首页 > 最新文献

Canadian Journal of Emergency Medicine最新文献

英文 中文
Grant Innes: a visionary leader in Canadian emergency medicine. Grant Innes:加拿大急诊医学领域富有远见的领导者。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-09-01 DOI: 10.1007/s43678-023-00580-5
Eddy Lang
{"title":"Grant Innes: a visionary leader in Canadian emergency medicine.","authors":"Eddy Lang","doi":"10.1007/s43678-023-00580-5","DOIUrl":"10.1007/s43678-023-00580-5","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 9","pages":"721"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10274555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Global Research Highlights. 全球研究亮点。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-09-01 DOI: 10.1007/s43678-023-00582-3
{"title":"Global Research Highlights.","authors":"","doi":"10.1007/s43678-023-00582-3","DOIUrl":"10.1007/s43678-023-00582-3","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 9","pages":"780-784"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10274557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of acute heart failure patients managed in the emergency department. 急诊科管理的急性心力衰竭患者的结果。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-09-01 Epub Date: 2023-08-03 DOI: 10.1007/s43678-023-00555-6
Jessica Poliwoda, Debra Eagles, Krishan Yadav, Marie-Joe Nemnom, Charlotte Grace Walmsley, Lisa Mielniczuk, Ian G Stiell

Background: Acute heart failure is a serious condition commonly seen in the emergency department (ED). The HEARTRISK6 Scale has been recently developed to identify the risk of poor outcomes but has not been tested. We sought to describe the management and outcomes of ED patients with acute heart failure and to evaluate the potential impact of the HEARTRISK6 Scale.

Methods: We conducted a health records review of 300 consecutive acute heart failure patients presenting to two tertiary care EDs. Two evaluators abstracted clinical variables, ED management and treatment details, and patient outcomes using the electronic health records platform (EPIC) and attending physicians verified the data. The primary outcome measure was a short-term serious outcome, as shown in Results. In addition, the HEARTRISK6 score was calculated retrospectively.

Results: We included 300 patients with mean age of 78.5 years, 51.0% male, 56.3% arrival by ambulance, and 67.0% admitted to hospital. 25.3% experienced a short-term serious outcome 1) after admission (N = 201): non-invasive ventilation 14.9%, intubation 1.5%, major cardiac procedure 5.0%, myocardial infarction 2.0%, death 8.5%; 2) after ED discharge (N = 99): return to ED 21.2%, death 4.0%. Those initially admitted experienced a much higher proportion of serious outcomes compared to those discharged (29.9% vs. 16.2%). A HEARTRISK6 Scale cut-point score of ≥ 1 would have had a sensitivity of 91.0%, specificity 24.5%, and negative likelihood ratio 0.37 for short-term serious outcomes and suggested hospital admission for 80.7% of cases.

Conclusion: There was a large range of severity of illness of acute heart failure patients and a wide variety of treatments were administered in the ED. Both admitted and discharged patients experienced a high proportion of poor outcomes. The HEARTRISK6 Scale showed a high sensitivity for short-term serious outcomes but with the potential to increase hospital admissions. Further validation of the HEARTRISK6 Scale is required before routine clinical use.

背景:急性心力衰竭是急诊科常见的严重疾病。HEARTRISK6量表是最近开发的,用于确定不良结果的风险,但尚未进行测试。我们试图描述急性心力衰竭ED患者的管理和结果,并评估HEARTRISK6量表的潜在影响。方法:我们对300名连续接受两次三级护理ED的急性心力衰竭患者进行了健康记录审查。两名评估人员提取了临床变量、ED管理和治疗细节,以及使用电子健康记录平台(EPIC)和主治医师验证数据的患者结果。主要的结果指标是短期严重结果,如结果所示。此外,对HEARTRISK6评分进行了回顾性计算。结果:我们纳入了300名患者,平均年龄78.5岁,51.0%为男性,56.3%由救护车抵达,67.0%入院。25.3%的患者入院后出现短期严重后果(1)(N = 201):无创通气14.9%,插管1.5%,主要心脏手术5.0%,心肌梗死2.0%,死亡8.5%;2) ED放电后(N = 99):恢复ED 21.2%,死亡4.0%。与出院者相比,最初入院的患者出现严重后果的比例要高得多(29.9%对16.2%) ≥ 1对短期严重后果的敏感性为91.0%,特异性为24.5%,负似然比为0.37,建议80.7%的病例入院。结论:急性心力衰竭患者的病情严重程度各不相同,急诊科采用了多种治疗方法。入院和出院患者的不良结局比例都很高。HEARTRISK6量表显示出对短期严重后果的高度敏感性,但有可能增加住院人数。在常规临床使用之前,需要对HEARTRISK6量表进行进一步验证。
{"title":"Outcomes of acute heart failure patients managed in the emergency department.","authors":"Jessica Poliwoda,&nbsp;Debra Eagles,&nbsp;Krishan Yadav,&nbsp;Marie-Joe Nemnom,&nbsp;Charlotte Grace Walmsley,&nbsp;Lisa Mielniczuk,&nbsp;Ian G Stiell","doi":"10.1007/s43678-023-00555-6","DOIUrl":"10.1007/s43678-023-00555-6","url":null,"abstract":"<p><strong>Background: </strong>Acute heart failure is a serious condition commonly seen in the emergency department (ED). The HEARTRISK6 Scale has been recently developed to identify the risk of poor outcomes but has not been tested. We sought to describe the management and outcomes of ED patients with acute heart failure and to evaluate the potential impact of the HEARTRISK6 Scale.</p><p><strong>Methods: </strong>We conducted a health records review of 300 consecutive acute heart failure patients presenting to two tertiary care EDs. Two evaluators abstracted clinical variables, ED management and treatment details, and patient outcomes using the electronic health records platform (EPIC) and attending physicians verified the data. The primary outcome measure was a short-term serious outcome, as shown in Results. In addition, the HEARTRISK6 score was calculated retrospectively.</p><p><strong>Results: </strong>We included 300 patients with mean age of 78.5 years, 51.0% male, 56.3% arrival by ambulance, and 67.0% admitted to hospital. 25.3% experienced a short-term serious outcome 1) after admission (N = 201): non-invasive ventilation 14.9%, intubation 1.5%, major cardiac procedure 5.0%, myocardial infarction 2.0%, death 8.5%; 2) after ED discharge (N = 99): return to ED 21.2%, death 4.0%. Those initially admitted experienced a much higher proportion of serious outcomes compared to those discharged (29.9% vs. 16.2%). A HEARTRISK6 Scale cut-point score of ≥ 1 would have had a sensitivity of 91.0%, specificity 24.5%, and negative likelihood ratio 0.37 for short-term serious outcomes and suggested hospital admission for 80.7% of cases.</p><p><strong>Conclusion: </strong>There was a large range of severity of illness of acute heart failure patients and a wide variety of treatments were administered in the ED. Both admitted and discharged patients experienced a high proportion of poor outcomes. The HEARTRISK6 Scale showed a high sensitivity for short-term serious outcomes but with the potential to increase hospital admissions. Further validation of the HEARTRISK6 Scale is required before routine clinical use.</p>","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 9","pages":"752-760"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10568155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The association between paramedic service system hospital offload time and response time. 辅助医疗服务系统医院卸载时间和响应时间之间的关联。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-09-01 Epub Date: 2023-05-19 DOI: 10.1007/s43678-023-00521-2
I E Blanchard, T S Williamson, B E Hagel, D J Niven, D J Lane, S Dean, M N Shah, E S Lang, C J Doig

Objective: To address an important care issue in Canada, we tested the association between paramedic system hospital offload and response time, while considering the impact of other system-level factors.

Methods: Data from Calgary, Alberta (2014-2017), included median offload (exposure) and response (outcome) time aggregated by hour, with covariates paramedic system episodes of care-dispatch and arrival of a response unit-and hospital transport arrivals (collectively called volume), time of day, and season. Analyses used linear regression and modified Poisson models.

Results: 301,105 EMS episodes of care over 26,193 1-h periods were included. For any given 1-h period, the median (IQR) across all episodes of care for offload time, response time, episodes of care, and hospital transport arrivals were 55.3 (45.7, 66.3) min, 8.6 (7.6, 9.8) min, 12 (8, 16) episodes, and 8 (5, 10) hospital arrivals, respectively. Multivariable modelling revealed a complex association differing over levels of exposure and covariates, requiring description using "light stress" and "heavy stress" system scenarios. The light scenario was defined as median offload of 30 min and volume < 10th percentile (six episodes and four hospital arrivals), in the summer, and the heavy scenario as median offload of 90 min and volume > 90th percentile (17 episodes and 13 hospital arrivals), in the winter. An increase is reported in minutes:seconds for median hourly response time between scenarios by time of day: 1:04-4:16 (0000-0559 h.), 0:42-2:05 (0600-1159 h.), 0:57-3:01 (1200-1759 h.), and 0:18-2:21 (1800-2359 h.).

Conclusions: Increasing offload is associated with increased response time; however the relationship is complex, with a greater impact on response time noted in select situations such as high volume in the winter. These observations illustrate the interdependence of paramedic, ED, and inpatient systems and provide high-yield targets for polices to mitigate the risk to community availability of paramedic resources at times of high offload delay/system stress.

目的:为了解决加拿大的一个重要护理问题,我们测试了护理系统医院负荷与响应时间之间的关系,同时考虑了其他系统级因素的影响。方法:阿尔伯塔省卡尔加里市(2014-2017年)的数据包括按小时汇总的中位卸载(暴露)和响应(结果)时间,以及护理人员系统护理派遣和响应单位到达的事件和医院交通到达(统称为量)、一天中的时间和季节的协变量。分析使用了线性回归和修正的泊松模型。结果:包括301105例超过26193个1小时的EMS护理事件。在任何给定的1小时内,所有护理事件的卸货时间、反应时间、护理事件和医院运输到达的中位数(IQR)分别为55.3(45.7,66.3)分钟、8.6(7.6,9.8)分钟、12(8,16)次和8(5,10)次。多变量建模揭示了一种复杂的关联,在暴露水平和协变量方面有所不同,需要使用“轻度压力”和“重度压力”系统场景进行描述。轻型场景定义为30分钟的中值卸载和容量  第90百分位(17次发作和13次住院)。据报道,按一天中的时间,情景之间的中位小时响应时间以分:秒为单位增加:1:04-4:16(0000-0559小时)、0:42-2:05(0600-1159小时)、:057-3:01(1200-1759小时)和0:18:21(1800-2359小时)。结论:卸载增加与响应时间增加有关;然而,这种关系是复杂的,在某些情况下,如冬季的高流量,对响应时间的影响更大。这些观察结果说明了护理人员、急诊科和住院系统的相互依赖性,并为政策提供了高收益的目标,以减轻在高卸载延迟/系统压力时社区护理人员资源可用性的风险。
{"title":"The association between paramedic service system hospital offload time and response time.","authors":"I E Blanchard,&nbsp;T S Williamson,&nbsp;B E Hagel,&nbsp;D J Niven,&nbsp;D J Lane,&nbsp;S Dean,&nbsp;M N Shah,&nbsp;E S Lang,&nbsp;C J Doig","doi":"10.1007/s43678-023-00521-2","DOIUrl":"10.1007/s43678-023-00521-2","url":null,"abstract":"<p><strong>Objective: </strong>To address an important care issue in Canada, we tested the association between paramedic system hospital offload and response time, while considering the impact of other system-level factors.</p><p><strong>Methods: </strong>Data from Calgary, Alberta (2014-2017), included median offload (exposure) and response (outcome) time aggregated by hour, with covariates paramedic system episodes of care-dispatch and arrival of a response unit-and hospital transport arrivals (collectively called volume), time of day, and season. Analyses used linear regression and modified Poisson models.</p><p><strong>Results: </strong>301,105 EMS episodes of care over 26,193 1-h periods were included. For any given 1-h period, the median (IQR) across all episodes of care for offload time, response time, episodes of care, and hospital transport arrivals were 55.3 (45.7, 66.3) min, 8.6 (7.6, 9.8) min, 12 (8, 16) episodes, and 8 (5, 10) hospital arrivals, respectively. Multivariable modelling revealed a complex association differing over levels of exposure and covariates, requiring description using \"light stress\" and \"heavy stress\" system scenarios. The light scenario was defined as median offload of 30 min and volume < 10th percentile (six episodes and four hospital arrivals), in the summer, and the heavy scenario as median offload of 90 min and volume > 90th percentile (17 episodes and 13 hospital arrivals), in the winter. An increase is reported in minutes:seconds for median hourly response time between scenarios by time of day: 1:04-4:16 (0000-0559 h.), 0:42-2:05 (0600-1159 h.), 0:57-3:01 (1200-1759 h.), and 0:18-2:21 (1800-2359 h.).</p><p><strong>Conclusions: </strong>Increasing offload is associated with increased response time; however the relationship is complex, with a greater impact on response time noted in select situations such as high volume in the winter. These observations illustrate the interdependence of paramedic, ED, and inpatient systems and provide high-yield targets for polices to mitigate the risk to community availability of paramedic resources at times of high offload delay/system stress.</p>","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 9","pages":"736-741"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10272031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Return visit audits, quality improvement infrastructure, and a culture of safety: a theoretical model and practical assessment tool. 回访审计、质量改进基础设施和安全文化:理论模型和实用评估工具。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-08-01 DOI: 10.1007/s43678-023-00539-6
Jesse T T McLaren, Tahara D Bhate, Ahmed K Taher, Lucas B Chartier
{"title":"Return visit audits, quality improvement infrastructure, and a culture of safety: a theoretical model and practical assessment tool.","authors":"Jesse T T McLaren,&nbsp;Tahara D Bhate,&nbsp;Ahmed K Taher,&nbsp;Lucas B Chartier","doi":"10.1007/s43678-023-00539-6","DOIUrl":"https://doi.org/10.1007/s43678-023-00539-6","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 8","pages":"649-652"},"PeriodicalIF":2.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10385624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Overuse of pharmacological treatments for patients with benign paroxysmal positional vertigo in the emergency department. 急诊科对良性阵发性体位性眩晕患者过度使用药物治疗。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-08-01 DOI: 10.1007/s43678-023-00549-4
Michaela McGillis, Danielle Roy, David Savage, Sarah McIsaac, Jenna Nicholls, Danielle Waltenbury, Robert Ohle
{"title":"Overuse of pharmacological treatments for patients with benign paroxysmal positional vertigo in the emergency department.","authors":"Michaela McGillis,&nbsp;Danielle Roy,&nbsp;David Savage,&nbsp;Sarah McIsaac,&nbsp;Jenna Nicholls,&nbsp;Danielle Waltenbury,&nbsp;Robert Ohle","doi":"10.1007/s43678-023-00549-4","DOIUrl":"https://doi.org/10.1007/s43678-023-00549-4","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 8","pages":"710-711"},"PeriodicalIF":2.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9988013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An assessment of mass casualty triage systems using the Alberta trauma registry. 使用艾伯塔省创伤登记处的大规模伤亡分诊系统的评估。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-08-01 DOI: 10.1007/s43678-023-00529-8
David Jerome, David W Savage, Matthew Pietrosanu

Objective: Triage is the process of identifying patients with both the greatest clinical need and the greatest likelihood of benefit in the setting of limited clinical resources. The primary objective of this study was to assess the ability of formal mass casualty incident triage tools to identify patients requiring urgent lifesaving interventions.

Methods: Data from the Alberta Trauma Registry (ATR) was used to assess seven triage tools: START, JumpSTART, SALT, RAMP, MPTT, BCD and MITT. Clinical data captured in the ATR was used to determine which triage category each of the seven tools would have applied to each patient. These categorizations were compared to a reference standard definition based on the patients' need for specific urgent lifesaving interventions.

Results: Of the 9448 records that were captured 8652 were included in our analysis. The most sensitive triage tool was MPTT, which demonstrated a sensitivity of 0.76 (0.75, 0.78). Four of the seven triage tools evaluated had sensitivities below 0.45. JumpSTART had the lowest sensitivity and the highest under-triage rate for pediatric patients. All the triage tools evaluated had a moderate to high positive predictive value (> 0.67) for patients who had experienced penetrating trauma.

Conclusions: There was a wide range in the sensitivity of triage tools to identify patients requiring urgent lifesaving interventions. MPTT, BCD and MITT were the most sensitive triage tools assessed. All of the triage tools assessed should be employed with caution during mass casualty incidents as they may fail to identify a large proportion of patients requiring urgent lifesaving interventions.

目的:分诊是在临床资源有限的情况下,确定临床需求最大和获益可能性最大的患者的过程。本研究的主要目的是评估正式的大规模伤亡事件分诊工具识别需要紧急救生干预的患者的能力。方法:采用艾伯塔省创伤登记处(ATR)的数据评估7种分诊工具:START、JumpSTART、SALT、RAMP、MPTT、BCD和MITT。ATR中捕获的临床数据用于确定七种工具中的每种工具适用于每个患者的分诊类别。将这些分类与基于患者对特定紧急救生干预措施需求的参考标准定义进行比较。结果:在捕获的9448条记录中,有8652条包含在我们的分析中。最敏感的分类工具是MPTT,其敏感性为0.76(0.75,0.78)。评估的7种分诊工具中有4种的敏感性低于0.45。JumpSTART对儿科患者的敏感性最低,分类不足率最高。所有评估的分诊工具对有穿透性创伤的患者都有中高阳性预测值(> 0.67)。结论:在识别需要紧急救生干预的患者时,分诊工具的敏感性差异很大。MPTT、BCD和MITT是最敏感的分诊工具。在大规模伤亡事件中,应谨慎使用评估的所有分诊工具,因为它们可能无法识别需要紧急救生干预措施的大部分患者。
{"title":"An assessment of mass casualty triage systems using the Alberta trauma registry.","authors":"David Jerome,&nbsp;David W Savage,&nbsp;Matthew Pietrosanu","doi":"10.1007/s43678-023-00529-8","DOIUrl":"https://doi.org/10.1007/s43678-023-00529-8","url":null,"abstract":"<p><strong>Objective: </strong>Triage is the process of identifying patients with both the greatest clinical need and the greatest likelihood of benefit in the setting of limited clinical resources. The primary objective of this study was to assess the ability of formal mass casualty incident triage tools to identify patients requiring urgent lifesaving interventions.</p><p><strong>Methods: </strong>Data from the Alberta Trauma Registry (ATR) was used to assess seven triage tools: START, JumpSTART, SALT, RAMP, MPTT, BCD and MITT. Clinical data captured in the ATR was used to determine which triage category each of the seven tools would have applied to each patient. These categorizations were compared to a reference standard definition based on the patients' need for specific urgent lifesaving interventions.</p><p><strong>Results: </strong>Of the 9448 records that were captured 8652 were included in our analysis. The most sensitive triage tool was MPTT, which demonstrated a sensitivity of 0.76 (0.75, 0.78). Four of the seven triage tools evaluated had sensitivities below 0.45. JumpSTART had the lowest sensitivity and the highest under-triage rate for pediatric patients. All the triage tools evaluated had a moderate to high positive predictive value (> 0.67) for patients who had experienced penetrating trauma.</p><p><strong>Conclusions: </strong>There was a wide range in the sensitivity of triage tools to identify patients requiring urgent lifesaving interventions. MPTT, BCD and MITT were the most sensitive triage tools assessed. All of the triage tools assessed should be employed with caution during mass casualty incidents as they may fail to identify a large proportion of patients requiring urgent lifesaving interventions.</p>","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 8","pages":"659-666"},"PeriodicalIF":2.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9985840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Code at home: chaos and crisis. 国内守则:混乱和危机。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-08-01 Epub Date: 2023-05-28 DOI: 10.1007/s43678-023-00524-z
Suneel Upadhye
{"title":"Code at home: chaos and crisis.","authors":"Suneel Upadhye","doi":"10.1007/s43678-023-00524-z","DOIUrl":"10.1007/s43678-023-00524-z","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 8","pages":"704"},"PeriodicalIF":2.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality of health economic evaluations in emergency medicine journals: a systematic review. 急诊医学期刊的健康经济评价质量:一项系统综述。
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-08-01 Epub Date: 2023-06-30 DOI: 10.1007/s43678-023-00535-w
Shawn Chhabra, Austin Cameron, Kednapa Thavorn, Lindsey Sikora, Krishan Yadav

Objective: Health economic evaluations are used in decision-making regarding resource allocation and it is imperative that they are completed with rigor. The primary objectives were to describe the characteristics and assess the quality of economic evaluations published in emergency medicine journals.

Methods: Two reviewers independently searched 19 emergency medicine-specific journals via Medline and Embase from inception until March 3, 2022. Quality assessment was completed using the Quality of Health Economic Studies (QHES) tool, and the primary outcome was the QHES score out of 100. Additionally, we identified factors that may contribute to higher-quality publications.

Results: 7260 unique articles yielded 48 economic evaluations that met inclusion criteria. Most studies were cost-utility analyses and of high quality, with a median QHES score of 84 (interquartile range, IQR: 72, 90). Studies based on mathematical models and those primarily designed as an economic evaluation were associated with higher quality scores. The most commonly missed QHES items were: (i) providing and justifying the perspective of the analysis, (ii) providing justification for the primary outcome, and (iii) selecting an outcome that was long enough to allow for relevant events to occur.

Conclusions: The majority of health economic evaluations in the emergency medicine literature are cost-utility analyses and are of high quality. Decision analytic models and studies primarily designed as economic analyses were positively correlated with higher quality. To improve study quality, future EM economic evaluations should justify the choice of the perspective of the analysis and the selection of the primary outcome.

目标:卫生经济评估用于资源分配决策,必须严格完成。主要目的是描述急诊医学期刊上发表的经济评估的特点并评估其质量。方法:从创刊到2022年3月3日,两名评审员通过Medline和Embase独立检索了19种急诊医学专用期刊。使用健康经济研究质量(QHES)工具完成质量评估,主要结果是QHES评分为100分。此外,我们还确定了可能有助于提高出版物质量的因素。结果:7260篇独特的文章产生了48项符合纳入标准的经济评价。大多数研究都是高质量的成本效用分析,平均QHES得分为84(四分位间距,IQR:72,90)。基于数学模型的研究和那些主要设计为经济评估的研究与更高的质量分数有关。最常见的遗漏QHES项目是:(i)提供并证明分析的观点,(ii)为主要结果提供理由,以及(iii)选择一个足够长的结果,以允许相关事件发生。结论:急诊医学文献中的大多数健康经济评价都是成本效用分析,质量较高。决策分析模型和主要设计为经济分析的研究与更高的质量呈正相关。为了提高研究质量,未来的新兴市场经济评估应该证明分析视角的选择和主要结果的选择是合理的。
{"title":"Quality of health economic evaluations in emergency medicine journals: a systematic review.","authors":"Shawn Chhabra,&nbsp;Austin Cameron,&nbsp;Kednapa Thavorn,&nbsp;Lindsey Sikora,&nbsp;Krishan Yadav","doi":"10.1007/s43678-023-00535-w","DOIUrl":"10.1007/s43678-023-00535-w","url":null,"abstract":"<p><strong>Objective: </strong>Health economic evaluations are used in decision-making regarding resource allocation and it is imperative that they are completed with rigor. The primary objectives were to describe the characteristics and assess the quality of economic evaluations published in emergency medicine journals.</p><p><strong>Methods: </strong>Two reviewers independently searched 19 emergency medicine-specific journals via Medline and Embase from inception until March 3, 2022. Quality assessment was completed using the Quality of Health Economic Studies (QHES) tool, and the primary outcome was the QHES score out of 100. Additionally, we identified factors that may contribute to higher-quality publications.</p><p><strong>Results: </strong>7260 unique articles yielded 48 economic evaluations that met inclusion criteria. Most studies were cost-utility analyses and of high quality, with a median QHES score of 84 (interquartile range, IQR: 72, 90). Studies based on mathematical models and those primarily designed as an economic evaluation were associated with higher quality scores. The most commonly missed QHES items were: (i) providing and justifying the perspective of the analysis, (ii) providing justification for the primary outcome, and (iii) selecting an outcome that was long enough to allow for relevant events to occur.</p><p><strong>Conclusions: </strong>The majority of health economic evaluations in the emergency medicine literature are cost-utility analyses and are of high quality. Decision analytic models and studies primarily designed as economic analyses were positively correlated with higher quality. To improve study quality, future EM economic evaluations should justify the choice of the perspective of the analysis and the selection of the primary outcome.</p>","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 8","pages":"676-688"},"PeriodicalIF":2.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9985527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Who cares about the money: do health economic evaluation studies published in emergency medicine journals cut the mustard? 谁在乎钱:发表在急诊医学期刊上的健康经济评估研究是否符合要求?
IF 2.4 4区 医学 Q2 EMERGENCY MEDICINE Pub Date : 2023-08-01 DOI: 10.1007/s43678-023-00562-7
Suzanne Mason, Abel Wakai, Anton Pak
{"title":"Who cares about the money: do health economic evaluation studies published in emergency medicine journals cut the mustard?","authors":"Suzanne Mason,&nbsp;Abel Wakai,&nbsp;Anton Pak","doi":"10.1007/s43678-023-00562-7","DOIUrl":"https://doi.org/10.1007/s43678-023-00562-7","url":null,"abstract":"","PeriodicalId":55286,"journal":{"name":"Canadian Journal of Emergency Medicine","volume":"25 8","pages":"647-648"},"PeriodicalIF":2.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10349335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Canadian Journal of Emergency Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1