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Evidence based emergency medicine

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https://www.readbyqxmd.com/read/28539372/toward-evidence-based-emergency-medicine-best-bets-from-the-manchester-royal-infirmary
#1
Craig Ferguson
No abstract text is available yet for this article.
June 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28532613/the-practice-of-evidence-based-medicine-involves-the-care-of-whole-persons
#2
W Scott Richardson
In this issue of the Journal, Dr. Fava posits that evidence-based medicine (EBM) was bound to fail. I share some of the concerns he expresses, yet I see more reasons for optimism. Having been on rounds with both Drs. Engel and Sackett, I reckon they would have agreed more than they disagreed. Their central teaching was the compassionate and well-informed care of sick persons. The model that emerged from these rounds was that patient care could be both person-centered and evidence-based, that clinical judgment was essential to both, and the decisions could and should be shared...
April 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28526591/macrophage-based-therapeutic-strategies-in-regenerative-medicine
#3
Kara L Spiller, Timothy J Koh
Mounting evidence suggests that therapeutic cell and drug delivery strategies designed to actively harness the regenerative potential of the inflammatory response have great potential in regenerative medicine. In particular, macrophages have emerged as a primary target because of their critical roles in regulating multiple phases of tissue repair through their unique ability to rapidly shift phenotypes. Herein, we review macrophage-based therapies, focusing on the translational potential for cell delivery of ex vivo-activated macrophages and delivery of molecules and biomaterials to modulate accumulation and phenotype of endogenous macrophages...
May 16, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28498004/a-sequential-implementation-model-for-workforce-development-a-case-study-of-medical-residency-training-for-substance-use-concerns
#4
Patricia S O'Sullivan, Patrick Yuan, Derek D Satre, Maria Wamsley, Jason Satterfield
PROBLEM: In graduate medical education, residency programs are often educationally isolated from each other, with varying needs and patient populations, so strategies are needed when attempting to implement training in evidence-based practices across multiple residencies. INTERVENTION: Using implementation science as a guide, we adapted a community development model to sequentially implement an evidence-based intervention, Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and drug use problems, across internal medicine, pediatrics, emergency medicine, psychiatry, and obstetrics and gynecology residency programs...
May 12, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28476098/developing-quality-indicators-for-the-care-of-patients-with-musculoskeletal-injuries-in-the-emergency-department-study-protocol
#5
Kirsten Strudwick, Anthony Bell, Trevor Russell, Melinda Martin-Khan
BACKGROUND: Musculoskeletal injuries are a common presentation to the Emergency Department (ED). The quality of care provided is important to the patients, clinicians, organisations and purchasers of care. In the context of the increasing burden of musculoskeletal disease, quality of care needs to occur despite financial impacts, variations in care, and pressure to reach time-based performance measures. This study aims to develop a suite of evidence-based quality indicators (QI) which will provide a measure of the quality of care for patients with musculoskeletal injuries in the ED...
May 5, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28475698/the-growing-need-for-validated-biomarkers-and-endpoints-for-dry-eye-clinical-research
#6
Neeta S Roy, Yi Wei, Eric Kuklinski, Penny A Asbell
Purpose: Biomarkers with minimally invasive and reproducible objective metrics provide the key to future paradigm shifts in understanding of the underlying causes of dry eye disease (DED) and approaches to treatment of DED. We review biomarkers and their validity in providing objective metrics for DED clinical research and patient care. Methods: The English-language literature in PubMed primarily over the last decade was surveyed for studies related to identification of biomarkers of DED: (1) inflammation, (2) point-of-care, (3) ocular imaging, and (4) genetics...
May 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/28472533/a-systematic-review-of-the-impact-of-physician-implicit-racial-bias-on-clinical-decision-making
#7
Erin Dehon, Nicole Weiss, Jonathan Jones, Whitney Faulconer, Elizabeth Hinton, Sarah Sterling
OBJECTIVES: Disparities in diagnosis and treatment of racial minorities exist in the emergency department (ED). A better understanding of how physician implicit (unconscious) bias contributes to these disparities may help identify ways to eliminate such racial disparities. The objective of this systematic review was to examine and summarize the evidence on the association between physician implicit racial bias and clinical decision making. METHODS: Based on PRISMA guidelines, a structured electronic literature search of PubMed, CINAHL, Scopus, and PsycINFO databases was conducted...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28469903/transitional-care-management-in-the-outpatient-setting
#8
Analiza Baldonado, Ofelia Hawk, Thomas Ormiston, Danielle Nelson
Patients who are high risk high cost (HRHC), those with severe or multiple medical issues, and the chronically ill elderly are major drivers of rising health care costs.1 The HRHC patients with complex health conditions and functional limitations may likely go to emergency rooms and hospitals, need more supportive services, and use long-term care facilities.2 As a result, these patient populations are vulnerable to fragmented care and "falling through the cracks".2 A large county health and hospital system in California, USA introduced evidence-based interventions in accordance with the Triple AIM3 focused on patient-centered health care, prevention, health maintenance, and safe transitions across the care continuum...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28468682/unto-the-third-generation-evidence-for-strong-familial-aggregation-of-physicians-psychologists-and-psychotherapists-among-first-year-medical-and-psychology-students-in-a-nationwide-austrian-cohort-census
#9
Ulrich S Tran, Nina Berger, Martin E Arendasy, Tobias Greitemeyer, Monika Himmelbauer, Florian Hutzler, Hans-Georg Kraft, Karl Oettl, Ilona Papousek, Oliver Vitouch, Martin Voracek
BACKGROUND: Medical students present higher numbers of physician relatives than expectable from the total population prevalence of physicians. Evidence for such a familial aggregation effect of physicians has emerged in investigations from the Anglo-American, Scandinavian, and German-speaking areas. In particular, past data from Austria suggest a familial aggregation of the medical, as well as of the psychological and psychotherapeutic, professions among medical and psychology undergraduates alike...
May 3, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28435507/blog-and-podcast-watch-orthopedic-emergencies
#10
Andrew Grock, Salim Rezaie, Anand Swaminathan, Alice Min, Kaushal H Shah, Michelle Lin
INTRODUCTION: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM) based on the ongoing ALiEM Approved Instructional Resources (AIR) and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of orthopedic emergencies from the AIR series. METHODS: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Directors (CORD) annual testing schedule...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28419016/an-evaluation-of-a-new-debriefing-framework-reflect
#11
Lauren E Zinns, Paul C Mullan, Karen J OʼConnell, Leticia M Ryan, Angela T Wratney
BACKGROUND: Postresuscitation debriefing (PRD) is recommended by the American Heart Association guidelines but is infrequently performed. Prior studies have identified barriers for pediatric emergency medicine (PEM) fellows including lack of a standardized curriculum. OBJECTIVE: Our objective was to create and assess the feasibility of a time-limited, structured PRD framework entitled REFLECT: Review the event, Encourage team participation, Focused feedback, Listen to each other, Emphasize key points, Communicate clearly, and Transform the future...
April 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28401128/planning-for-retirement-from-medicine-a-mixed-methods-study
#12
Michelle Pannor Silver, Laura K Easty
BACKGROUND: Evidence suggests there are important personal and social consequences associated with inadequate retirement planning for physicians. We evaluated whether academic physicians felt satisfied with their retirement planning, and identified obstacles to retirement planning and a set of factors to facilitate retirement planning. METHODS: We applied a sequential mixed-methods research design to explore and examine factors that facilitate academic physician retirement planning using data collected from multiple sources (including 7 focus groups, an internet-based survey and 23 in-depth interviews)...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28394864/safety-of-cochlear-implants-in-electrosurgery-a-systematic-review-of-the-literature
#13
James Behan, Shauna Higgins, Ashley Wysong
BACKGROUND: The implications of electrosurgical instrument use in patients with cochlear implants (CIs) are becoming increasingly relevant for dermatologic surgeons as the number of implanted CI devices continues to grow. The literature, however, fails to provide clear recommendations for appropriate treatment of these patients. OBJECTIVE: To systematically consolidate and critique the current literature regarding electrosurgical instrument use in patients with CI, to determine implications of various electrosurgical devices and settings on CI function and health of cochlear tissues, and to devise recommendations for appropriate use...
June 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28385575/intersecting-worlds-of-transfusion-and-transplantation-medicine-an-international-symposium-organized-by-the-canadian-blood-services-centre-for-innovation
#14
REVIEW
Kendra M Hodgkinson, Jeffrey Kiernan, Andrew W Shih, Ziad Solh, William P Sheffield, Nicolas Pineault
The principal theme of the symposium was centered on how the world of regenerative medicine intersects with that of transfusion medicine, with a particular focus on hematopoietic stem cells (HSCs) and stem cell therapies. The symposium highlighted several exciting developments and identified areas where additional research is needed. A revised map of human hematopoietic hierarchy was presented based on the functional and phenotypic analysis of thousands of single stem and progenitor cells from adult bone marrow and fetal liver...
March 22, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28385046/peripheral-muscle-training-in-patients-with-chronic-obstructive-pulmonary-disease-novel-approaches-and-recent-advances
#15
Gianna W Bisca, Carlos A Camillo, Vinicius Cavalheri, Fabio Pitta, Christian R Osadnik
Pulmonary rehabilitation is one of the most effective non-pharmacological management options for individuals with chronic obstructive pulmonary disease (COPD). Exercise training is the cornerstone of pulmonary rehabilitation, however considerable variability exists regarding the way it is delivered across the world. It is widely accepted that efforts should be made to tailor specific therapeutic approaches to individuals' needs. This applies as much to respiratory medicine as it does to respiratory rehabilitation...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28384533/risk-factors-for-pressure-injuries-among-critical-care-patients-a-systematic-review
#16
REVIEW
Jenny Alderden, June Rondinelli, Ginette Pepper, Mollie Cummins, JoAnne Whitney
OBJECTIVE: To identify risk factors independently predictive of pressure injury (also known as pressure ulcer) development among critical-care patients. DESIGN: We undertook a systematic review of primary research based on standardized criteria set forth by the Institute of Medicine. DATA SOURCES: We searched the following databases: CINAHL (EBSCOhost), the Cochrane Library (Wilson), Dissertations & Theses Global (ProQuest), PubMed (National Library of Medicine), and Scopus...
March 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28379822/improving-patient-clinician-conversations-during-annual-wellness-visits
#17
Zsolt J Nagykaldi, Ami Dave, Connor J Kristof, Tanya N Watts, Sravanthi Utpala, Elizabeth Wickersham
BACKGROUND: Health risk assessments (HRAs) have been implemented and studied for decades in various settings, but little is known about the effect of introducing HRAs on the dynamics and content of patient-clinician conversations during Medicare Annual Wellness Visits (AWVs) and whether the effective use of HRAs requires additional training and resources. METHODS: We used Conversation Analysis techniques to analyze 40 AWVs conducted in an academic family medicine residency practice...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28362667/implementation-strategies-in-pediatric-neurocritical-care
#18
Christopher Markham, Enola K Proctor, Jose A Pineda
PURPOSE OF REVIEW: Brain-directed critical care for children is a relatively new area of subspecialization in pediatric critical care. Pediatric neurocritical care teams combine the expertise of neurology, neurosurgery, and critical care medicine. The positive impact of delivering specialized care to pediatric patients with acute neurological illness is becoming more apparent, but the optimum way to implement and sustain the delivery of this is complicated and poorly understood. We aim to provide emerging evidence supporting that effective implementation of pediatric neurocritical care pathways can improve patient survival and outcomes...
June 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28355975/the-potential-of-collective-intelligence-in-emergency-medicine
#19
Juliane E Kämmer, Wolf E Hautz, Stefan M Herzog, Olga Kunina-Habenicht, Ralf H J M Kurvers
BACKGROUND: Evidence suggests that pooling multiple independent diagnoses can improve diagnostic accuracy in well-defined tasks. We investigated whether this is also the case for diagnostics in emergency medicine, an ill-defined task environment where diagnostic errors are rife. METHODS: A computer simulation study was conducted based on empirical data from 2 published experimental studies. In the computer experiments, 285 medical students independently diagnosed 6 simulated patients arriving at the emergency room with dyspnea...
March 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28350223/potential-facilitators-and-barriers-to-adopting-standard-treatment-guidelines-in-clinical-practice
#20
Sangeeta Sharma, Ajay Pandit, Fauzia Tabassum
Purpose The purpose of this paper is to assess medicines information sources accessed by clinicians, if sources differed in theory and practice and to find out the barriers and facilitators to effective guideline adoption. Design/methodology/approach In all, 183 doctors were surveyed. Barriers and facilitators were classified as: communication; potential adopters; innovation; organization characteristics and environmental/social/economic context. Findings Most of the clinicians accessed multiple information sources including standard treatment guidelines, but also consulted seniors/colleagues in practice...
April 18, 2017: International Journal of Health Care Quality Assurance
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