Aging, Author Interviews, Emergency Care, Lifestyle & Health, Orthopedics / 26.04.2023

MedicalResearch.com Interview with: Ridge Maxson M.D. Candidate, Class of 2024 Johns Hopkins University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dog walking is an increasingly popular mode of physical activity for adults in the US, but its injury burden and associated risk factors are not fully understood. This study found that the 3 most common injuries sustained by adult dog walkers in the US were finger fracture, TBI, and shoulder sprain or strain. Dog walking-related injuries sent approximately 423,000 adults to US EDs between 2001 and 2020, with an annual average of more than 21,000 visits. During that 20-year period, the estimated annual injury incidence increased by more than 4-fold. Among injured dog walkers, older adults and women were particularly vulnerable to serious injury, such as fracture and TBI. (more…)
Emergency Care / 28.02.2023

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle, When something doesn’t feel right, a trip to the ER might be on your mind. But what happens when it is a nonemergency? Urgent care exists as an alternative to the ER when there are nonemergency related health concerns.

Warning Signs

Before you take a trip to Instacare, take a long look at common emergency warning signs. Trouble breathing, consistent chest pain, profuse bleeding or an inability to discern reality. All of these are signs that you should prioritize an ER visit. There are plenty of other warning signs to look out for, and several unique situations that will also require an ER visit. Getting wrapped up in the meaning of warning signs should not lead to unneeded stress. Do you feel comfortable driving to an urgent care, or would it be too difficult to manage? Being able to get behind the wheel is a good sign that your health-related issue can be handled by an urgent care. (more…)
Author Interviews, Emergency Care, JAMA / 03.08.2022

MedicalResearch.com Interview with: John A. Staples, MD, FRCPC, MPH Academic General Internist Vancouver General Hospital Clinical Assistant Professor at UBC MedicalResearch.com:  What is the background for this study?    Response: As a hospital-based general internist, I often see patients in the emergency department after an episode of syncope. Syncope is a medical term for suddenly losing consciousness (the public generally knows this as “fainting”). As you can imagine, fainting out of the blue can be very unnerving. Patients and clinicians worry that it may happen again and wonder whether it’s safe to drive. The first time I was asked this question, I remember scouring the research literature for an answer and not finding any robust evidence to guide my advice to patients. (more…)
Author Interviews, CDC, Emergency Care, JAMA / 06.10.2021

MedicalResearch.com Interview with: Dr. Daniel S.  Budnitz MD MPH CAPT, USPHS Division of Healthcare Quality Promotion Director, Centers for Disease Control and Prevention’s Medication Safety Program Atlanta, Georgia  MedicalResearch.com: What is the background for this study?  Response: Medications are generally safe when used as prescribed or as directed on the label, but there can be risks in taking any medication. Adverse drug events are harms resulting from the use of medication. The risk of adverse drug events is highest among older adults and very young children. Older adults have higher risks because they typically take more medications and are more likely to have underlying medical conditions. Very young children have higher risks because they often find and ingest medications meant for others. Previous studies of medication safety have focused on harm from medications when taken for therapeutic reasons. Separate studies have focused on harm from specific types of non-therapeutic use (taking medications for recreational use or self-harm). This study examined the number of emergency department (ED) visits that resulted when people who took medications for any reason – as directed by a clinician or for other reasons, including recreational use or intentional self-harm.  (more…)
Author Interviews, Columbia, Emergency Care, JAMA, Pediatrics, Race/Ethnic Diversity, Yale / 17.09.2021

MedicalResearch.com Interview with: Destiny Tolliver, MD National Clinician Scholars Program Yale University School of Medicine New Haven, CT 06510-8088 Katherine Nash MD, MHS Assistant Professor of Pediatrics Columbia University Irving Medical Center MedicalResearch.com: What is the background for this study? Response: This study was motivated by work from our colleagues in the adult Emergency Medicine world. Earlier this year Dr. Ambrose Wong and colleagues published work describing racial disparities in the physical restraint of adults in the ED. This prompted our group to consider whether these disparities were also present for children. (more…)
Abuse and Neglect, Author Interviews, COVID -19 Coronavirus, Emergency Care, Heart Disease / 21.12.2020

MedicalResearch.com Interview with: Michalis Katsoulis PhD Immediate PostDoctoral BHF fellow Institute of Health Informatics Senior Research Fellow, UCL MedicalResearch.com: What is the background for this study? Response: In the early stage of the pandemic, we observed a decline in patient visits to Emergency Departments (ED), including those for cardiac diseases. This decline may have been due to fear of coronavirus infection when attending hospital, public reluctance to overload National Health Service facilities, or difficulty accessing care. In our study, we tried to estimate the impact of reduced ED visits on cardiac mortality in England. We used data from ED visits from the Public Health England Emergency Department Syndromic Surveillance System (EDSSS). For cardiovascular disease outcomes, we obtained mortality counts for cardiac disease from the Office of National Statistics (ONS) for England. (more…)
Author Interviews, Emergency Care, Social Issues, Technology / 23.10.2020

MedicalResearch.com Interview with: Susan Lu PhD Gerald Lyles Rising Star Associate Professor of Management Krannert School of Management Purdue University  MedicalResearch.com: What is the background for this study? Response: We started this project in 2016. Overcrowding in emergency rooms (ERs) is a common yet nagging problem. It not only is costly for hospitals but also compromises care quality and patient experience. Hence, finding effective ways to improve ER care delivery is of great importance. Meanwhile, the advancement of healthcare technologies including electronic medical records, online doctor ratings and 4G mobile network motivates us to think about the impact of telemedicine on ER operations in the near future.  (more…)
Accidents & Violence, Author Interviews, Brigham & Women's - Harvard, Emergency Care, JAMA, Surgical Research / 01.09.2020

MedicalResearch.com Interview with: Sarabeth Spitzer, MD Co-Chair of Board, Scrubs Addressing the Firearm Epidemic (SAFE) Department of Surgery, Brigham and Women’s Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Firearm injury is a significant cause of morbidity and mortality in the United States, resulting in almost 40,000 deaths annually in the United States, but very little is known about the epidemiology of nonfatal firearm injuries. Nonfatal firearm injuries can have significant long-term morbidity and are associated with significant cost. We found that there were over 81,000 nonfatal firearm injuries in California over the study period. Over the period, there was a decrease in nonfatal firearm injuries by 38.1%, driven primarily by a decrease in assault injuries.   (more…)
Author Interviews, Emergency Care, Heart Disease, Social Issues / 28.06.2020

MedicalResearch.com Interview with: Sriman Gaddam The University of Texas at Austin Austin, TX 78705 MedicalResearch.com: What is the background for this study? Response: The quality of care that patients receive from the US healthcare system continues to be influenced by socioeconomic status (SES). Given that cardiac arrest is one of the most common causes of death in the US and that the prehospital setting has an especially high mortality for cardiac arrest, we wanted to determine if the socioeconomic disparities found in the overall US healthcare system continued into the prehospital cardiac arrest setting. MedicalResearch.com: What are the main findings? Response: We found that socioeconomic disparities were present in the prehospital cardiac arrest setting. As the SES of a patient declines, so does the patient's likelihood of achieving return of spontaneous circulation (ROSC). Between the most and least wealthy patients, there was nearly a 13% difference in the probability of achieving ROSC. However, we recognized that not all patients who achieve ROSC are equal as patients can have significantly different neurological functioning depending on the length of time spent in cardiac arrest. Consequently, this paper analyzed cardiac arrest outcomes not only through the occurrence of ROSC but also through the duration of time spent in cardiac arrest. In line with the socioeconomic disparities found in ROSC occurrence, it was found that as a patient's SES declines, the duration of time spent in cardiac arrest before ROSC is achieved increases. This indicates that patients with a low SES are both more likely to not achieve ROSC and if ROSC is achieved more likely to have neurological impairment due to longer time spent in cardiac arrest compared to patients with a high SES. (more…)
Author Interviews, Cannabis, Emergency Care / 20.06.2020

MedicalResearch.com Interview with: Ryan Vandrey, Ph.D. Associate Professor Behavioral Pharmacology Research Unit Johns Hopkins University School of Medicine Baltimore, MD 21224  MedicalResearch.com: What is the background for this study? Response: The background for this study is that 33 states in the U.S. have legalized medicinal cannabis use and millions of people are using cannabis for therapeutic purposes, but we have very little data on the broad health impacts of medicinal cannabis use. We surveyed medicinal cannabis users and non-using controls who had a variety of health problems and found that the cannabis users reported better health, quality of life, and less healthcare utilization compared with controls.  Because we worried about group characteristics accounting for the differences observed, we then did an analysis of people who switched groups over time (e.g. non-users who later initiated cannabis use or cannabis users who later quit) and found the same differences emerged in the same individuals over time.  Important to note here is that not all individuals who used cannabis benefited from it and that most participants were using high CBD varieties of cannabis in conjunction with more traditional treatments. (more…)
Author Interviews, COVID -19 Coronavirus, Emergency Care, Infections, NEJM, Stroke / 09.05.2020

MedicalResearch.com Interview with: Akash Kansagra, MD, MS Assistant Professor of Radiology Neurological Surgery, and Neurology Director, Endovascular Surgical Neuroradiology Co-Director, Stroke and Cerebrovascular Center Washington University and Barnes-Jewish Hospital MedicalResearch.com: What is the background for this study? Response: Over the past five years, medicine has made enormous strides in stroke treatment. The effectiveness of these therapies has been absolutely astounding, and our ability to get patients to hospitals that can provide this life-saving care has also improved dramatically. (more…)
Author Interviews, Emergency Care, Heart Disease, JAMA, UT Southwestern / 22.04.2020

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Cost of Health Care, Emergency Care / 22.02.2020

MedicalResearch.com Interview with: Collin Tebo BA Georgetown University School of Medicine Washington, DCCollin Tebo BA Georgetown University School of Medicine Washington, DC MedicalResearch.com: What is the background for this study? Response: The growing cost of pharmaceuticals is an issue of increasing concern in the United States where a large portion of the nation’s Gross Domestic Product is health care spending. During the past decade, visits to Emergency Departments (EDs) have increased considerably. Pharmaceutical drugs are utilized in the care of most patients who visit the ED therefore, rising drug prices are a concern for emergency medicine physicians, administrators, and patients throughout the US. (more…)
Author Interviews, Emergency Care, Opiods / 13.02.2020

MedicalResearch.com Interview with: Casey P. Balio, BA Department of Health Policy and Management Indiana University Richard M. Fairbanks School of Public Health Indianapolis, IN  MedicalResearch.com: What is the background for this study? Response:   There are numerous studies that estimate the prevalence of various opioid-related outcomes including emergency department (ED) encounters, hospitalizations, and overdoses as well as risk factors for these. However, there is limited evidence about repeated opioid-related encounters. This study uses health information exchange (HIE) data for four hospital systems in the state of Indiana from 2012-2017 to identify individual, prescription, encounter, and community characteristics that may be associated with having repeat opioid-related encounters. (more…)
Author Interviews, Cost of Health Care, Emergency Care, Neurology / 10.01.2020

MedicalResearch.com Interview with: Simon Borghs MSc RWE Strategy Lead of Neurology UCB:  Union Chimique Belge MedicalResearch.com: What is the background for this study? Response: Epilepsy is an episodic disease and so is associated with a more or less unpredictable occurrence of health care encounters. These encounters are costly and so reducing them, or their unpredictability, could be cost saving. The objective was to assess one half of this equation, that is the actual cost of those encounters to insurers. This could prompt insurers to consider addressing possible interventions in epilepsy to reduce the number of encounters (more…)
Author Interviews, Beth Israel Deaconess, Emergency Care, Health Care Systems, JAMA / 05.11.2019

MedicalResearch.com Interview with: Laura Burke, MD, MPH Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston, MA 02215Laura Burke, MD, MPH Department of Emergency Medicine Beth Israel Deaconess Medical Center Boston, MA 02215  MedicalResearch.com: What is the background for this study? Response: There has been a lot of attention to the growing intensity and costs of emergency care, but relatively little study of how outcomes have changed in recent years for patients using the ED. We examined 30-day mortality rates for traditional Medicare beneficiaries age 65 and older using the emergency department (ED) from 2009-2016 and also examined how their rates of hospitalization have changed over time.   (more…)
Author Interviews, Cost of Health Care, Emergency Care / 24.10.2019

MedicalResearch.com Interview with: Murtaza Akhter, MD Assistant Professor Department of Emergency Medicine University of Arizona College of Medicine Phoenix MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent years have brought a significant increase in emergency department visits, and therefore also a boon in openings of freestanding emergency departments (FrEDs). However, it is has been unclear whether the opening of FrEDs reduces healthcare costs. Our study showed that in increase in FrEDs was associated with an increase in spending per Blue Cross Blue Shield enrollee. (more…)
Author Interviews, Electronic Records, Emergency Care, JAMA / 19.09.2019

MedicalResearch.com Interview with: Carl Berdahl, MD, MS Emergency Physician and Health Services Researcher CEDARS-SINAI West Hollywood CA MedicalResearch.com: What is the background for this study? Response: The length of a doctor’s note is taken account when determining how much a doctor or medical center is paid for a visit. However, in the digital era, a doctor can generate large amounts of text with just a few keystrokes. Given this incentive structure, we were concerned doctors’ notes might be inaccurate in certain sections of the chart that are important for billing. We used observers to determine how accurately doctors’ notes reflected the interactions between patients and physicians. (more…)
Author Interviews, Emergency Care, JAMA, Race/Ethnic Diversity / 09.09.2019

MedicalResearch.com Interview with: Amresh D Hanchate, PhD Research Assistant Professor Department of Medicine, School of Medicine Boston University MedicalResearch.com: What is the background for this study? Response: National guidelines require EMS transportation to the nearest suitable hospital. To what extent this occurs and whether this varies by the race and ethnicity of the patient is unknown since there is little to no prior research on destination patterns of EMS-transported patients to hospitals. (more…)
Author Interviews, Biomarkers, Brain Injury, Emergency Care, Pediatrics / 31.08.2019

MedicalResearch.com Interview with: Linda Papa, MD Emergency Physicians of Central Florida Orlando Health Orlando, Florida  MedicalResearch.com: What is the background for this study? Response: In 2018 serum biomarkers Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-terminal hydrolase (UCH-L1) were FDA-approved in adults to detect abnormalities on CT scan in mild to moderate traumatic brain injury. However, they have not been approved to detect concussion and they have not been approved for use in children. Previous studies have focused on detecting lesions on CT in more severely injured patients. However, not having brain lesions on a CT scan does not mean there is no brain injury or concussion. Therefore, this study focused on patients with concussion who looked well and likely had normal-appearing CT scans of the brain. This study includes THREE groups of trauma patients:
  • 1) those with concussion,
  • 2) those who hit their head but had no symptoms (subconcussive), and
  • 3) those who injured their bones but did not hit their head (no concussion).
There is a group of individuals with head trauma who have been significantly understudied, and in whom biomarkers are rarely, if at all, examined. These are people who experience head trauma without symptoms of concussion. They may be classified as having “no injury” or they may represent milder forms of concussion that do not elicit the typical signs or symptoms associated with concussion and are referred to as “subconcussive” injuries.  (more…)
Alcohol, Author Interviews, CMAJ, Emergency Care / 22.07.2019

MedicalResearch.com Interview with: Daniel Myran, MD, MPH, CCFP Public Health & Preventive Medicine, PGY-5 University of Ottawa MedicalResearch.com: What is the background for this study? Response: We know that alcohol consumption results in enormous health and societal harms globally and in Canada. While several studies have looked at changes in alcohol harms, such as Emergency Department (ED) visits and Hospitalizations due alcohol, this study is the first to examine in detail how harms related to alcohol have been changing over time in Canada. (more…)
Author Interviews, Emergency Care, JAMA, Medical Imaging, Pediatrics / 04.06.2019

MedicalResearch.com Interview with: Eyal Cohen, MD, M.Sc, FRCP(C) Professor, Pediatrics University of Toronto Co-Founder, Complex Care Program The Hospital for Sick Children   MedicalResearch.com: What is the background for this study? Response: Minimizing care that provides little benefit to patients has become an important focus to decrease health care costs and improve the quality of care delivery.  Diagnostic imaging in children is a common focus for campaigns designed to reduce overuse both in Canada and the US. There are some suggestions that there may be more overuse of care in the United States than Canada, but there has been little study in children. We compared the use of low-value diagnostic imaging rates from four pediatric emergency departments in Ontario to 26 in the United States from 2006 to 2016.  We defined low-value imaging as situations where children are discharged from an emergency department with a diagnosis for which routine use of diagnostic imaging may not be necessary, like asthma or constipation.  (more…)
Author Interviews, Emergency Care, Mental Health Research, Psychological Science / 03.06.2019

MedicalResearch.com Interview with: Stephen L. Ristvedt, Ph.D. Associate Professor of Anesthesiology Washington University St. Louis, MO  63110-1093  MedicalResearch.com: What is the background for this study? Response: Having a usual source of healthcare – either with a regular doctor or a medical clinic – is the best way to manage one’s health in a proactive way.  Doctors and clinics can provide ongoing guidance with regard to the use of preventive medical screenings as well as the management of chronic illness.  Unfortunately, a significant proportion of US adults do not have a usual source of healthcare.  Also, many people often rely for their healthcare needs on a hospital emergency department, where there is neither sufficient continuity of care nor counseling for prevention. We wanted to investigate what factors might contribute to suboptimal utilization of healthcare resources.  We were particularly interested in looking at individual psychological factors that might play a role in the choices that people make when seeking healthcare.  One specific psychological characteristic proved to be important in our study.  That characteristic is called “threat sensitivity,” and it is measured with a simple questionnaire.  People who are relatively high in threat sensitivity are prone to experience high levels of anxiety in potentially threatening situations  (more…)
Author Interviews, CDC, Emergency Care, Occupational Health, Opiods / 02.05.2019

MedicalResearch.com Interview with: Sophia K. Chiu, MD Epidemic Intelligence Service, CDC Division of Surveillance, Hazard Evaluations, and Field Studies National Institute for Occupational Safety and Health CDC  MedicalResearch.com: What is the background for this study? Response:  Responders across the United States are reporting work-related health effects during incidents in which suspected opioids (including fentanyl) and other illicit drugs such as cocaine, methamphetamine, cathinones, and synthetic cannabinoids are present, often as a mixture. These health effects have interfered with responders’ ability to perform their job duties. Since 2018, a number of responder organizations have requested that NIOSH investigate the health effects experienced by emergency responders during these response incidents. These organizations are looking for ways to protect their responders and prevent the symptoms responders have reported experiencing, so that they can in turn better serve the public. NIOSH’s goal is to increase awareness among responders of how they can remain safe while providing the care the public needs. (more…)
Author Interviews, Cancer Research, CMAJ, Emergency Care / 29.04.2019

MedicalResearch.com Interview with: Keerat Grewal, MD, MSc, FRCPC Schwartz/Reisman Emergency Medicine Institute Mount Sinai Hospital Toronto, ON  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Patients with cancer have complex care requirements and often use the emergency department. The purpose of our study was to determine whether continuity of care, cancer expertise, or both, impact outcomes among cancer patients in the emergency setting. Using administrative data we looked at adult patients with cancer who received chemotherapy or radiation therapy in the 30 days prior to an emergency department visit.  (more…)
Author Interviews, Emergency Care, Gastrointestinal Disease, Pediatrics / 15.04.2019

MedicalResearch.com Interview with: Danielle Orsagh-Yentis, MD Pediatric GI Motility Fellow Department of Gastroenterology, Hepatology and Nutrition Nationwide Children’s Hospital Columbus, Ohio MedicalResearch.com: What is the background for this study? Response: Foreign body ingestions are quite common in young children. Much of the literature and advocacy to date has focused on the harms of button battery and magnet ingestions. We found that foreign body ingestions in children younger than 6 years of age have been increasing over the past 2 decades. This overall increase is mirrored by the rise in coin, toy, and jewelry ingestions, as well as batteries, which, when swallowed, have the potential to cause considerable harm.  (more…)
Author Interviews, Emergency Care, Global Health, JAMA / 12.04.2019

MedicalResearch.com Interview with: Margaret B. Greenwood-Ericksen MD, MSc Department of Emergency Medicine University of New Mexico Albuquerque, NM 87109 MedicalResearch.com: What is the background for this study?   Response: I’m an emergency physician, so I see first-hand how emergency department use patterns provide a lens into the status of health care delivery in the communities they serve. Troubling declines in the health of rural Americans coupled with rising rural hospital closures – with little access to alternative sites of care like urgent care – all led me to hypothesize that rural populations may be engaging with the health care system differently than their urban counterparts. Understanding the health care use of individuals in rural areas may yield insights into addressing rural health disparities. Further, this information may help healthcare systems and policymakers to make data-driven decisions informing new models of healthcare delivery for rural communities. (more…)