levetiracetam vs. fosphenytoin for seizure prevention.

Journal Article Epilepsy Behav · March 2012 Continuous electroencephalography (cEEG) is increasingly used to detect both clinical and subclinical seizures in patients with traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). We assess whether EEG findings predict outcomes in TBI/SAH patien ... Full text Link to item Cite

Comparison of two depression measures for predicting stroke outcomes.

Journal Article J Psychosom Res · March 2012 OBJECTIVES: Little is known about the effect of lifetime history of depression on ischemic stroke outcomes. This study compared a measure of current symptoms of depression at the time of the stroke and a measure of lifetime history of depression for their ... Full text Link to item Cite

Dog bite prevention: an assessment of child knowledge.

Journal Article J Pediatr · February 2012 OBJECTIVES: To determine what children know about preventing dog bites and to identify parental desires for dog bite prevention education. STUDY DESIGN: This cross-sectional study sampled 5- to 15-year-olds and their parents/guardians presenting to a pedia ... Full text Link to item Cite

Emergency department adherence to American Heart Association guidelines for blood pressure management in acute ischemic stroke.

Journal Article Stroke · February 2012 BACKGROUND AND PURPOSE: Severely elevated blood pressure (BP) and aggressive BP reduction are both associated with poor outcome in acute ischemic stroke (AIS). In nontissue-type plasminogen activator patients, the American Heart Association recommends anti ... Full text Link to item Cite

Ground emergency medical services requests for helicopter transfer of ST-segment elevation myocardial infarction patients decrease medical contact to balloon times in rural and suburban settings.

Journal Article Acad Emerg Med · February 2012 OBJECTIVES:   ST-segment elevation myocardial infarction (STEMI) care is time-dependent. Many STEMI patients require interhospital helicopter transfer for percutaneous coronary intervention (PCI) if ground emergency medical services (EMS) initially transpo ... Full text Link to item Cite

Self-reported cocaine use, emergency physician testing and outcomes in suspected acute coronary syndromes: a nested matched case-control study.

Journal Article BMJ Open · 2012 OBJECTIVES: The primary purpose was to compare the odds of acute coronary syndrome-pertinent diagnostic testing between self-reported cocaine users and non-users at the turn of the century. The secondary purpose was to compare the odds of acute coronary sy ... Full text Link to item Cite

Bedside renal ultrasound in the evaluation of suspected ureterolithiasis.

Journal Article Am J Emerg Med · January 2012 OBJECTIVE: To determine whether ultrasound changes emergency physicians' estimated likelihood of acute ureterolithiasis in patients with flank pain. METHODS: This prospective, observational study enrolled patients awaiting computed tomographic (CT) scan fo ... Full text Link to item Cite

A comparison of criterion standard methods to diagnose acute heart failure.

Journal Article Congest Heart Fail · 2012 The authors sought to compare and contrast the clinical criterion standards currently used in a cohort of emergency department (ED) patients to diagnose acute heart failure syndromes (AHFS). In a prospective observational study of patients with signs and s ... Full text Link to item Cite

The degree of bandemia in septic ED patients does not predict inpatient mortality.

Journal Article Am J Emerg Med · January 2012 BACKGROUND: A delay in diagnosis of sepsis and appropriate treatment increases subsequent mortality. An association with the degree of bandemia, or the presence of immature neutrophils in the white blood cell count, has not been explored in septic patients ... Full text Link to item Cite

Biomarker changes during acute heart failure treatment.

Journal Article Congest Heart Fail · 2012 Biomarker changes may provide physicians with objective evidence of treatment efficacy in patients with acute decompensated heart failure (ADHF) and facilitate early hospital discharge. The authors hypothesize that mid-regional-pro-adrenomedullin (MR-proAD ... Full text Link to item Cite

Combination treatment with rt-PA is more effective than rt-PA alone in an in vitro human clot model.

Journal Article Curr Neurovasc Res · November 2011 Incidence of intra-cranial hemorrhage linked to treatment of ischemic stroke with recombinant tissue plasminogen activator (rt-PA) has led to interest in adjuvant therapies such as ultrasound (US) or plasminogen, to enhance rt-PA efficacy and improve patie ... Full text Link to item Cite

Evaluation metrics for biostatistical and epidemiological collaborations.

Journal Article Stat Med · October 15, 2011 Increasing demands for evidence-based medicine and for the translation of biomedical research into individual and public health benefit have been accompanied by the proliferation of special units that offer expertise in biostatistics, epidemiology, and res ... Full text Link to item Cite

Preliminary program evaluation of emergency department HIV prevention counseling.

Journal Article Ann Emerg Med · July 2011 OBJECTIVE: Controversy surrounds the linkage of prevention counseling with emergency department (ED)-based HIV testing. Further, the effectiveness and feasibility of prevention counseling in the ED setting is unknown. We investigate these issues by conduct ... Full text Link to item Cite

A simple method for estimating the prevalence of undiagnosed HIV infection in an emergency department.

Journal Article Ann Emerg Med · July 2011 OBJECTIVES: Estimating the prevalence of undiagnosed HIV in emergency departments (EDs) is not straightforward. Regional epidemiologic data are unlikely to translate directly to a single ED setting, and the prevalence of undiagnosed HIV likely differs betw ... Full text Link to item Cite

Operational methods of HIV testing in emergency departments: a systematic review.

Journal Article Ann Emerg Med · July 2011 OBJECTIVES: Casual review of existing literature reveals a multitude of individualized approaches to emergency department (ED) HIV testing. Cataloging the operational options of each approach could assist translation by disseminating existing knowledge, en ... Full text Link to item Cite

2009 US emergency department HIV testing practices.

Journal Article Ann Emerg Med · July 2011 OBJECTIVES: We characterize HIV testing practices and programs in US emergency departments (EDs) in 2009. METHODS: A national Web-based survey of members of the National ED HIV Testing Consortium, participants in the 2007 Centers for Disease Control and Pr ... Full text Link to item Cite

Comparison of missed opportunities for earlier HIV diagnosis in 3 geographically proximate emergency departments.

Journal Article Ann Emerg Med · July 2011 OBJECTIVE: Differences in the prevalence of undiagnosed HIV between different types of emergency departments (EDs) are not well understood. We seek to define missed opportunities for HIV diagnosis within 3 geographically proximate EDs serving different pat ... Full text Link to item Cite

Effect of an emergency department HIV testing program on the proportion of emergency department patients who have been tested.

Journal Article Ann Emerg Med · July 2011 OBJECTIVE: The lack of well-described population-level outcome measures for emergency department (ED) HIV testing is one barrier to translation of screening into practice. We demonstrate the impact of an ED diagnostic testing and targeted screening program ... Full text Link to item Cite

Public health and clinical impact of increasing emergency department-based HIV testing: perspectives from the 2007 conference of the National Emergency Department HIV Testing Consortium.

Journal Article Ann Emerg Med · July 2011 OBJECTIVE: Understanding perceived benefits and disadvantages of HIV testing in emergency departments (EDs) is imperative to overcoming barriers to implementation. We codify those domains of public health and clinical care most affected by implementing HIV ... Full text Link to item Cite

Predictors of 30-day cardiovascular events in patients with prior percutaneous coronary intervention or coronary artery bypass grafting.

Conference Acad Emerg Med · June 2011 OBJECTIVES: Risk stratification of patients with potential acute coronary syndrome (ACS) is difficult. Patients with prior revascularization are considered higher risk, but they can also have symptoms from noncardiac causes. This study evaluated whether th ... Full text Link to item Cite

An International Health Track Is Associated With Care for Underserved US Populations in Subsequent Clinical Practice.

Journal Article J Grad Med Educ · June 2011 BACKGROUND: Recent efforts to increase insurance coverage have revealed limits in primary care capacity, in part due to physician maldistribution. Of interest to policymakers and educators is the impact of nontraditional curricula, including global health ... Full text Link to item Cite

Needle and guidewire visualization in ultrasound-guided internal jugular vein cannulation.

Journal Article Am J Emerg Med · May 2011 STUDY OBJECTIVE: Reimbursement for ultrasound-guided central lines requires documenting the needle entering the vessel lumen. We hypothesized that physicians often successfully perform ultrasound-guided internal jugular (IJ) cannulation without visualizing ... Full text Link to item Cite

Risk, reasons for refusal, and impact of counseling on consent among ED patients declining HIV screening.

Journal Article Am J Emerg Med · May 2011 Screening for HIV in the emergency department (ED) is recommended by the Centers for Disease Control and Prevention. The relative importance of efforts to increase consent among those who currently decline screening is not well understood. We compared the ... Full text Link to item Cite

Clostridium difficile infection and treatment in the pediatric inflammatory bowel disease population.

Journal Article J Pediatr Gastroenterol Nutr · April 2011 OBJECTIVE: Recent changes in the epidemiology of Clostridium difficile infection include an increase in the incidence of C difficile-associated disease (CDAD) and the identification of patients with inflammatory bowel disease (IBD) as a group at risk. In a ... Full text Link to item Cite

Reperfusion is delayed beyond guideline recommendations in patients requiring interhospital helicopter transfer for treatment of ST-segment elevation myocardial infarction.

Journal Article Ann Emerg Med · March 2011 STUDY OBJECTIVE: Early reperfusion portends better outcomes for ST-segment elevation myocardial infarction (STEMI) patients. This investigation estimates the proportions of STEMI patients transported by a hospital-based helicopter emergency medical service ... Full text Link to item Cite

Cardiac point-of-care testing: Impact on emergency department door to disposition time is modified by patient acuity and hospital setting

Journal Article Point of Care · March 1, 2011 Background: Implementing point-of-care testing (POCT) is thought to improve emergency department (ED) patient throughput by decreasing time to disposition, but evidence is lacking. We implemented POCT for cardiac biomarkers and determined whether it improv ... Full text Cite

Outcomes associated with small changes in normal-range cardiac markers.

Journal Article Am J Emerg Med · February 2011 INTRODUCTION: Troponin concentrations rising above an institutional cutpoint are used to define acute myocardial necrosis, yet it is uncertain what outcomes are associated with fluctuations in troponin that do not exceed this level. We evaluate the associa ... Full text Link to item Cite

Ischemic stroke survivors' opinion regarding research utilizing exception from informed consent.

Journal Article Cerebrovasc Dis · 2011 INTRODUCTION: 'Exception from informed consent for research' (EFIC) is a rigorous procedure regulated by the FDA that requires community assent but allows enrollment without patient or family consent. Recently, several acute stroke trials have explored the ... Full text Link to item Cite

Nonoperative treatment of both-bone forearm shaft fractures in children: predictors of early radiographic failure.

Journal Article J Pediatr Orthop · 2011 BACKGROUND: Forearm shaft fractures are the third most common fracture in children. Although closed reduction and casting is the preferred treatment; outcomes remain variable. The purpose of this study was to identify factors associated with failure of non ... Full text Link to item Cite

Radiation exposure in emergency physicians working in an urban ED: a prospective cohort study.

Journal Article Am J Emerg Med · November 2010 OBJECTIVE: The National Council on Radiation Protection (NCRP) limits health care-associated occupational exposures to radiation to 5000 mrem/y. Previous studies suggested that emergency physicians were not exposed over this limit. Their relevance to conte ... Full text Link to item Cite

International variations in the clinical, diagnostic, and treatment characteristics of emergency department patients with acute heart failure syndromes.

Journal Article Eur J Heart Fail · November 2010 AIMS: Results from investigations in one area of the world may not translate to another if patient characteristics and practices differ. We examine differences in the presentation and management of emergency department (ED) patients with dyspnoea from acut ... Full text Link to item Cite

Making the right choice: optimizing rt-PA and eptifibatide lysis, an in vitro study.

Journal Article Thromb Res · October 2010 INTRODUCTION: Recombinant tissue plasminogen activator (rt-PA) is the only FDA approved lytic therapy for acute ischemic stroke. However, there can be complications such as intra-cerebral hemorrhage. This has led to interest in adjuncts such as GP IIb-IIIa ... Full text Link to item Cite

Utility of a bedside acoustic cardiographic model to predict elevated left ventricular filling pressure.

Journal Article Emerg Med J · September 2010 BACKGROUND: The authors previously described an acoustic cardiographic model that predicted echocardiographic correlates of elevated left ventricular (LV) filling pressure. This study evaluated this bedside acoustic cardiographic model against invasive mea ... Full text Link to item Cite

Key personnel and "long distance" settings: determining who must report financial conflict of interest.

Journal Article Account Res · July 2010 Conflicts of interest (COIs) can impact the integrity of scientific research. While public imagination has focused on scientists, regulatory discourse recognizes a broader range of individuals who might have financial COIs. This essay asks, for personnel w ... Full text Link to item Cite

Sacral neuromodulation for nonobstructive urinary retention: a meta-analysis.

Journal Article Female Pelvic Med Reconstr Surg · July 2010 OBJECTIVE: : The objective of this study is to systematically review the literature regarding the efficacy of sacral neuromodulation (InterStim) for treatment of nonobstructive urinary retention. METHODS: : Eligible studies were selected through an electro ... Full text Link to item Cite

Which stroke symptoms prompt a 911 call? A population-based study.

Journal Article Am J Emerg Med · June 2010 INTRODUCTION: Many studies show that a major barrier to short-term treatment of stroke is patient or bystander delay in responding to stroke symptoms. Most studies have found that less than half of stroke/transient ischemic attack (TIA) events result in a ... Full text Link to item Cite

Motivations, job procurement, and job satisfaction among current and former ultrasound fellows.

Journal Article Acad Emerg Med · June 2010 OBJECTIVES: Over the past decade, emergency medicine ultrasound (US) fellowships have proliferated, yet there are no published data describing employment trends among fellowship graduates. This study sought to assess factors motivating emergency physicians ... Full text Link to item Cite

Seizure control in patients with idiopathic generalized epilepsies: EEG determinants of medication response.

Journal Article Epilepsy Behav · April 2010 In a minority of patients with idiopathic generalized epilepsies (IGEs), seizures continue despite appropriate treatment. We sought to determine the clinical and EEG factors associated with medication response in these patients. All patients with IGEs eval ... Full text Link to item Cite

Prospective, randomized, single-blinded comparative trial of intravenous levetiracetam versus phenytoin for seizure prophylaxis.

Journal Article Neurocrit Care · April 2010 BACKGROUND: Anti-epileptic drugs are commonly used for seizure prophylaxis after neurological injury. We performed a study comparing intravenous (IV) levetiracetam (LEV) to IV phenytoin (PHT) for seizure prophylaxis after neurological injury. METHODS: In t ... Full text Link to item Cite

Postnatal growth of the clavicle: birth to 18 years of age.

Journal Article J Pediatr Orthop · December 2009 BACKGROUND: The purpose of our study was to perform a large cross-sectional study aimed at determining the postnatal growth pattern of the clavicle from birth to 18 years of age. METHODS: We analyzed the digital chest radiographs of a convenience sample of ... Full text Link to item Cite

Relationship of self-reported prior testing history to undiagnosed HIV positivity and HIV risk.

Journal Article Curr HIV Res · November 2009 Screening everyone for HIV at least once is estimated to be cost-effective. Screening in health care settings is recommended to help achieve that goal. Health care settings often encounter the same patient repeatedly, and it is unknown if limited resources ... Full text Link to item Cite

Evaluating emergency care research networks: what are the right metrics?

Journal Article Acad Emerg Med · October 2009 Research networks can enable the inclusion of large, diverse patient populations in different settings. However, the optimal measures of a research network's failure or success are not well defined or standardized. To define a framework for metrics used to ... Full text Link to item Cite

Performance of a body surface mapping system using emergency physician real-time interpretation.

Journal Article Am J Emerg Med · September 2009 OBJECTIVE: We compared the performance characteristics of the 12-lead electrocardiography (ECG) with body surface mapping (BSM) in patients presenting for evaluation of symptoms suggestive of acute coronary syndromes. METHODS: The diagnostic test character ... Full text Link to item Cite

Low-risk acute heart failure patients: external validation of the Society of Chest Pain Center's recommendations.

Journal Article Crit Pathw Cardiol · September 2009 INTRODUCTION: Risk-stratification in acute heart failure syndromes (AHFS) is problematic. A recent set of recommendations describes emergency department (ED) patients with AHFS who do not fulfill high-risk criteria and may be good candidates for observatio ... Full text Link to item Cite

A systematic review of emergency department point-of-care cardiac markers and efficiency measures

Journal Article Point of Care · September 1, 2009 Effects of point-of-care testing for serum markers of cardiac necrosis on the process and outcomes of patient care in the emergency department (ED) have yet to be fully elucidated. We conducted this systematic review to summarize the current state of knowl ... Full text Cite

The rationale for an acute heart failure syndromes clinical trials network.

Journal Article J Card Fail · August 2009 BACKGROUND: Clinical trials involving novel therapies treating acute heart failure syndromes (AHFS) have shown limited success with regard to both efficacy and safety. As a direct result, outcomes have changed little over time and AHFS remains a disease pr ... Full text Link to item Cite

Emergency physician high pretest probability for acute coronary syndrome correlates with adverse cardiovascular outcomes.

Journal Article Acad Emerg Med · August 2009 OBJECTIVES: The value of unstructured physician estimate of risk for disease processes, other than acute coronary syndrome (ACS), has been demonstrated. The authors sought to evaluate the predictive value of unstructured physician estimate of risk for ACS ... Full text Open Access Link to item Cite

Ultrasound-enhanced thrombolysis with tPA-loaded echogenic liposomes.

Journal Article Thromb Res · July 2009 BACKGROUND AND PURPOSE: Currently, the only FDA-approved therapy for acute ischemic stroke is the administration of recombinant tissue plasminogen activator (tPA). Echogenic liposomes (ELIP), phospholipid vesicles filled with gas and fluid, can be manufact ... Full text Link to item Cite

The use of penicillin skin testing to assess the prevalence of penicillin allergy in an emergency department setting.

Conference Ann Emerg Med · July 2009 STUDY OBJECTIVE: Patient-reported penicillin allergies are often unreliable and can result in unnecessary changes in antibiotic therapy. Although penicillin allergy skin testing is commonly performed in allergy clinics, it has not been used in emergency de ... Full text Link to item Cite

S3 detection as a diagnostic and prognostic aid in emergency department patients with acute dyspnea.

Journal Article Ann Emerg Med · June 2009 STUDY OBJECTIVE: Dyspneic emergency department (ED) patients present a diagnostic dilemma. Recent technologic advances have made it possible to capture information about pathologic heart sounds at ECG recording. This study evaluates the effect of an S3 cap ... Full text Link to item Cite

Bedside prediction of increased filling pressure using acoustic electrocardiography.

Journal Article Am J Emerg Med · May 2009 BACKGROUND: Patients presenting with acute dyspnea are often a diagnostic dilemma. A bedside tool that accurately and rapidly identifies increased left ventricular (LV) filling pressure would be helpful. We evaluated acoustic electrocardiography for this p ... Full text Link to item Cite

A multicenter randomized controlled trial comparing central laboratory and point-of-care cardiac marker testing strategies: the Disposition Impacted by Serial Point of Care Markers in Acute Coronary Syndromes (DISPO-ACS) trial.

Conference Ann Emerg Med · March 2009 STUDY OBJECTIVE: Point-of-care testing reduces time to cardiac marker results in patients evaluated for acute coronary syndromes, yet evidence this translates to a decreased length of stay is lacking. We hypothesized that point-of-care testing decreases le ... Full text Link to item Cite

Serial venous point-of-care lactate measurements for the evaluation and triage of undifferentiated patients with blunt trauma

Journal Article Point of Care · March 1, 2009 Background: Lactate has prognostic use in critically ill medical and trauma patients. Although some centers use lactate in the initial evaluation of patients with obvious severe trauma, it has not been investigated as a triage tool in the initial emergency ... Full text Cite

Emergency medical services use by stroke patients: a population-based study.

Journal Article Am J Emerg Med · February 2009 OBJECTIVES: Emergency medical services (EMS) use by stroke patients varies from 38% to 65%. In an epidemiological study, we determined the proportion of stroke patients who used EMS, hypothesizing that demographics, stroke severity, stroke type, and locati ... Full text Link to item Cite

Nomenclature and definitions for emergency department human immunodeficiency virus (HIV) testing: report from the 2007 conference of the National Emergency Department HIV Testing Consortium.

Journal Article Acad Emerg Med · February 2009 Early diagnosis of persons infected with human immunodeficiency virus (HIV) through diagnostic testing and screening is a critical priority for individual and public health. Emergency departments (EDs) have an important role in this effort. As EDs gain exp ... Full text Link to item Cite

Clinical prediction of functional outcome after ischemic stroke: the surprising importance of periventricular white matter disease and race.

Journal Article Stroke · February 2009 BACKGROUND AND PURPOSE: We sought to build models that address questions of interest to patients and families by predicting short- and long-term mortality and functional outcome after ischemic stroke, while allowing for risk restratification as comorbid ev ... Full text Link to item Cite

Comparison of emergency department HIV testing data with visit or patient as the unit of analysis.

Journal Article J Med Screen · 2009 OBJECTIVES: Outcomes in an episodic care setting like an emergency department (ED) are traditionally evaluated in comparison with the number of visits as opposed to the number of unique patients, although patients commonly present to the ED multiple times. ... Full text Link to item Cite

Effect of low frequency ultrasound on combined rt-PA and eptifibatide thrombolysis in human clots.

Journal Article Thromb Res · 2009 INTRODUCTION: Fibrinolytics such as recombinant tissue plasminogen activator (rt-PA) are used to treat thrombotic disease such as acute myocardial infarction (AMI) and ischemic stroke. Interest in increasing efficacy and reducing side effects has led to th ... Full text Link to item Cite

Seizure control in patients with epilepsy: the physician vs. medication factors.

Conference BMC Health Serv Res · December 18, 2008 BACKGROUND: Little is known about the relationship between types of healthcare providers and outcomes in patients with epilepsy. This study compares the relative effects of provider type (epileptologist vs. other neurologist) and pharmacologic treatment (n ... Full text Link to item Cite

Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c.

Journal Article Blood · November 15, 2008 Although red blood cell (RBC) life span is a known determinant of percentage hemoglobin A1c (HbA1c), its variation has been considered insufficient to affect clinical decisions in hematologically normal persons. However, an unexplained discordance between ... Full text Link to item Cite

Tissue plasminogen activator concentration dependence of 120 kHz ultrasound-enhanced thrombolysis.

Journal Article Ultrasound Med Biol · November 2008 It has been known for some time that the application of ultrasound can enhance the efficacy of thrombolytic medications such as recombinant tissue plasminogen activator (rt-PA). Potential clinical applications of this ultrasound-enhanced thrombolysis (UET) ... Full text Link to item Cite

Derivation of a risk assessment tool for emergency department patients with sickle cell disease.

Journal Article Emerg Med J · October 2008 INTRODUCTION: Sickle cell patients commonly present to the emergency department (ED). Identifying those requiring admission and those who can safely be discharged is difficult. It was hypothesised that ED variables predictive of 96-h adverse sickle cell pa ... Full text Link to item Cite

Serum cleaved tau does not predict postconcussion syndrome after mild traumatic brain injury.

Journal Article Am J Emerg Med · September 2008 OBJECTIVES: Our objective was to determine if the biomarker for axonal injury, serum cleaved tau (C-tau), predicts postconcussion syndrome (PCS) in adults after mild traumatic brain injury (mTBI). METHODS: C-tau was measured from blood obtained in the emer ... Full text Link to item Cite

Evidence for interindividual heterogeneity in the glucose gradient across the human red blood cell membrane and its relationship to hemoglobin glycation.

Journal Article Diabetes · September 2008 OBJECTIVE: To determine whether interindividual heterogeneity in the erythrocyte (red blood cell [RBC]) transmembrane glucose gradient might explain discordances between A1C and glycemic control based on measured fructosamine. RESEARCH DESIGN AND METHODS: ... Full text Link to item Cite

Improving health status of homeless patients at a nurse-managed clinic in the Midwest USA.

Journal Article Health Soc Care Community · September 2008 Homeless adults have a higher rate of morbidity and mortality than their housed counterparts. Improving the health of homeless adults is a complex problem because of the overlay of individual risk factors, social issues and lack of economic resources. Due ... Full text Link to item Cite

Initial risk stratification and presenting characteristics of patients with evolving myocardial infarctions.

Journal Article Emerg Med J · August 2008 OBJECTIVES: To describe the presenting characteristics and risk stratification of patients presenting to the emergency department with chest pain who have a normal initial troponin level followed by a raised troponin level within 12 h (evolving myocardial ... Full text Link to item Cite

Contributions to early HIV diagnosis among patients linked to care vary by testing venue.

Journal Article BMC Public Health · June 25, 2008 OBJECTIVE: Early HIV diagnosis reduces transmission and improves health outcomes; screening in non-traditional settings is increasingly advocated. We compared test venues by the number of new diagnoses successfully linked to the regional HIV treatment cent ... Full text Link to item Cite

A method for the continuous calculation of the age of labeled red blood cells.

Journal Article Am J Hematol · June 2008 New methods for labeling red blood cells (RBC) and monitoring their survival have made it possible to explore changes in the properties of RBC as they age in the circulation. We have adapted a method, originally developed for studying wild animals, to calc ... Full text Link to item Cite

Fluoroquinolone resistance during 2000-2005: an observational study.

Journal Article BMC Infect Dis · May 24, 2008 BACKGROUND: Moxifloxacin is a respiratory fluoroquinolone with a community acquired pneumonia indication. Unlike other fluoroquinolones used in our healthcare system, moxifloxacin's urinary excretion is low and thus we hypothesized that increased use of mo ... Full text Link to item Cite

Inadequate provision of postintubation anxiolysis and analgesia in the ED.

Journal Article Am J Emerg Med · May 2008 INTRODUCTION: Patients intubated in the emergency department (ED) often have extended ED stays. We hypothesize that ED intubated patients receive inadequate postintubation anxiolysis and analgesia after rapid sequence induction (RSI). METHODS: This was a r ... Full text Link to item Cite

Variability in expert assessments of child physical abuse likelihood.

Journal Article Pediatrics · April 2008 OBJECTIVES: In the absence of a gold standard, clinicians and researchers often categorize their opinions of the likelihood of inflicted injury using several ordinal scales. The objective of this protocol was to determine the reliability of expert ratings ... Full text Link to item Cite

National US estimates of recombinant tissue plasminogen activator use: ICD-9 codes substantially underestimate.

Journal Article Stroke · March 2008 BACKGROUND AND PURPOSE: Current US estimates of recombinant tissue plasminogen activator (rt-PA) use have been based either on extrapolation of regional studies or on administrative database estimates, both of which may have inherent biases. We sought to c ... Full text Link to item Cite

A proposal to standardize dyspnoea measurement in clinical trials of acute heart failure syndromes: the need for a uniform approach.

Journal Article Eur Heart J · March 2008 Dyspnoea is the most common presenting symptom amongst patients with acute heart failure syndromes (AHFS). It is distressing to patients and therefore an important target for treatment in clinical practice, clinical trials, and for regulatory approval of n ... Full text Link to item Cite

Comparison of characteristics of admitted emergency department patients requiring cardiopulmonary resuscitation in the ICU and non-ICU setting.

Journal Article Emerg Med J · February 2008 BACKGROUND: Hospitalised patients requiring cardiopulmonary resuscitation (CPR) have better outcomes in intensive care units (ICUs) than wards. Survival could potentially be improved for patients at high risk for CPR if they can be identified while in the ... Full text Link to item Cite

Evidence-based emergency medicine. Creating a system to facilitate translation of evidence into standardized clinical practice: a preliminary report.

Journal Article Ann Emerg Med · January 2008 STUDY OBJECTIVE: The Institute of Medicine, through its landmark report concerning errors in medicine, suggests that standardization of practice through systematic development and implementation of evidence-based clinical pathways is an effective way of re ... Full text Link to item Cite

Age accounts for racial differences in ischemic stroke volume in a population-based study.

Journal Article Cerebrovasc Dis · 2008 BACKGROUND: The stroke volume among black ischemic stroke patients in phase I of the population-based Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) was smaller than reported among acute stroke studies, with a median stroke volume of 2.5 cm. Ho ... Full text Link to item Cite

Health status and access to care for homeless adults with problem alcohol and drug use

Journal Article Journal of Addictions Nursing · January 1, 2008 Problem alcohol and drug use by adult homeless persons may put them at higher risk for other health problems and impact their access to health care. The purpose of this study was to determine if those with a positive screen for problem alcohol or drug use ... Full text Cite

Comprehensive presurgical functional MRI language evaluation in adult patients with epilepsy.

Journal Article Epilepsy Behav · January 2008 Functional magnetic resonance imaging (fMRI) has the potential to replace the intracarotid amobarbital procedure (IAP) in presurgical evaluation of patients with epilepsy. In this study, we compared fMRI verb generation (VG) and semantic decision/tone deci ... Full text Link to item Cite

Prevalence and demographics of methicillin resistant Staphylococcus aureus in culturable skin and soft tissue infections in an urban emergency department.

Journal Article BMC Emerg Med · October 31, 2007 BACKGROUND: The rising incidence of methicillin resistant Staph. aureus (MRSA) infections is a concern for emergency practitioners. While studies have examined MRSA in inpatients, few have focused on emergency department populations. We sought to describe ... Full text Link to item Cite

A novel emergency department based prevention intervention program for people living with HIV: evaluation of early experiences.

Journal Article BMC Health Serv Res · October 15, 2007 BACKGROUND: HIV prevention is increasingly focused on people living with HIV (PLWH) and the role of healthcare settings in prevention. Emergency Departments (EDs) frequently care for PLWH, but do not typically endorse a prevention mission. We conducted a p ... Full text Link to item Cite

The elder patient with suspected acute coronary syndromes in the emergency department.

Conference Acad Emerg Med · August 2007 OBJECTIVES: To describe the evaluation and outcomes of elder patients with suspected acute coronary syndromes (ACS) presenting to the emergency department (ED). METHODS: This was a post hoc analysis of the Internet Tracking Registry for Acute Coronary Synd ... Full text Link to item Cite

Endothelial microparticle levels are similar in acute ischemic stroke and stroke mimics due to activation and not apoptosis/necrosis.

Conference Acad Emerg Med · August 2007 BACKGROUND: Endothelial microparticles (EMPs) are <2-microm membranous blebs from endothelial cell membranes that have been demonstrated to be elevated in vasculopathic conditions. One study has demonstrated elevated EMPs in acute ischemic stroke (AIS) ver ... Full text Link to item Cite

Postal survey methodology to assess patient satisfaction in a suburban emergency medical services system: an observational study.

Journal Article BMC Emerg Med · June 15, 2007 BACKGROUND: Patient satisfaction is of growing importance to providers of emergency medical services (EMS). Prior reports of patient satisfaction have frequently used resource-intensive telephone follow-up to assess satisfaction. We determine the feasibili ... Full text Link to item Cite

Emergency Department education improves patient knowledge of coronary artery disease risk factors but not the accuracy of their own risk perception.

Journal Article Prev Med · June 2007 BACKGROUND: Coronary artery disease (CAD) is the single largest killer of both males and females in the United States. The Emergency Department (ED) represents a unique environment in which patient education may improve coronary artery disease risk factor ... Full text Link to item Cite

The effect of offering international health training opportunities on family medicine residency recruiting.

Journal Article Fam Med · April 2007 BACKGROUND AND OBJECTIVES: While medical students' interest in family medicine declines, and residency programs face recruiting challenges, interest in international health is increasing. We studied the influence of offering an international health track ( ... Link to item Cite

Duty cycle dependence of ultrasound enhanced thrombolysis in a human clot model.

Journal Article Ultrasound Med Biol · April 2007 Combined ultrasound and tissue plasminogen activator (rt-PA) therapy, or ultrasound enhanced thrombolysis (UET), has been shown to improve recanalization in patients with acute ischemic stroke. We measured the effect of ultrasound duty cycle on the lytic e ... Full text Link to item Cite

The role of cardiac risk factor burden in diagnosing acute coronary syndromes in the emergency department setting.

Journal Article Ann Emerg Med · February 2007 STUDY OBJECTIVE: We seek to determine whether cardiac risk factor burden (defined as the number of conventional cardiac risk factors present) is useful for the diagnosis of acute coronary syndromes in the emergency department (ED) setting. METHODS: This wa ... Full text Link to item Cite

Interpreting and implementing the 2006 CDC recommendations for HIV testing in health-care settings.

Journal Article Public Health Rep · 2007 On September 22, 2006, the Centers for Disease Control and Prevention (CDC) announced recommendations to expand the role of health-care providers in human immunodeficiency virus (HIV) testing. These clearlyjustified guidelines aim to remove traditional tes ... Full text Link to item Cite

Elevated serum cardiac markers predict coronary artery disease in patients with a history of heart failure who present with chest pain: insights from the i*trACS registry.

Journal Article Congest Heart Fail · 2007 The significance of a history of heart failure (HF) in patients presenting with acute coronary syndromes and elevated cardiac markers is unclear. The authors performed an analysis of patients enrolled in the Internet Tracking Registry of Acute Coronary Syn ... Full text Link to item Cite

Evaluation of dyslipidemia in the emergency department: impact of cholesterol testing on subsequent therapy.

Journal Article Am Heart J · December 2006 BACKGROUND: Dyslipidemia is not routinely evaluated in emergency department (ED) patients. We hypothesized that many ED patients would qualify for lipid therapy and that methods of follow-up for patients would not achieve adequate treatment goals. METHODS: ... Full text Link to item Cite

The Internet Tracking Registry of Acute Coronary Syndromes (i*trACS): a multicenter registry of patients with suspicion of acute coronary syndromes reported using the standardized reporting guidelines for emergency department chest pain studies.

Journal Article Ann Emerg Med · December 2006 STUDY OBJECTIVE: Observational studies of well-described patient populations presenting to emergency departments (EDs) with suspicion of acute coronary syndrome are necessary to understand the relationships between patients' signs and symptoms, cardiac ris ... Full text Link to item Cite

Discordant cardiac biomarkers: frequency and outcomes in emergency department patients with chest pain.

Journal Article Ann Emerg Med · December 2006 STUDY OBJECTIVE: We evaluate associations between pairs of discordant cardiac biomarkers (positive MB band of creatine kinase [CKMB] with negative creatine kinase, positive CKMB with negative cardiac troponin, and positive troponin with negative CKMB) and ... Full text Link to item Cite

Clinical characteristics of emergency department heart failure patients initially diagnosed as non-heart failure.

Journal Article BMC Emerg Med · November 14, 2006 BACKGROUND: Since previous studies suggest the emergency department (ED) misdiagnosis rate of heart failure is 10-20% we sought to describe the characteristics of ED patients misdiagnosed as non-decompensated heart failure in the ED. METHODS: We analyzed a ... Full text Link to item Cite

The use of sleep aids among Emergency Medicine residents: a web based survey.

Journal Article BMC Health Serv Res · October 19, 2006 BACKGROUND: Sleepiness is a significant problem among residents due to chronic sleep deprivation. Recent studies have highlighted medical errors due to resident sleep deprivation. We hypothesized residents routinely use pharmacologic sleep aids to manage t ... Full text Link to item Cite

High fidelity medical simulation in the difficult environment of a helicopter: feasibility, self-efficacy and cost.

Journal Article BMC Med Educ · October 5, 2006 BACKGROUND: This study assessed the feasibility, self-efficacy and cost of providing a high fidelity medical simulation experience in the difficult environment of an air ambulance helicopter. METHODS: Seven of 12 EM residents in their first postgraduate ye ... Full text Link to item Cite

Association of serial biochemical markers with acute ischemic stroke: the National Institute of Neurological Disorders and Stroke recombinant tissue plasminogen activator Stroke Study.

Journal Article Stroke · October 2006 BACKGROUND AND PURPOSE: Biochemical markers of acute neuronal injury may aid in the diagnosis and management of acute ischemic stroke. Serum samples from the National Institute for Neurological Disorders and Stroke (NINDS) recombinant tissue plasminogen ac ... Full text Link to item Cite

Emergency department multimarker point-of-care testing reduces time to cardiac marker results without loss of diagnostic accuracy

Journal Article Point of Care · September 1, 2006 We assessed the hypothesis that emergency department point-of-care (POC) testing for myoglobin and cardiac troponin T (cTnT) reduces the time to result with no reduction in diagnostic accuracy for acute coronary syndrome (ACS) compared with standard-of-car ... Full text Cite

Evidence for independent heritability of the glycation gap (glycosylation gap) fraction of HbA1c in nondiabetic twins.

Journal Article Diabetes Care · August 2006 OBJECTIVE: HbA(1c) (A1C) is substantially determined by genetic factors not shared in common with glucose. Fractions of the variance in A1C, the glycation gap (GG; previously called the glycosylation gap) and the hemoglobin glycosylation index, correlate w ... Full text Link to item Cite

Lack of evidence for an association between hemodynamic variables and hematoma growth in spontaneous intracerebral hemorrhage.

Journal Article Stroke · August 2006 BACKGROUND AND PURPOSE: Early hematoma expansion in spontaneous intracerebral hemorrhage (ICH) is associated with worse clinical outcome. We hypothesized that hemodynamic parameters are associated with the increase in hematoma volume owing to their relatio ... Full text Link to item Cite

Community socioeconomic status and prehospital times in acute stroke and transient ischemic attack: do poorer patients have longer delays from 911 call to the emergency department?

Journal Article Stroke · June 2006 BACKGROUND AND PURPOSE: Timely access to medical treatment is critical for patients with acute stroke because acute therapies must be given very quickly after symptom onset. We examined the effect of socioeconomic status on prehospital delays in stroke and ... Full text Link to item Cite

An evaluation of emergency physician selection of observation unit patients.

Journal Article Am J Emerg Med · May 2006 OBJECTIVE: Appropriate patient selection is critical for maximal observation unit (OU) effectiveness. We hypothesized emergency physicians underuse the OU for admitted patients and overuse the OU for patients who would otherwise be discharged. METHODS: Tre ... Full text Link to item Cite

The combined utility of an S3 heart sound and B-type natriuretic peptide levels in emergency department patients with dyspnea.

Journal Article J Card Fail · May 2006 BACKGROUND: Emergency department (ED) patients with undifferentiated dyspnea are a diagnostic dilemma. We hypothesized that electronic detection of an S3 would be more accurate in determining decompensated heart failure than physician auscultation, and tha ... Full text Link to item Cite

The use of standardized patients for mock oral board exams in neurology: a pilot study.

Journal Article BMC Med Educ · April 25, 2006 BACKGROUND: Mock oral board exams, fashioned after the live patient hour of the American Board of Psychiatry and Neurology exam, are commonly part of resident assessment during residency training. Exams using real patients selected from clinics or hospital ... Full text Link to item Cite

Chronic kidney disease in patients with non-ST-segment elevation acute coronary syndromes.

Journal Article Am J Med · March 2006 PURPOSE: Chronic kidney disease has been linked to high mortality rates in patients with ST-segment elevation myocardial infarction but has not been well described for patients with non-ST-segment elevation acute coronary syndromes. We examined the treatme ... Full text Link to item Cite

Evaluating an emergency medical services-initiated nontransport system.

Journal Article Prehosp Emerg Care · 2006 OBJECTIVE: To evaluate both factors predicting nontransport and mortality rates in an emergency medical services system with a nontransport policy. METHODS: We reviewed data from 1,581 transported and nontransported patients from October 2001 to July 2003. ... Full text Link to item Cite

Health care needs of homeless adults at a nurse-managed clinic.

Journal Article J Community Health Nurs · 2006 Up to 55% of the homeless population report health problems. They often use the emergency department (ED) to obtain care when the health needs are not urgent. Nurse-managed clinics have the potential to reduce nonurgent ED use and improve the health of the ... Full text Link to item Cite

Effect of mild hypothermia on the thrombolytic efficacy of 120 kHz ultrasound enhanced thrombolysis in an in-vitro human clot model.

Journal Article Thromb Res · 2006 INTRODUCTION: Ischemic stroke causes substantial death and disability. Currently, recombinant tissue plasminogen activator (rt-PA) is the only FDA approved therapy. However, there are dangerous side effects and therapy must start within 3 h of onset. There ... Full text Link to item Cite

The effect of treatment on the presence of abnormal heart sounds in emergency department patients with heart failure.

Journal Article Am J Emerg Med · January 2006 OBJECTIVE: We sought to assess the proportion of ED patients with an electronically detected S(3) or S(4), determine the relation of these heart sounds to heart failure (HF), and analyze how the proportion changes with ED treatment. METHODS: Heart sounds w ... Full text Link to item Cite

Door-to-ECG time in patients with chest pain presenting to the ED.

Conference Am J Emerg Med · January 2006 OBJECTIVE: To describe time to electrocardiogram (ECG) acquisition, identify factors associated with timely acquisition, and evaluate the influence of time to ECG on adverse clinical outcomes. METHODS: We measured the door-to-ECG time for emergency departm ... Full text Link to item Cite

Prevalence of negative chest radiography results in the emergency department patient with decompensated heart failure.

Journal Article Ann Emerg Med · January 2006 STUDY OBJECTIVE: Although chest radiography is quick and inexpensive, previous research suggests that it is often misleading in emergency department (ED) patients with decompensated heart failure, resulting in misdiagnosis and inappropriate treatment. This ... Full text Link to item Cite

Test battery for assessing vascular disturbances of fingers.

Journal Article Environ Health Prev Med · November 2005 The diagnosis of vibration-induced white finger (VWF) is difficult, often relying on medical interview and history. The condition is characterized by an exaggerated vasoconstriction of digital arteries in response to cold. The complete closure of digital a ... Full text Link to item Cite

Test battery for assessing vascular disturbances of fingers

Journal Article Environmental Health and Preventive Medicine · November 1, 2005 The diagnosis of vibration-induced white finger (VWF) is difficult, often relying on medical interview and history. The condition is characterized by an exaggerated vasoconstriction of digital arteries in response to cold. The complete closure of digital a ... Full text Cite

Neurologic education in emergency medicine training programs.

Journal Article Acad Emerg Med · September 2005 OBJECTIVES: Neurologic complaints are a frequent cause of emergency department visits. The morbidity and mortality of neurologic complaints such as headache and stroke can be extensive. Thus, emergency medicine residency programs should ensure adequate tra ... Full text Link to item Cite

Changes in cardiac troponin T measurements are associated with adverse cardiac events in patients with chronic kidney disease.

Journal Article Am J Emerg Med · July 2005 The purpose of this study was to determine whether long-term and short-term changes in cardiac troponin T (cTnT) were associated with adverse cardiac events (ACEs) in patients with chronic kidney disease. Long-term changes were defined as changes in cTnT b ... Full text Link to item Cite

Emergency department HIV testing and counseling: an ongoing experience in a low-prevalence area.

Journal Article Ann Emerg Med · July 2005 STUDY OBJECTIVE: Despite recommendations, emergency department (ED)-based HIV screening is not widespread, and feasibility studies are generally limited to settings with high HIV prevalence (>1%). This investigation was to evaluate an ongoing, publicly fun ... Full text Link to item Cite

Performance of a population-based cardiac risk stratification tool in Asian patients with chest pain.

Conference Acad Emerg Med · May 2005 OBJECTIVES: Most contemporary cardiac risk stratification tools have been derived and validated in mixed-race populations. Their validity in single-race populations has not been tested. The authors sought to compare the performance of a risk stratification ... Full text Link to item Cite

Prehospital cardiac arrest in a paramedic first-responder system using the Utstein style.

Journal Article Prehosp Emerg Care · 2005 OBJECTIVES: To describe the characteristics of patients found to have cardiac arrest and to evaluate the characteristics predictive of survival after cardiac arrest in a paramedic first-responder model. METHODS: All patients who suffered out-of-hospital ca ... Full text Link to item Cite

Health department collaboration with emergency departments as a model for public health programs among at-risk populations.

Journal Article Public Health Rep · 2005 OBJECTIVES: Accessing at-risk and underserved populations for intervention remains a major obstacle for public health programs. Emergency departments (EDs) care for patients not otherwise interacting with the health care system, and represent a venue for s ... Full text Link to item Cite

Validity of a retrospective National Institutes of Health Stroke Scale scoring methodology in patients with severe stroke.

Journal Article J Stroke Cerebrovasc Dis · 2005 OBJECTIVE: Quantifying stroke severity is essential for interpreting outcomes in stroke studies; severity impacts outcomes. Because outcome studies often enroll patients some time after stroke and there is little standardization of the history and physical ... Full text Link to item Cite

Prevalence of the third and fourth heart sound in asymptomatic adults.

Journal Article Congest Heart Fail · 2005 The prevalence of abnormal diastolic heart sounds in asymptomatic adults has been the subject of great debate. The authors determined the prevalence of an electronically detected S3 and S4 in 1329 asymptomatic adults between the ages of 18 and 94. The auth ... Full text Link to item Cite

Emergency department observation of heart failure: preliminary analysis of safety and cost.

Journal Article Congest Heart Fail · 2005 Emergency-department (ED)-based observation-unit treatment has been shown to reduce inpatient admissions, hospital bed-hours, and costs without adversely affecting outcomes for several conditions. A sequential group design study compared risk-matched, acut ... Full text Link to item Cite

Is the initial diagnostic impression of "noncardiac chest pain" adequate to exclude cardiac disease?

Conference Ann Emerg Med · December 2004 STUDY OBJECTIVE: In patients presenting to the emergency department (ED) with an initial diagnostic impression of noncardiac chest pain, we determine the 30-day incidence of adverse cardiac events and characteristics associated with those events. METHODS: ... Full text Link to item Cite

Effect of education and guidelines for treatment of uncomplicated dental pain on patient and provider behavior.

Conference Ann Emerg Med · October 2004 STUDY OBJECTIVE: Patients with uncomplicated odontalgia use a significant proportion of emergency department (ED) resources. Some odontalgia patients are unaware that routine dental care is unavailable in most EDs. Using extensive input from regional denti ... Full text Link to item Cite

Emergency department pelvic examination and Pap testing: addressing patient misperceptions.

Journal Article Acad Emerg Med · April 2004 OBJECTIVES: Failure to obtain cervical cancer screening can be precipitated by limited knowledge. This study describes understanding of Papanicolaou (Pap) smear testing among women undergoing emergency department (ED) pelvic examination and tests the feasi ... Full text Link to item Cite

Insurance status and the treatment of myocardial infarction at academic centers.

Conference Acad Emerg Med · April 2004 UNLABELLED: Numerous studies have documented treatment disparities in patients with acute coronary syndromes based on race and gender. Other causes for treatment disparities may exist. OBJECTIVES: To determine if insurance status affects quality of care in ... Full text Link to item Cite

Contributions of infertility treatment to very-low-birth-weight multiple birth infants receiving neonatal intensive care.

Journal Article Am J Obstet Gynecol · February 2004 OBJECTIVE: This study was undertaken to determine proportions of very-low-birth-weight (VLBW) multiple birth infants receiving neonatal intensive care whose mothers received various types of infertility treatment and to evaluate infertility treatment-assoc ... Full text Link to item Cite

Evaluating disparities in an ems-initiated non-transport system

Journal Article Prehospital Emergency Care · January 1, 2004 Full text Cite

The impact of race on the acute management of chest pain.

Journal Article Acad Emerg Med · November 2003 OBJECTIVES: African Americans with acute coronary syndromes receive cardiac catheterization less frequently than whites. The objective was to determine if such disparities extend to acute evaluation and non interventional treatment. METHODS: Data on adults ... Full text Link to item Cite

The Impact of Race on the Acute Management of Chest Pain

Journal Article Academic Emergency Medicine · November 2003 Full text Cite

Mitigation of pennyroyal oil hepatotoxicity in the mouse.

Journal Article Acad Emerg Med · October 2003 OBJECTIVES: Pennyroyal oil ingestion has been associated with severe hepatotoxicity and death. The primary constituent, R-(+)-pulegone, is metabolized via hepatic cytochrome P450 to toxic intermediates. The purpose of this study was to assess the ability o ... Full text Link to item Cite

Mitigation of Pennyroyal Oil Hepatotoxicity in the Mouse

Journal Article Academic Emergency Medicine · October 2003 Full text Cite

A national survey on the current status of general internal medicine residency education in geriatric medicine.

Journal Article J Gen Intern Med · September 2003 OBJECTIVES: The dramatic increase in the U.S. elderly population expected over the coming decades will place a heavy strain on the current health care system. General internal medicine (GIM) residents need to be prepared to take care of this population. In ... Full text Link to item Cite

Normative vibrotactile thresholds measured at five European test centres.

Journal Article Int Arch Occup Environ Health · September 2003 OBJECTIVES: To compare vibrotactile thresholds between five international test centres, to determine causes of variability, and to provide normative data for use by health professionals. METHODS: Vibrotactile thresholds were measured on various fingers in ... Full text Link to item Cite

Geriatric medicine fellowship programs: a national study from the Association of Directors of Geriatric Academic Programs' Longitudinal Study of Training and Practice in Geriatric Medicine.

Journal Article J Am Geriatr Soc · July 2003 This report documents the development and growth of geriatric medicine fellowship training in the United States through 2002. A cross-sectional survey of geriatric medicine fellowship programs was conducted in the fall 2001. All allopathic (119) and osteop ... Full text Link to item Cite

Surveillance of infectious disease occurrences in the community: an analysis of symptom presentation in the emergency department.

Conference Acad Emerg Med · July 2003 OBJECTIVES: To determine the effectiveness of a simulated emergency department (ED)-based surveillance system to detect infectious disease (ID) occurrences in the community. METHODS: Medical records of patients presenting to an urban ED between January 1, ... Full text Link to item Cite

Can electrocardiographic criteria predict adverse cardiac events and positive cardiac markers?

Journal Article Acad Emerg Med · March 2003 OBJECTIVES: To determine electrocardiogram (ECG) predictors of positive cardiac markers and short-term adverse cardiac events in an undifferentiated chest pain population presenting to emergency departments (EDs). The authors hypothesized that specific ECG ... Full text Link to item Cite

Geriatric psychiatry fellowship programs in the United States: findings from the Association of Directors of Geriatric Academic Programs' longitudinal study of training and practice.

Journal Article Am J Geriatr Psychiatry · 2003 OBJECTIVE: The authors document the development and growth of geriatric psychiatry fellowship training in the United States (U.S.) through 2002. METHODS: A cross-sectional survey of the 62 U.S. geriatric psychiatry fellowship programs was conducted in Fall ... Link to item Cite

Geriatric psychiatry fellowship programs in the United States: Findings from the Association of Directors of Geriatric Academic Programs' Longitudinal Study of Training and Practice

Journal Article American Journal of Geriatric Psychiatry · January 1, 2003 Objective: The authors document the development and growth of geriatric psychiatry fellowship training in the United States (US.) through 2002. Methods: A cross-sectional survey of the 62 US. geriatric psychiatry fellowship programs was conducted in Fall 2 ... Full text Cite

Academic geriatric programs in US allopathic and osteopathic medical schools.

Journal Article JAMA · November 13, 2002 CONTEXT: By 2030, 20% of the US population will be older than 65 years compared with 12.4% in 2000. The development of geriatric medicine research and training programs to prepare for this increasing number of older individuals is largely dependent on the ... Full text Link to item Cite

Effects of antenatal glucocorticoids on outcomes of very low birth weight multifetal gestations.

Journal Article Am J Obstet Gynecol · September 2002 OBJECTIVE: The purpose of this study was to test the hypothesis that benefits of antenatal glucocorticoids to reduce death or major morbidities are similar in very low birth weight multiple and singleton infants. STUDY DESIGN: Infants with birth weight of ... Full text Link to item Cite

Normative data for vascular and neurological tests of the hand-arm vibration syndrome.

Journal Article Int Arch Occup Environ Health · January 2002 OBJECTIVES: To assist occupational health professionals to interpret the results of standardised tests for components of the hand-arm vibration syndrome by presenting data for healthy subjects and identifying the effects of some of the confounding variable ... Full text Link to item Cite

Interpretation of the finger skin temperature response to cold provocation.

Journal Article Int Arch Occup Environ Health · July 2001 OBJECTIVES: To compare alternative methods of interpreting the response of finger skin temperature (FST) to cold provocation for the detection of the abnormal cold response observed in vibration-induced white finger (VWF). METHOD: The FST response to cold ... Full text Link to item Cite

Response of finger circulation to energy equivalent combinations of magnitude and duration of vibration.

Journal Article Occup Environ Med · March 2001 OBJECTIVES: To investigate the acute response of finger circulation to vibration with different combinations of magnitude and duration but with the same "energy equivalent" acceleration magnitude according to current standards for hand transmitted vibratio ... Full text Link to item Cite

Acute vascular responses to the frequency of vibration transmitted to the hand.

Journal Article Occup Environ Med · June 2000 OBJECTIVES: To investigate the acute effects of the frequency of hand transmitted vibration on finger circulation. A further aim was to investigate whether the frequency weighting assumed in current standards for hand transmitted vibration reflects the hae ... Full text Link to item Cite

Thermal thresholds, vibrotactile thresholds and finger systolic blood pressures in dockyard workers exposed to hand-transmitted vibration.

Journal Article Int Arch Occup Environ Health · September 1999 OBJECTIVES: To quantify neurological dysfunction in workers exposed to hand-transmitted vibration using alternative neurological tests. To relate the neurological findings to the results of vascular tests and the symptoms reported by subjects with vibratio ... Full text Link to item Cite

Magnitude of acute exposures to vibration and finger circulation.

Journal Article Scand J Work Environ Health · June 1999 OBJECTIVES: Changes in finger circulation were studied during and after acute exposure to increasing magnitudes of hand-transmitted vibration. METHODS: Finger skin temperature (FST) and finger blood flow (FBF) were measured in the middle fingers of both ha ... Full text Link to item Cite

Duration of acute exposures to vibration and finger circulation.

Journal Article Scand J Work Environ Health · April 1998 OBJECTIVES: This study investigated changes in finger circulation after different durations of exposure to hand-transmitted vibration. METHODS: Finger skin temperature (FST), finger blood flow (FBF), and finger systolic blood pressure (FSBP) were measured ... Full text Link to item Cite

Finger systolic blood pressures: effects of cold provocation on the reference finger.

Conference Cent Eur J Public Health · 1995 Finger systolic blood pressure measured after cold provocation and ischemia of a digit is used to assist in the diagnosis of vibration-induced white finger, VWF. A reduction in finger systolic blood pressure after cooling is assumed to indicate vascular dy ... Link to item Cite