RebelEM

OCTOBER 2, 2023

No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 No statistical differences in safety between groups Operational Impact Median ED LOS (PRIMARY OUTCOME): SQuID: 8.9hrs (6.5 tests/hr (0.8 Traditional: 1.0 tests/hr (0.8 Pre-Intervention: 1.0 tests/hr (0.9

Operations 99

Operations Academics Outcomes Fluid Resuscitation 99

RebelEM

SEPTEMBER 14, 2023

to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% to 1.03) Poor Neurologic Outcome (CPC 3 or 4): 24.8% Control: 53.4% D ECLS: 18.2% Control 8.7% Control 38.0% Control: 49.0% RR 0.98; 95% CI 0.80 to 1.19; p = 0.81

Shock 134

Shock Outcomes Resuscitation Stroke 134

PulmCCM

JUNE 12, 2023

TTM2 found no improvement in survival or neurologic outcome among patients randomized to cooling to a target of 33 °C, as compared to controls receiving fever prevention (e.g. with acetaminophen) until temperatures reached 37.8 °C who then received external cooling to maintain a target temperature of 37.5 °C.

Hyperthermia / Hypothermia 105

Hyperthermia / Hypothermia Academics Documentation/Coding Outcomes 105

Sensible Medicine

JANUARY 17, 2024

The episode details examples of academic papers with fraud — the data were fabricated, and there were many tell tale signatures of fraud along the way. Most academics create causal conclusions that aren’t true. This week Freakonomics has an interesting podcast about science. It explores how and why this happens.

Academics 103

Academics Outcomes Wellness 103

Stop and Think

JANUARY 14, 2024

Since Andrew Foy and I wrote our Case Against Coronary Artery Scans in an academic journal, the test has only increased in popularity. The academic proponents of CAC scans strongly recommend CAC scans only to guide decision-making about using primary prevention therapies, such as statin drugs, in medium risk people. Pause there.

Academics 125

Academics Outcomes Wellness 125

Sensible Medicine

SEPTEMBER 16, 2023

Noting that the former is a difference in outcome, and the latter is treating someone differently based solely on consideration of race. Instead, their work product merely serves to further the careers of mediocre academics, performing irreproducible, low quality and often unhelpful research. Same is true for many other interventions.

Research 118

Research Academics Outcomes Administration 118

PulmCCM

SEPTEMBER 28, 2023

Systemic corticosteroids (such as intravenous dexamethasone) improve outcomes in severe pneumonia due to SARS-CoV-2 infection. It makes sense that inhaled steroids might improve outcomes from less severe infections. Do inhaled steroids improve Covid pneumonia? About two thirds of patients in each arm were vaccinated.

COPD 95

COPD Stroke Academics Urgent Care 95

The Skeptics' Guide to EM

JANUARY 6, 2024

One of the key motivations was the recognition that we needed to get out of the ivory towers of academic pediatric emergency medicine centers as most children are cared for outside of academic centers. Background: Back in August of 2022, we announced the start of #SGEMPeds for SGEM Season 11. Veterans Affairs and prison hospitals.

Emergency Department 103

Emergency Department Pediatrics Anaphylaxis Leadership 103

The Skeptics' Guide to EM

NOVEMBER 16, 2024

He leads an AI team intending to improve patient outcomes and healthcare system efficiency. In healthcare, AI is being leveraged to enhance clinical decision-making, streamline administrative processes, and improve patient outcomes. Despite the potential benefits, integrating AI into clinical workflows presents challenges.

Administration 87

Administration Emergency Department Outcomes Patient Safety 87

Don't Forget the Bubbles

JUNE 30, 2023

The primary outcome was 28-day mortality – TXA improved survival with no increased risk of cerebral clots. Survival was better, both at 24 hours and six months, in the TXA group, although the primary outcome, a quality of life score at six months, called the Glasgow Outcome Scale Extended (GOS-E), was the same in both groups ( 53.7%

Head Injuries 145

Head Injuries Seizures Pediatrics Outcomes 145

Dr. Smith's ECG Blog

MARCH 14, 2024

Written by Jesse McLaren Three patients presented with acute chest pain and ECGs that were labeled by the computer as completely normal, and which was confirmed by the final cardiology interpretation (which is blinded to patient outcome) also as completely normal. The reliability of these ECGs should be based on patient outcome.

EKG/ECG 105

EKG/ECG Documentation/Coding Patient Safety Outcomes 105

RebelEM

FEBRUARY 29, 2024

1, 2 Its occurrence often portends worse outcomes in intubated patients, whose projected hospital course was already tenuous. SECONDARY OUTCOMES At day 28 , ceftriaxone group had (vs placebo): Lower VAP risk (20% vs 36%); hazard ratio 0.62 4, 8 Paper: Dahyot-Fizelier, C.,

CDC 114

CDC Radiology Radiology Outcomes 114

Sensible Medicine

APRIL 14, 2024

Including: The academic speakers— who often consult for the drug companies and receive sizable personal payments. Medicine has become a financial commodity with the rare adverse event of better health outcomes. Let’s be clear: that is not sustainable. Yet, most present at the meeting cheered on the changes.

Patient Safety 135

Patient Safety Academics Outcomes Wellness 135

Taming the SRU

SEPTEMBER 22, 2023

Several single-center and moderately-sized studies have compared the outcomes of these two methods with varying results. Trial personnel reviewed the medical record to collect each patient's baseline characteristics, periprocedural care, and clinical outcomes.

Operations 103

Operations Outcomes Emergency Department Academics 103

ALiEM

OCTOBER 30, 2023

Those who take the academic route face unclear promotion expectations, uncertainty about their niche, and a double-whammy of high clinical burden and a tacit expectation that you “prove” your worth as a teacher by taking on more tasks before being rewarded with salary support. And that’s exactly the purpose of a coach.

Academics 64

Academics Leadership Wellness Research 64

ACEP Now

AUGUST 13, 2024

Furthermore, the importance of DEI in medical education goes beyond academic discussions. Studies consistently show that having a diverse physician workforce leads to improved patient outcomes, lower mortality, reduced morbidity rates, and, ultimately, a more robust health care system. Diversity improves performance and outcomes.

Leadership 111

Leadership Outcomes Academics Emergency Department 111

Emergency Medicine Journal

MAY 23, 2023

We validated the score in a large patient data set and constructed a model that allows early prediction of the probability of clinical outcomes based on the individual’s NEWS+L Score. The outcomes were hospital death or a composite of hospital death and intensive care unit admission at 24 hours, 48 hours and 72 hours.

Outcomes 40

Outcomes Emergency Department Academics Operations 40

Stop and Think

JUNE 13, 2023

One of my colleagues, a former academic, who is now in industry, tells me I shouldn’t have this chapter. In PARAGON-HF, the new drug reduced a composite primary outcome of heart failure events and death from cardiovascular causes but the reduction failed to meet statistical significance. PARAGON-HF randomized 10x more.)

Outcomes 98

Outcomes Academics Shock Hospitals 98

EMDocs

SEPTEMBER 30, 2024

5 urban academic EDs, attending charts. Primary outcome: Prescription of ICS on ED discharge from the index visit Secondary outcomes: ICS prescription rates in high-risk subgroups Rates of outpatient follow-up within 30 days of an ED visit for asthma Variation in ICS prescription rates among attending ED physicians.

Outcomes 83

Outcomes Documentation/Coding Academics Administration 83

Sensible Medicine

JUNE 28, 2024

If I had it all to do again, there is no doubt that I would choose medicine in general and academic general internal medicine in particular, but occasionally we all have a bad week. There were no personal crises or untoward patient outcomes. Last week was one of them. By the time she leaves the hospital, she has no residual symptoms.

Stroke 80

Stroke Academics Hospitals EKG/ECG 80

Sensible Medicine

JANUARY 6, 2025

In fact, TAXUS-IV heralded future trials in finding no difference in hard outcomes such as CV death, MI or stent thrombosis between the two stent types. Stent thrombosis, which is a terrible outcome, almost always leading to MI or death, were slightly lower in the DES arm (0.8 This is not an esoteric academic question.

Outcomes 76

Outcomes Academics 76

The Skeptics' Guide to EM

DECEMBER 28, 2024

AEM December 2024 Population: Adult patients with diagnosed OUD presenting to an academic ED between February and August 2023. Intervention: NA Comparison: NA Primary Outcome: The level of fear of enacted stigma, measured via the 9-item subscale of the Substance Abuse Self-Stigma Scale.

Emergency Department 76

Emergency Department Research Academics Outcomes 76

Sensible Medicine

NOVEMBER 28, 2023

For many doctors in academic medicine, publishing in peer reviewed journal is an important part of their careers. People can rise through the academic ranks as gifted clinicians, creative and effective educators, and talented administrators. Patients were then randomly assigned to apixaban or 81 mg of ASA.

Stroke 71

Stroke Academics Outcomes Administration 71

Sensible Medicine

JULY 10, 2023

At the risk of sounding naive, I want to believe that people who choose academic medicine do so to answer important scientific questions. I’ve traveled the world and met academics. To compare these two devices, the authors chose an endpoint with 5 bad outcomes from the implant.

Academics 90

Academics Research Outcomes 90

PulmCCM

JANUARY 15, 2025

That task—requiring simultaneous measurements of oxygen saturation from pulse oximetry and arterial blood gases in hundreds or thousands of patients—will likely fall to academic clinicians, who were the first to identify and report the potential scale of the problem. Nature (news). January 2024. Fawzy et al. Ferryman et al.

Documentation/Coding 81

Documentation/Coding Academics Administration Research 81

Emergency Medicine Cases

APRIL 9, 2019

Olivia Ostrow, Pediatric Emergency Physician at Hospital for Sick Children, Assistant professor at the University of Toronto and a Medical Safety Leader with an academic focus in quality improvement, discusses a case that exemplifies how indiscriminate work up of pediatric UTI can lead to over-testing, over-treating and even worse outcomes.

Pediatrics 52

Pediatrics Academics EMS Outcomes 52

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Reference: Roberts et al.

Academics 52

Academics Resuscitation EMS Stroke 52

Sensible Medicine

SEPTEMBER 12, 2024

3 Another meta-analysis in HF patients indicated that higher doses of ACEIs and ARBs, compared to lower doses, significantly improved outcomes. 4 The study's open-label design increases the risk of differential misclassification of outcomes and performance biases. References 1. Bocchi EA, Echeverria LE, Demacq C, et al.

Academics 63

Academics Outcomes Hospitals Wellness 63

Taming the SRU

APRIL 17, 2024

3) Methods This study was a retrospective observational study at a single academic tertiary care facility in their medical intensive care unit (MICU). The primary outcome was defined as agreement of less than 10 % of the mean arterial pressure (MAP) between simultaneously recorded IABP and NIBP measurements.

Sepsis 92

Sepsis Research Stroke Academics 92

SheMD

MAY 4, 2023

80% of department chair roles in academic medicine are held by men. Article Summary What they looked at: This article aimed to look at career trajectory differences between genders in faculty who have attained academic chair roles in emergency medicine. How does this apply to us? JAMA Netw Open. 2020;3(7):e2011292. Moran, C.J.

Leadership 52

Leadership Academics Operations Administration 52

RebelEM

JUNE 8, 2023

Assessed clinical practice, outcome, length of stay, safety, and efficacy of both phenylephrine and epinephrine peripherally administered through a push dose. PMID: 36108346 Clinical Question: What is the efficacy and safety of peripherally administered push dose pressors for the treatment of acute hypotension?

Administration 98

Administration Emergency Department Outcomes Documentation/Coding 98

Don't Forget the Bubbles

JANUARY 8, 2024

Dr Bourke’s work is not only about deepening academic understanding but also about forging practical approaches to help healthcare professionals navigate the nuanced and often uncertain waters of adolescent care in emergency settings. Mulraney, M., Coghill, D., Sciberras, E., and Sawyer, M.,

Research 105

Research Emergency Department Psychiatric Outcomes 105

SheMD

DECEMBER 17, 2023

Emergency medicine has a notable gender gap in publications, which is a factor in career advancement in academic medicine. How they measured things: Articles published in Annals of Emergency Medicine and Academic Emergency Medicine from March 2019 to February 2021 were included, aside from the annual scientific assembly.

Academics 52

Academics Leadership Research Outcomes 52

The Skeptics' Guide to EM

NOVEMBER 21, 2020

He is also the CME editor for Academic Emergency Medicine. He is also the CME editor for Academic Emergency Medicine. Date: November 19th, 2020 Guest Skeptic: Dr. Corey Heitz is an emergency physician in Roanoke, Virginia. Reference: Pines et al. AEM November 2020. Reference: Pines et al. AEM November 2020. .

Emergency Department 52

Emergency Department Telemedicine Academics Outcomes 52

Sensible Medicine

AUGUST 21, 2023

On yesterday’s podcast , I talked with Bobby Yeh, an academic cardiologist who made a compelling case for enhancing credibility of observational research. Another problem, which is possibly surmountable, is the conflation of what one can call “patient outcomes” versus “doctor outcomes.”

Administration 76

Administration Outcomes Research COPD 76

ACEP Now

NOVEMBER 16, 2023

2,3 In the 2021-2022 academic year, categorical (non-combined) EM residency lengths included 221 (80 percent) PGY 1-3 and 55 (20 percent) PGY 1-4 programs. A fourth year of EM training offers additional supervised clinical and academic experience. Academic career preparation for residents – are we on the right track?

Academics 52

Academics EMS Telemedicine Research 52

Taming the SRU

OCTOBER 31, 2024

Ann Emerg Med 2024; Study Design Validation of the qPS4 was performed as part of a retrospective cohort study of pediatric patients presenting to a tertiary academic emergency department between the ~9 year study period (01/01/2012 - 12/31/2021). The primary outcome (development of septic shock) was present in 0.3% of patients.

Sepsis 71

Sepsis Shock Pediatrics Administration 71