Featured Publications
Real-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications
Sangal R, Rothenberg C, Hawk K, D'Onofrio G, Hsiao A, Solad Y, Venkatesh A. Real-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications. The Joint Commission Journal On Quality And Patient Safety 2023, 49: 239-246. PMID: 36914528, DOI: 10.1016/j.jcjq.2023.01.013.Peer-Reviewed Original ResearchConceptsOpioid prescribingED visitsElectronic health recordsOpioid prescriptionsEmergency department opioid prescriptionsAnalgesia prescriptionOpioid stewardshipOpioid medicationsSecondary outcomesPrimary outcomePreintervention periodInterruptive alertsCommon interventionPrescribingAlert fatigueElectronic prescribingPrevious interventionsHospital systemObservational evaluationHealth recordsVisitsStewardship policiesInterventionOutcomesPrescriptionDisparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act
Sangal RB, Powers E, Rothenberg C, Ndumele C, Ulrich A, Hsiao A, Venkatesh AK. Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act. Annals Of Emergency Medicine 2021, 78: 593-598. PMID: 34353651, DOI: 10.1016/j.annemergmed.2021.06.014.Peer-Reviewed Original ResearchConceptsProportion of patientsPatient portal accessEmergency departmentOpen notesClinical notesPortal accessPublic insuranceUrgent care centersCentury Cures ActDifferent patient demographicsSingle health systemPatient demographicsPrimary outcomeCures ActPatient utilizationPatient visitsCare centerObservational studyPatientsDigital health toolsAge 18Health systemHealth toolsUnique barriersNon-English speakersSociodemographic Disparities in Queue Jumping for Emergency Department Care
Sangal R, Su H, Khidir H, Parwani V, Liebhardt B, Pinker E, Meng L, Venkatesh A, Ulrich A. Sociodemographic Disparities in Queue Jumping for Emergency Department Care. JAMA Network Open 2023, 6: e2326338. PMID: 37505495, PMCID: PMC10383013, DOI: 10.1001/jamanetworkopen.2023.26338.Peer-Reviewed Original ResearchConceptsCross-sectional studyHigh acuityPatient demographicsSame acuityLatino ethnicityNon-Hispanic raceEmergency department careBed placementTime of triageNon-Hispanic blacksNon-Hispanic whitesED visitsPrimary outcomeED arrivalED patientsMedicaid insuranceMean ageTriage acuityStudy visitAcuity patientsSociodemographic disparitiesED outcomesHigher oddsMAIN OUTCOMECare accessClinical Decision Support: Moving Beyond Interruptive “Pop-up” Alerts
Sangal R, Sharifi M, Rhodes D, Melnick E. Clinical Decision Support: Moving Beyond Interruptive “Pop-up” Alerts. Mayo Clinic Proceedings 2023, 98: 1275-1279. PMID: 37661138, PMCID: PMC10491420, DOI: 10.1016/j.mayocp.2023.05.025.Peer-Reviewed Original Research
2024
409 The Impact of Level Loading in a Large Academic Medical System
Dilip M, Su H, Zhang W, Meng L, Tuffuor K, Pham L, Fogarty R, Venkatesh A, Pinker E, Sangal R. 409 The Impact of Level Loading in a Large Academic Medical System. Annals Of Emergency Medicine 2024, 84: s184-s185. DOI: 10.1016/j.annemergmed.2024.08.408.Peer-Reviewed Original ResearchAccelerated Chest Pain Treatment With Artificial Intelligence–Informed, Risk-Driven Triage
Hinson J, Taylor R, Venkatesh A, Steinhart B, Chmura C, Sangal R, Levin S. Accelerated Chest Pain Treatment With Artificial Intelligence–Informed, Risk-Driven Triage. JAMA Internal Medicine 2024, 184: 1125-1127. PMID: 39037785, PMCID: PMC11264065, DOI: 10.1001/jamainternmed.2024.3219.Peer-Reviewed Original ResearchBalancing act: the complex role of artificial intelligence in addressing burnout and healthcare workforce dynamics
Pavuluri S, Sangal R, Sather J, Taylor R. Balancing act: the complex role of artificial intelligence in addressing burnout and healthcare workforce dynamics. BMJ Health & Care Informatics Online 2024, 31: e101120. PMID: 39181545, PMCID: PMC11344516, DOI: 10.1136/bmjhci-2024-101120.Peer-Reviewed Original ResearchConceptsQuality of patient careSustainability of health systemsComplexity of medical informationArtificial intelligenceWorkforce attritionHealth systemClinical skillsPatient careSense of purposeHealthcare workersHealthcareMedical informationWorkforce dynamicsMedical practiceProfessional attributesDigital scribeData management systemCognitive burdenBurnoutAdvanced data management systemsAI technologyAI potentialAutomated billingSignificant riskCaregiversPatient-Representing Population's Perceptions of GPT-Generated Versus Standard Emergency Department Discharge Instructions: Randomized Blind Survey Assessment
Huang T, Safranek C, Socrates V, Chartash D, Wright D, Dilip M, Sangal R, Taylor R. Patient-Representing Population's Perceptions of GPT-Generated Versus Standard Emergency Department Discharge Instructions: Randomized Blind Survey Assessment. Journal Of Medical Internet Research 2024, 26: e60336. PMID: 39094112, PMCID: PMC11329854, DOI: 10.2196/60336.Peer-Reviewed Original ResearchInterrogating and Uprooting Systemic Racism in the Emergency Department
Sangal R, Khidir H, Agarwal A. Interrogating and Uprooting Systemic Racism in the Emergency Department. JAMA Health Forum 2024, 5: e242347. PMID: 39177981, DOI: 10.1001/jamahealthforum.2024.2347.Peer-Reviewed Original ResearchImpact of the geriatric emergency medicine specialist intervention on final emergency department disposition
Cohen I, Sangal R, Taylor R, Crawford A, Lai J, Martin P, Palleschi S, Rothenberg C, Tomasino D, Hwang U. Impact of the geriatric emergency medicine specialist intervention on final emergency department disposition. Journal Of The American Geriatrics Society 2024, 72: 2017-2026. PMID: 38667266, DOI: 10.1111/jgs.18908.Peer-Reviewed Original ResearchED length of stayED lengthLength of stayObservation admissionsED dispositionInpatient admissionsEmergency departmentOdds of inpatient admissionRate of hospital admissionsAdvanced practice providersGeriatric ED patientsEmergency medicine specialistsTarget trial emulation frameworkHospital admission ratesOdds of dischargeRegional healthcare systemEmergency department dispositionIncreased odds of dischargeCare planningPractice providersED sitesED visitsOlder adultsSpecialist interventionAdmission ratesAutomated HEART score determination via ChatGPT: Honing a framework for iterative prompt development
Safranek C, Huang T, Wright D, Wright C, Socrates V, Sangal R, Iscoe M, Chartash D, Taylor R. Automated HEART score determination via ChatGPT: Honing a framework for iterative prompt development. Journal Of The American College Of Emergency Physicians Open 2024, 5: e13133. PMID: 38481520, PMCID: PMC10936537, DOI: 10.1002/emp2.13133.Peer-Reviewed Original ResearchPrompt designsChest pain evaluationRule-based logicScore determinationLanguage modelPrivacy safeguardsPrompt improvementExtract insightsPain evaluationClinical notesRate of responseDiagnostic performancePhysician assessmentPrompt testingDetermination of heartChatGPTDesign frameworkNote analysisHeartSubscoresSimulated patientsClinical spaceUsing an artificial intelligence software improves emergency medicine physician intracranial haemorrhage detection to radiologist levels
Warman P, Warman A, Warman R, Degnan A, Blickman J, Smith D, McHale P, Coburn Z, McCormick S, Chowdhary V, Dash D, Sangal R, Vadhan J, Bueso T, Windisch T, Neves G. Using an artificial intelligence software improves emergency medicine physician intracranial haemorrhage detection to radiologist levels. Emergency Medicine Journal 2024, 41: 298-303. PMID: 38233106, DOI: 10.1136/emermed-2023-213158.Peer-Reviewed Original ResearchCranial CT scanEmergency physiciansIntracranial haemorrhageBoard-certified emergency physiciansCT scanYears of practice experienceNon-contrast cranial CT scansED physiciansClinical careImaging ReportingEP cohortArtificial intelligenceReader accuracyNon-contrastPatient outcomesRadiologistsRandom orderPhysiciansPatientsCohort
2023
Inequities among patient placement in emergency department hallway treatment spaces
Tuffuor K, Su H, Meng L, Pinker E, Tarabar A, Van Tonder R, Chmura C, Parwani V, Venkatesh A, Sangal R. Inequities among patient placement in emergency department hallway treatment spaces. The American Journal Of Emergency Medicine 2023, 76: 70-74. PMID: 38006634, DOI: 10.1016/j.ajem.2023.11.013.Peer-Reviewed Original ResearchEscalation of careAdjusted odds ratioED revisitsHallway bedsEmergency departmentHigher oddsPatient placementPatient insurance coverageSocial risk factorsPatient social factorsDischarge AMAED visitsSecondary outcomesPatient agePatient demographicsPrimary outcomeMale sexPatient sexTreatment spaceED censusFemale sexRisk factorsOdds ratioED staffingObservational studyRapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T
Malaeb H, Vera M, Sangal R, Venkatesh A, Possick S, Maciejak L, Oberle E, El-Khoury J. Rapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T. Clinica Chimica Acta 2023, 551: 117630. PMID: 37931733, DOI: 10.1016/j.cca.2023.117630.Peer-Reviewed Original ResearchRapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T.
Malaeb H, Vera M, Sangal R, Venkatesh A, Possick S, Maciejak L, Oberle E, El-Khoury J. Rapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T. Clinica Chimica Acta 2023, 551: 117630. PMID: 38420909, DOI: 10.1016/j.cca.2023.117630.Peer-Reviewed Original ResearchConceptsRapid Serum TubesPlasma separation tubesHigh-sensitivity troponin THs-cTnT valuesHs-cTnTSource of hemolysisEmergency departmentTroponin TSerum tubesFalse positive resultsMedian reductionEffect of hemolysisED patientsSample collectionEffects of tube typeHemolysisPatientsPositive resultsSeparator tubesCorrelations among common emergency medicine physician performance measures: Mixed messages or balancing forces?
Scofi J, Underriner E, Sangal R, Rothenberg C, Patel A, Pickens A, Sather J, Parwani V, Ulrich A, Venkatesh A. Correlations among common emergency medicine physician performance measures: Mixed messages or balancing forces? The American Journal Of Emergency Medicine 2023, 72: 58-63. PMID: 37481955, DOI: 10.1016/j.ajem.2023.07.021.Peer-Reviewed Original ResearchEmergency department visits in Connecticut for survivors of sexual assault before and during the COVID-19 pandemic
Yang D, Cordone A, Sun W, Gawel M, Sangal R, Dodington J. Emergency department visits in Connecticut for survivors of sexual assault before and during the COVID-19 pandemic. The American Journal Of Emergency Medicine 2023, 67: 97-99. PMID: 36842427, PMCID: PMC9927790, DOI: 10.1016/j.ajem.2023.02.010.Peer-Reviewed Original ResearchConceptsEmergency departmentChart reviewCOVID-19 pandemicMedical careRetrospective chart reviewStructured chart reviewUrban emergency departmentCare of survivorsLong-term careED presentationsWhite/CaucasianED treatmentSurvivorsCarePatientsSexual assaultMonthsPandemicDepartmentSexual assault survivorsReviewAssault survivorsCaucasiansChoice Architecture to Assist Clinicians with Appropriate COVID-19 Test Ordering
Sangal R, Venkatesh A, Cahill J, Pettker C, Peaper D. Choice Architecture to Assist Clinicians with Appropriate COVID-19 Test Ordering. The Journal Of Applied Laboratory Medicine 2023, 8: 98-105. PMID: 36610419, DOI: 10.1093/jalm/jfac104.Peer-Reviewed Original ResearchConceptsRSV testingSymptomatic visitsED visitsSARS-CoV-2 nucleic acid amplification testsCOVID-19Respiratory syncytial virus testingNucleic acid amplification testsElectronic health record ordersSystems-based interventionsSARS-CoV-2Symptomatic patientsPrimary outcomeInfluenza testingClinical guidelinesClinician educationClinician practiceVirus testingAmplification testsPatientsTest orderingInstitutional guidelinesClinical needHospital systemVisitsTesting patterns
2022
Deep Learning System Boosts Radiologist Detection of Intracranial Hemorrhage
Warman R, Warman A, Warman P, Degnan A, Blickman J, Chowdhary V, Dash D, Sangal R, Vadhan J, Bueso T, Windisch T, Neves G, Degnan A, Blickman J, Vadhan J. Deep Learning System Boosts Radiologist Detection of Intracranial Hemorrhage. Cureus 2022, 14: e30264. PMID: 36381767, PMCID: PMC9653089, DOI: 10.7759/cureus.30264.Peer-Reviewed Original ResearchIntracranial hemorrhage subtypesIntracranial hemorrhageCranial computed tomographyInter-reader agreementDetect intracranial hemorrhageCohort of radiologistsPerformance of radiologistsImprove patient outcomesReduce misdiagnosisRadiologistsPatient outcomesRadiologist's abilityMedical treatmentSubtypesPositive outcomesOutcomesImplementation of an Electronic Health Record Integrated Clinical Pathway Improves Adherence to COVID-19 Hospital Care Guidelines
Sangal RB, Liu RB, Cole KO, Rothenberg C, Ulrich A, Rhodes D, Venkatesh AK. Implementation of an Electronic Health Record Integrated Clinical Pathway Improves Adherence to COVID-19 Hospital Care Guidelines. American Journal Of Medical Quality 2022, 37: 335-341. PMID: 35026785, PMCID: PMC9241559, DOI: 10.1097/jmq.0000000000000036.Peer-Reviewed Original ResearchConceptsClinical pathwaySecondary outcomesCOVID-19 treatment guidelinesEmergency department cliniciansIntegrated clinical pathwayCOVID-19Electronic health recordsPrimary outcomeTreatment guidelinesClinician adherenceED cliniciansED patientsCare guidelinesTreatment recommendationsMedication administrationPatient outcomesPatient carePatientsCliniciansHealth systemHealth recordsOutcomesAdherenceAspirinCOVID-19 pandemic