Population Health Research Design

Population Health Research Design

Consolidating Emergency Department-specific Data to Enable Linkage with Large Administrative Datasets

Boggs, KM.

The American Hospital Association (AHA) has hospital-level data, while the Centers for Medicare & Medicaid Services (CMS) has patient-level data. Merging these with other distinct databases would permit analyses of hospital-based specialties, units, or departments, and patient outcomes. One distinct database is the National Emergency Department Inventory (NEDI), which contains information about all EDs in the United States. However, a challenge with merging these databases is that NEDI lists all US EDs individually, while the AHA and CMS group some EDs by hospital network. Consolidating data for this merge may be preferential to excluding grouped EDs. Our objectives were to consolidate ED data to enable linkage with administrative datasets and to determine the effect of excluding grouped EDs on ED-level summary results.

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Population Health Research Design

Universal Screening for Hepatitis C Virus in the ED Using a Best Practice Advisory

Ford, JS.

In 2019 the United States Preventive Services Task Force (USPSTF) released draft guidelines recommending universal hepatitis C virus (HCV) screening for individuals aged 18–79. We aimed to assess the efficacy of an emergency department-based HCV screening program, by comparing screening practices before and after its implementation.

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Population Health Research Design

Emergency Medicine Influencers’ Twitter Use During the COVID-19 Pandemic: A Mixed-methods Analysis

Leibowitz, MK.

The objective of this study was to analyze the messages of influential emergency medicine (EM) Twitter users in the United States (US) during the early stages of the coronavirus disease 2019 (COVID-19) global pandemic by characterizing the themes, emotional tones, temporal viewpoints, and depth of engagement with the tweets.

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Population Health Research Design

Enroller Experience and Parental Familiarity of Disease Influence Participation in a Pediatric Trial

Schunk, JE.

Acquiring parental consent is critical to pediatric clinical research, especially in interventional trials. In this study we investigated demographic, clinical, and environmental factors associated with likelihood of parental permission for enrollment in a study of therapies for diabetic ketoacidosis (DKA) in children.

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Population Health Research Design

Quality and Publication of Emergency Medicine Trials Registered in ClinicalTrials.gov

Calvocoressi, PhD, et al.

Promoting emergency medicine (EM) clinical trials research remains a priority. To characterize the status of clinical EM research, this study assessed trial quality, funding source, and publication of EM clinical trials and compared EM and non-EM trials on these key metrics. We also examined the volume of EM trials and their subspecialty areas.

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Population Health Research Design

Techniques to Shorten a Screening Tool for Emergency Department Patients

Weiner, MD, et al.

Opioids are prescribed frequently in the emergency department (ED) setting, but screening tools are often of significant length and therefore limited in their utility. We describe and evaluate three approaches to shortening a screening tool: creation of a short form; curtailment; and stochastic curtailment.

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Population Health Research Design

Understanding the Use of Composite Endpoints in Clinical Trials

McCoy, MD, MPH.

Researchers have been increasingly using composite endpoints in lieu of the customary single primary endpoint. Although statistically treated like a single primary endpoint, composite endpoints provide unique challenges for patient care. If used or interpreted incorrectly, they have the potential for detrimental impact on patient care on a large scale. This paper defines composite endpoints, discusses the rationale for their use, and provides a practical approach to understand whether they should be used in medical decision-making.

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Population Health Research Design

Understanding the Intention-to-treat Principle in Randomized Controlled Trials

McCoy, MD.

If an intervention is truly effective (truth), an intention-to-treat analysis will provide an unbiased estimate of the efficacy of the intervention at the level of adherence in the study. This article will review the “intention-to-treat” principle and its converse, “per-protocol” analysis, and illustrate how using the wrong method of analysis can lead to a significantly biased assessment of the effectiveness of an intervention.

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Population Health Research Design

Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review

McGregor, MD, et al.

The National Institutes of Health recently highlighted the significant role of sex as a biological variable (SABV) in research design, outcome and reproducibility, mandating that this variable be accounted for in all its funded research studies. We use three case-based scenarios in acute myocardial infarction, acute ischemic stroke and important considerations in pharmacologic therapy administration to highlight available data on SABV in evidence-based research to provide the EM community with an important foundation for future integration of patient sex in the delivery of emergency care as gaps in research are filled.

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Population Health Research Design

Factors Influencing Participation in Clinical Trials: Emergency Medicine vs. Other Specialties

Kurt, PhD, RN, et al.

This study investigated factors that influence emergency medicine (EM) patients’ decisions to participate in clinical trials and whether the impact of these factors differs from those of other medical specialties. A survey was distributed in EM, family medicine (FM), infectious disease (ID), and obstetrics/gynecology (OB/GYN) outpatient waiting areas. Eligibility criteria included those who were 18 years of age or older, active patients on the day of the survey, and able to complete the survey without assistance.

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Population Health Research Design

Getting Found: Indexing and the Independent Open Access Journal

Getting Found: Indexing and the Independent Open Access Journal
Katie Fourtney, JD, MLIS, et al.

Running an independent journal takes much effort, even if only focusing on managing the process of moving articles through the process of submission, review, and publication. Yet publishing an article is not the only goal. Even a great article has little impact unless it can easily be discovered for people to read and cite. Without visibility, even a journal with a terrific editorial board will not get the high quality submissions its editors seek.

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Population Health Research Design

Authorship Trends of Emergency Medicine Publications over the Last Two Decades

Volume 17, Issue 3, May 2016
Richard Lammers, MD, et al.

Introduction: With the recent merger of the American Osteopathic Association (AOA) and
the Accreditation Council for Graduate Medical Education (ACGME) a heightened pressure for
publication may become evident. Our objective was to determine whether there was a gap in the
type of both medical degree designation and advanced degree designation among authorship in
three United States-based academic emergency medicine journals.
Methods: We reviewed the Journal of Emergency Medicine, Academic Emergency Medicine and
Annals of Emergency Medicine for the type of degree designation that the first and senior authors
had obtained for the years 1995, 2000, 2005, 2010 and 2014.
Results: A total of 2.48% of all authors held a degree in osteopathic medicine. Osteopathic
physician first authors contributed to 3.26% of all publications while osteopathic physician senior
authors contributed 1.53%. No statistical trend could be established for the years studied for
osteopathic physicians. However, we noted an overall trend for increased publication for allopathic
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senior authors (p=0.001), allopathic first authors with a dual degree (p=0.003) and allopathic
senior authors with a dual degree (p=0.005). For each journal studied, no statistical trend could
be established for osteopathic first or senior authors but a trend was noted for allopathic first
and senior authors in the Journal of Emergency Medicine (p-value=0.020 and 0.006). Of those
with dual degrees, osteopathic physicians were in the minority with 1.85% of osteopathic first
authors and 0.60% of osteopathic senior authors attaining a dual degree. No statistical trend could
be established for increased dual degree publications for osteopathic physicians over the study
period, nor could a statistical trend be established for any of the journals studied.
Conclusion: Very few osteopathic physicians have published in the Journal of Emergency
Medicine, Academic Emergency Medicine or Annals of Emergency Medicine over the last two
decades. Despite a trend for increased publication by allopathic physicians in certain journals,
there appears to be no trend for increased publication of osteopathic physicians in emergency

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Population Health Research Design

Validation of ICD-9 Codes for Stable Miscarriage in the Emergency Department

Volume 16, Issue 4, July 2015
Kelly E. Quinley, MD, et al.

International Classification of Disease, Ninth Revision (ICD-9) diagnosis codes have not been validated for identifying cases of missed abortion where a pregnancy is no longer viable but the cervical os remains closed. Our goal was to assess whether ICD-9 code “632” for missed abortion has high sensitivity and positive predictive value (PPV) in identifying patients in the emergency department (ED) with cases of stable early pregnancy failure (EPF).

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Population Health Research Design

How do Medical Societies Select Science for Conference Presentation? How Should They?

Volume 16, Issue 4, July 2015
Thomas M. Kuczmarski, BA, et al.

Nothing has been published to describe the practices of medical societies in choosing abstracts for presentations at their annual meetings. We surveyed medical societies to determine their practices, and also present a theoretical analysis of the topic. We contacted a convenience sample of large U.S. medical conferences, and determined their approach to choosing abstracts. We obtained information from web sites, telephone, and email. Our theoretical analysis compares values-based and empirical approaches for scoring system development.

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Population Health Research Design

Feasibility of Tablet Computer Screening for Opioid Abuse in the Emergency Department

Volume 16 Issue 1, January 2015
Scott G. Weiner, MD, MPH et al.

Tablet computer-based screening may have the potential for detecting patients at risk for opioid abuse in the emergency department (ED). Study objectives were a) to determine if the revised Screener and Opioid Assessment for Patients with Pain (SOAPP®-R), a 24-question previously paper-based screening tool for opioid abuse potential, could be administered on a tablet computer to an ED patient population; b) to demonstrate that >90% of patients can complete the electronic screener without assistance in <5 minutes and; c) to determine patient ease of use with screening on a tablet computer.

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Discourse in Emergency Medicine and Population Health

In Response to “Temperature and Violent Crime in Dallas, Texas: Relationships and Implications of Climate Change”

Volume 14, Issue 5, September 2013
Matt N. Williams, MA, et al.

To the editor:

We were interested to read Gamble and Hess’s study finding that the daily incidence of violent crime in Dallas increased with temperatures up to 90°F (32.2°C), but decreased above this threshold. On this basis, their abstract surprisingly concludes that “higher ambient temperatures expected with climate change…. are not likely to be accompanied by markedly higher rates of violent crime” (p.239). This conclusion contrasts with the findings of previous studies.1–3

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Population Health Research Design

The Impact of Emergency Physician Turnover on Planning for Prospective Clinical Trials

Introduction: Emergency physician (EP) turnover is a significant issue that can have strong economic impact on hospital systems, as well as implications on research efforts to test and improve clinical practice.

Conclusion: EP workforce changes over an 18-month period were common. This has implications for emergency department directors, researchers, and individual EPs. Those planning research involving interventions upon EPs should account for turnover as it may have an impact when designing clinical trials to improve performance on healthcare delivery metrics for time-sensitive medical conditions such as stroke, acute myocardial infarction, or trauma.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

3800 W Chapman Ave Ste 3200
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org


ISSN: 1936-900X
e-ISSN: 1936-9018

ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.