Population Health Research Design

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
medicine.

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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

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: westjem@gmail.com

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

CPC-EM
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.