Author Interviews, Emergency Care, Heart Disease, JAMA, UT Southwestern / 22.04.2020
New Protocol for Rapid Exclusion of Heart Attack in a US Safety Net Hospital
MedicalResearch.com Interview with:
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Dr. Vigen[/caption]
Rebecca Vigen, MD, MSCS
Assistant Professor of Internal Medicine
UT Southwestern
MedicalResearch.com: What is the background for this study?
Response: Emergency department overcrowding is an urgent health priority and chest pain is a common reason for emergency department visits. We developed a new protocol that uses high sensitivity cardiac troponin testing with a risk assessment tool that guides decisions on discharge and stress testing for patients presenting with chest pain. The protocol allows us to rule out heart attacks more quickly than the protocols utilizing an older troponin assay.
Dr. Vigen[/caption]
Rebecca Vigen, MD, MSCS
Assistant Professor of Internal Medicine
UT Southwestern
MedicalResearch.com: What is the background for this study?
Response: Emergency department overcrowding is an urgent health priority and chest pain is a common reason for emergency department visits. We developed a new protocol that uses high sensitivity cardiac troponin testing with a risk assessment tool that guides decisions on discharge and stress testing for patients presenting with chest pain. The protocol allows us to rule out heart attacks more quickly than the protocols utilizing an older troponin assay.
Dr. Hollingsworth[/caption]
Alex Hollingsworth PhD
Assistant Professor
O'Neill School of Public and Environmental Affairs
Indiana University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I've been working with Coady Wing and Ashley Bradford on a few different studies of the effects of recreational marijuana laws on drug and alcohol use.
Soon after EVALI became a major issue, the prevailing theory from the CDC and others was that EVALI was caused by the use of vitamin E acetate in illegal THC vaping products.
Our group read about this and we thought about some of the things that often happen in black markets for illegal drugs. For instance, during the alcohol prohibition era, bootleg alcohol producers often made and sold alcohol products that were not that safe to drink. In more recent years, there are cases where black market sellers of illegal drugs like heroin try to increase profit margins by adding other substances, which can be harmful.
We thought that maybe something like that could be happening in EVALI. Perhaps people in states where recreational marijuana is legal tended to purchase marijuana products from the legal market and the legal market was not selling any marijuana vaping products that included vitamin E acetate.
Barbara Chaiyachati, MD PhD
SafePlace: The Center for Child Protection and Health
Division of General Pediatrics
The Children’s Hospital of Philadelphia,
Center for Pediatric Clinical Effectiveness
University of Pennsylvania
Philadelphia, Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Children in foster care have high rates of medical problems including chronic diseases. There is less known about the differences in mortality for children in foster care.
Looking at national data from 2003 to 2016, this study finds that children (ages 1 to 18) in foster care have higher mortality compared to children in the general population and that the difference in mortality has increased over time.

Vasily Giannakeas[/caption]
Vasily Giannakeas, MPH
Epidemiologist/ Dedicated ICES Analyst
Women's College Hospital
Toronto, Ontario, Canada
MedicalResearch.com: What is the background for this study?
Response: As some health care systems approach collapse, a pressing need exists for tools modeling the capacity of acute and critical care systems during the COVID-19 pandemic.
We developed an online tool to estimate the maximum number of COVID-19 cases that could be managed per day within the catchment area served by a health care system, given acute and critical care resource availability.
The COVID-19 Acute and Intensive Care Resource Tool (CAIC-RT) is open access and available at




