2024
Accelerated 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 ResearchRacial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department
Jivalagian P, Gettel C, Smith C, Robinson L, Brinker M, Shah D, Kumar A, Faustino I, Nath B, Chang-Sing E, Taylor R, Kennedy M, Hwang U, Wong A. Racial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department. American Journal Of Geriatric Psychiatry 2024 PMID: 39054237, DOI: 10.1016/j.jagp.2024.07.004.Peer-Reviewed Original ResearchPhysical restraint useRestraint useOlder adultsED visitsPhysical restraintEmergency departmentElectronic health record dataHealth record dataBlack non-HispanicPatient-level characteristicsAge-related disparitiesAssociated with increased useRegional hospital networkCross-sectional studyLogistic regression modelsChemical sedationRetrospective cross-sectional studyNon-Hispanic groupNon-HispanicAgitation managementHospital sitesHospital networkRecord dataWhite non-Hispanic groupPrimary outcomeGeriatric End-of-Life Screening Tool Prediction of 6-Month Mortality in Older Patients
Haimovich A, Burke R, Nathanson L, Rubins D, Taylor R, Kross E, Ouchi K, Shapiro N, Schonberg M. Geriatric End-of-Life Screening Tool Prediction of 6-Month Mortality in Older Patients. JAMA Network Open 2024, 7: e2414213. PMID: 38819823, PMCID: PMC11143461, DOI: 10.1001/jamanetworkopen.2024.14213.Peer-Reviewed Original ResearchConceptsElectronic health recordsEmergency departmentObserved mortality rateED encountersEnd-of-Life Screening ToolOlder adultsEnd-of-life preferencesMortality riskIllness criteriaLife-limiting illnessOptimal screening criteriaDays of ED arrivalEHR-based algorithmTertiary care EDLow risk of mortalityHigher mortality riskMortality rateRisk of mortalityHealth recordsReceiver operating characteristic curveIllness diagnosisMain OutcomesED arrivalSerious illnessDemographic subgroupsImpact 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 ratesIdentifying signs and symptoms of urinary tract infection from emergency department clinical notes using large language models
Iscoe M, Socrates V, Gilson A, Chi L, Li H, Huang T, Kearns T, Perkins R, Khandjian L, Taylor R. Identifying signs and symptoms of urinary tract infection from emergency department clinical notes using large language models. Academic Emergency Medicine 2024, 31: 599-610. PMID: 38567658, DOI: 10.1111/acem.14883.Peer-Reviewed Original ResearchElectronic health recordsNatural language processingNatural language processing modelsEmergency departmentTransformer-based modelsClinical notesF1-measureClinical decision supportLanguage modelSpaCy modelsU.S. health systemElements of natural language processingPublic health surveillanceConvolutional neural network-based modelProcessing long documentsIdentification of symptomsHealth recordsHealth systemClinician notesNeural network-based modelMedical careHealth surveillanceSymptom identificationEntity recognitionNetwork-based modelIdentifying incarceration status in the electronic health record using large language models in emergency department settings
Huang T, Socrates V, Gilson A, Safranek C, Chi L, Wang E, Puglisi L, Brandt C, Taylor R, Wang K. Identifying incarceration status in the electronic health record using large language models in emergency department settings. Journal Of Clinical And Translational Science 2024, 8: e53. PMID: 38544748, PMCID: PMC10966832, DOI: 10.1017/cts.2024.496.Peer-Reviewed Original ResearchElectronic health recordsNatural language processingHealth recordsIncarceration statusSignificant social determinant of healthSocial determinants of healthClinic electronic health recordsEHR databasePopulation health initiativesDeterminants of healthMitigate health disparitiesRacial health inequitiesEmergency department settingICD-10 codesHealth inequalitiesNatural language processing modelsHealth disparitiesHealth initiativesDepartment settingEmergency departmentSystem interventionsICD-10Clinical notesStudy populationLanguage modelFormative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol
Wong A, Nath B, Shah D, Kumar A, Brinker M, Faustino I, Boyce M, Dziura J, Heckmann R, Yonkers K, Bernstein S, Adapa K, Taylor R, Ovchinnikova P, McCall T, Melnick E. Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol. BMJ Open 2024, 14: e082834. PMID: 38373857, PMCID: PMC10882402, DOI: 10.1136/bmjopen-2023-082834.Peer-Reviewed Original ResearchConceptsComputerised clinical decision supportED treatRestraint useExperiences of restraint useMental health-related visitsEmergency departmentPrevent agitationSystems-related factorsImprove patient experienceClinical decision support systemsRegional health systemClinical decision supportDe-escalation techniquesRandomised controlled trialsFormative evaluationPeer-reviewed journalsBest-practice guidanceAt-risk populationsCDS toolsThematic saturationED cliniciansPatient experienceED sitesHealth systemED physicians
2023
Computational phenotypes for patients with opioid-related disorders presenting to the emergency department
Taylor R, Gilson A, Schulz W, Lopez K, Young P, Pandya S, Coppi A, Chartash D, Fiellin D, D’Onofrio G. Computational phenotypes for patients with opioid-related disorders presenting to the emergency department. PLOS ONE 2023, 18: e0291572. PMID: 37713393, PMCID: PMC10503758, DOI: 10.1371/journal.pone.0291572.Peer-Reviewed Original ResearchConceptsSubstance use disordersUse disordersED visitsPatient presentationCarlson comorbidity indexOpioid-related diagnosesOpioid-related disordersOne-year survivalRate of medicationOpioid use disorderElectronic health record dataPatient-oriented outcomesYears of ageHealth record dataChronic substance use disordersED returnComorbidity indexAcute overdoseMedical managementClinical entityRetrospective studyEmergency departmentChronic conditionsInclusion criteriaUnique cohortDisparities Associated With Electronic Behavioral Alerts for Safety and Violence Concerns in the Emergency Department
Haimovich A, Taylor R, Chang-Sing E, Brashear T, Cramer L, Lopez K, Wong A. Disparities Associated With Electronic Behavioral Alerts for Safety and Violence Concerns in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 100-107. PMID: 37269262, PMCID: PMC10689576, DOI: 10.1016/j.annemergmed.2023.04.004.Peer-Reviewed Original ResearchConceptsHealth care systemEmergency departmentPatient-level analysisCare systemED visitsLeft-without-being-seenNegative perceptions of patientsElectronic health record dataUnited States health care systemRegional health care systemStates health care systemDiscontinuity of careHealth record dataElectronic health recordsBlack non-Hispanic patientsPerceptions of patientsBlack non-HispanicRetrospective cross-sectional study of adult patientsAdult emergency departmentNon-Hispanic patientsCross-sectional study of adult patientsMixed-effects regression analysisStudy periodRetrospective cross-sectional studyCare deliveryClinical criteria to exclude acute vascular pathology on CT angiogram in patients with dizziness
Tu L, Malhotra A, Venkatesh A, Taylor R, Sheth K, Yaesoubi R, Forman H, Sureshanand S, Navaratnam D. Clinical criteria to exclude acute vascular pathology on CT angiogram in patients with dizziness. PLOS ONE 2023, 18: e0280752. PMID: 36893103, PMCID: PMC9997874, DOI: 10.1371/journal.pone.0280752.Peer-Reviewed Original ResearchConceptsAcute vascular pathologyEmergency departmentVascular pathologyNegative predictive valueDizzy patientsStroke codeCTA headPredictive valueAdult ED encountersTransient ischemic attackHalf of patientsLong-term smokersLarge vessel occlusionCoronary artery diseasePast medical historySeparate validation cohortCross-sectional analysisIschemic attackAnalysis cohortArterial dissectionArtery diseaseClinical factorsED encountersMedication useChief complaint
2022
56EMF Augmenting D-dimer Testing for Pulmonary Embolism Rule-out in the Emergency Department With Artificial Intelligence
Haimovich A, Lopez K, Forman H, Kline J, Venkatesh A, Taylor R. 56EMF Augmenting D-dimer Testing for Pulmonary Embolism Rule-out in the Emergency Department With Artificial Intelligence. Annals Of Emergency Medicine 2022, 80: s29-s30. DOI: 10.1016/j.annemergmed.2022.08.079.Peer-Reviewed Original Research
2021
49156 Effects of Race and Demographics on Use of Physical Restraints in the Emergency Department
Wong A, Whitfill T, Ohuabunwa E, Ray J, Dziura J, Bernstein S, Taylor R. 49156 Effects of Race and Demographics on Use of Physical Restraints in the Emergency Department. Journal Of Clinical And Translational Science 2021, 5: 121-122. PMCID: PMC8827920, DOI: 10.1017/cts.2021.710.Peer-Reviewed Original ResearchEmergency departmentAlcohol useAfrican AmericansHealth systemED visitsEffects of raceIllicit drug useOdds ratioPhysical restraintSignificant oddsUse of physical restraintsPrivate insuranceLack of private insuranceRegional health systemAssociated with significant oddsNon-Hispanic ethnicityPrevent self-harmTotal ED visitsAssociated with oddsRetrospective cohort analysisAssociated with safety risksAfrican American raceStatistically significant oddsTertiary health systemSignificant demographic factors
2018
Physical Restraint Use in Adult Patients Presenting to a General Emergency Department
Wong AH, Taylor RA, Ray JM, Bernstein SL. Physical Restraint Use in Adult Patients Presenting to a General Emergency Department. Annals Of Emergency Medicine 2018, 73: 183-192. PMID: 30119940, DOI: 10.1016/j.annemergmed.2018.06.020.Peer-Reviewed Original ResearchConceptsPhysical restraint useEmergency departmentRestraint ordersRestraint usePhysical restraintDrug useRegional health systemManagement of behavioral disordersAdult emergency departmentPrevent self-harmCross-sectional studyPrevalence of agitationCross-sectional study of adult patientsAssociation of alcoholAdult patientsGeneral EDHealth systemED visitsManaging agitationMedical complaintsStudy of adult patientsVulnerable populationsSelf-harmUnique patientsTotal ED visits
2017
Agreement Between Serum Assays Performed in ED Point-of-Care and Hospital Central Laboratories
Dashevsky M, Bernstein SL, Barsky CL, Taylor RA. Agreement Between Serum Assays Performed in ED Point-of-Care and Hospital Central Laboratories. Western Journal Of Emergency Medicine 2017, 18: 403-409. PMID: 28435491, PMCID: PMC5391890, DOI: 10.5811/westjem.2017.1.30532.Peer-Reviewed Original ResearchMeSH KeywordsAdultBiological AssayBiomarkersBlood Chemical AnalysisBlood Urea NitrogenCost-Benefit AnalysisCreatinineEmergency Medical ServicesFemaleHumansLaboratories, HospitalMaleMiddle AgedPoint-of-Care SystemsPotassiumQuality Assurance, Health CareReproducibility of ResultsRetrospective StudiesSodiumUnited StatesConceptsHospital central laboratoryBlood urea nitrogenEmergency departmentED patientsCentral laboratoryLevel of agreementBlood samplesClinical information systemsConfidence intervalsLevel I emergency departmentShorter ED lengthPatient/yearHospital's clinical information systemTime-sensitive diagnosisBland-Altman plotsED lengthSerum sodiumClinical criteriaLarge cohortSerum assaysUrea nitrogenClinical judgmentPatientsSerum samplesED point
2016
Use of Point‐of‐Care Ultrasound in the Emergency Department
Hall MK, Hall J, Gross CP, Harish NJ, Liu R, Maroongroge S, Moore CL, Raio CC, Taylor RA. Use of Point‐of‐Care Ultrasound in the Emergency Department. Journal Of Ultrasound In Medicine 2016, 35: 2467-2474. PMID: 27698180, DOI: 10.7863/ultra.16.01041.Peer-Reviewed Original ResearchConceptsCare ultrasoundEmergency departmentOdds ratioHealthcare Common Procedure Coding System codesMedicaid Services feeCare ultrasound useEmergency medicine practitionersMedical school graduation yearUse of pointPatient outcomesUltrasound examinationMedicare beneficiariesEM residenciesMedicare Part B feeUltrasound useMedicine practitionersPart B feePractice locationProvider UtilizationB feeService reimbursementEM practitionersReimbursementUltrasoundLower ratesImpact of point-of-care ultrasonography on ED time to disposition for patients with nontraumatic shock
Hall MK, Taylor RA, Luty S, Allen IE, Moore CL. Impact of point-of-care ultrasonography on ED time to disposition for patients with nontraumatic shock. The American Journal Of Emergency Medicine 2016, 34: 1022-1030. PMID: 26988105, DOI: 10.1016/j.ajem.2016.02.059.Peer-Reviewed Original ResearchConceptsPOC ultrasonographyEmergency departmentNontraumatic shockCare ultrasonographyPropensity scorePropensity score matchElectronic health recordsHospital mortalityShock patientsPrompt diagnosisED arrivalED patientsED physiciansPoint of careRetrospective studyUnique patientsImpact of pointMean reductionPropensity score modelPatientsUltrasonographyED timeDiagnostic ultrasonographyCovariates of timeEvidence of reduction
2015
Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection
Pare JR, Liu R, Moore CL, Sherban T, Kelleher MS, Thomas S, Taylor RA. Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection. The American Journal Of Emergency Medicine 2015, 34: 486-492. PMID: 26782795, DOI: 10.1016/j.ajem.2015.12.005.Peer-Reviewed Original ResearchMeSH KeywordsAortic Aneurysm, ThoracicAortic DissectionAutopsyDiagnostic ErrorsEchocardiography, TransesophagealEmergency Medical ServicesEmergency MedicineFemaleHumansMaleMedical RecordsMiddle AgedMulticenter Studies as TopicMulti-Institutional SystemsOutcome Assessment, Health CareRetrospective StudiesTime FactorsTomography, X-Ray ComputedConceptsAortic dissectionCardiac ultrasoundEmergency departmentEmergency physiciansAscending aortic dissectionPrimary outcome measureFocus groupsNonspecific presentationED visitsSecondary outcomesAortic dilationMedian timeRetrospective reviewResuscitate statusMedical recordsThoracic aortaDeadly diagnosisOutcome measuresAutopsy reportsPatientsMisdiagnosis rateDissectionUltrasoundMortalityPhysiciansThe “5Es” of Emergency Physician–performed Focused Cardiac Ultrasound: A Protocol for Rapid Identification of Effusion, Ejection, Equality, Exit, and Entrance
Hall M, Coffey EC, Herbst M, Liu R, Pare JR, Taylor R, Thomas S, Moore CL. The “5Es” of Emergency Physician–performed Focused Cardiac Ultrasound: A Protocol for Rapid Identification of Effusion, Ejection, Equality, Exit, and Entrance. Academic Emergency Medicine 2015, 22: 583-593. PMID: 25903585, DOI: 10.1111/acem.12652.Peer-Reviewed Original ResearchConceptsEmergency physiciansCardiac ultrasoundLife-threatening conditionLeft ventricular ejectionAcademic emergency departmentFocused cardiac ultrasoundRelevant clinical informationEmergency medicine literaturePericardial effusionEmergency departmentVentricular ejectionEmergency settingClinical informationFOCUS findingsMedicine literatureYears of experienceEffusionPhysiciansSpecific assessmentUltrasound
2013
Point-of-Care Focused Cardiac Ultrasound for Prediction of Pulmonary Embolism Adverse Outcomes
Taylor RA, Davis J, Liu R, Gupta V, Dziura J, Moore CL. Point-of-Care Focused Cardiac Ultrasound for Prediction of Pulmonary Embolism Adverse Outcomes. Journal Of Emergency Medicine 2013, 45: 392-399. PMID: 23827166, DOI: 10.1016/j.jemermed.2013.04.014.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overEchocardiographyEmergency Service, HospitalFemaleHemorrhageHospital MortalityHumansMaleMiddle AgedPoint-of-Care SystemsPredictive Value of TestsPrognosisPulmonary EmbolismRecurrenceRespiratory InsufficiencyRetrospective StudiesRisk FactorsShockVenous ThromboembolismVentricular Dysfunction, RightConceptsRight ventricular strainHospital adverse outcomesRetrospective chart reviewPulmonary embolismAdverse outcomesEmergency departmentChart reviewCardiac ultrasoundHighest positive likelihood ratioRecurrent venous thromboembolismLow negative likelihood ratioSignificant predictorsEmergency care practitionersFocused cardiac ultrasoundFOCUS examinationPositive likelihood ratioNegative likelihood ratioMajor bleedingLikelihood ratioRespiratory failureVenous thromboembolismTransthoracic echocardiographyHospital admissionIndependent predictorsVentricular strain
2012
Point‐of‐care Focused Cardiac Ultrasound for the Assessment of Thoracic Aortic Dimensions, Dilation, and Aneurysmal Disease
Taylor RA, Oliva I, Van Tonder R, Elefteriades J, Dziura J, Moore CL. Point‐of‐care Focused Cardiac Ultrasound for the Assessment of Thoracic Aortic Dimensions, Dilation, and Aneurysmal Disease. Academic Emergency Medicine 2012, 19: 244-247. PMID: 22288871, DOI: 10.1111/j.1553-2712.2011.01279.x.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic dilationThoracic aortic dimensionsCT angiographyTransthoracic echocardiographyAortic dissectionBland-Altman plotsAortic dimensionsEmergency departmentAortic aneurysmEmergency physiciansCardiac ultrasoundPilot studyNinety-two patientsThoracic aorta pathologyFurther prospective studiesThoracic aortic diameterThoracic aortic pathologyRetrospective pilot studySinus of ValsalvaAcademic emergency departmentCTA measurementsFocused cardiac ultrasoundRetrospective pilot analysisReference standard