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 ResearchAbbreviated MRI in the evaluation of dizziness: report turnaround times and impact on length of stay compared to CT, CTA, and conventional MRI
Tu L, Tegtmeyer K, de Oliveira Santo I, Venkatesh A, Forman H, Mahajan A, Melnick E. Abbreviated MRI in the evaluation of dizziness: report turnaround times and impact on length of stay compared to CT, CTA, and conventional MRI. Emergency Radiology 2024, 1-7. PMID: 39034381, DOI: 10.1007/s10140-024-02273-7.Peer-Reviewed Original ResearchLength of stayEvaluation of dizzinessAbbreviated MRIConventional MRIMRI protocolEmergency departmentNon-contrast CT headConventional MRI protocolHead and neckPosterior circulation strokeAnalysis of length of stayTurnaround timeED length of stayCT headNo significant differenceAcute dizzinessCirculation strokeRetrospective analysisDizzinessAcute settingAssociated with greater impactMRI studiesImaging modalitiesMRIPatientsTotal and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage
Gettel C, Salah W, Rothenberg C, Liang Y, Schwartz H, Scott K, Hwang U, Hastings S, Venkatesh A. Total and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage. Annals Of Emergency Medicine 2024, 84: 285-294. PMID: 38864783, PMCID: PMC11343654, DOI: 10.1016/j.annemergmed.2024.04.023.Peer-Reviewed Original ResearchOut-of-pocketED visitsTraditional MedicareOlder adultsEmergency departmentMedicare AdvantageMedicare Advantage plan enrolleesMedicare Current Beneficiary SurveyEmergency department careTreat-and-releaseOut-of-pocket expensesOut-of-pocket health care spendingHealth care spendingCross-sectional analysisProportion of costsMedian totalEmergency careTreat-and-release emergency departmentBeneficiary SurveyMedian total costProportion of expensesCare spendingPlan enrolleesMedicareVisitsEstimating the size and scope of the academic emergency physician workforce
Gettel C, Camargo C, Bennett C, Courtney D, Kaji A, Fermann G, Gallahue F, Nelson L, Hebbard C, Rothenberg C, Raja A, Venkatesh A. Estimating the size and scope of the academic emergency physician workforce. Academic Emergency Medicine 2024, 31: 732-738. PMID: 38769602, DOI: 10.1111/acem.14931.Peer-Reviewed Original ResearchProportion of emergency physiciansAccreditation Council for Graduate Medical EducationClinical training sitesED visitsEM residency programsAcademic emergency departmentEmergency physiciansEmergency departmentEM workforceEmergency medicineACGME-accredited EM residency programsAcademic sitesProportion of emergency departmentCenters for Medicare & Medicaid ServicesEmergency physician workforceResidency programsProportion of ED visitsDepartment of Veterans AffairsAccredited EM residency programsTraining of resident physiciansAmerican Hospital AssociationTraining sitesNational proportionsAcademic Emergency MedicineGraduate Medical EducationPayment Innovation in Emergency Care: A Case for Global Clinician Budgets
Pines J, Black B, Cirillo L, Kachman M, Nikolla D, Moghtahderi A, Oskvarek J, Rahman N, Venkatesh A, Venkat A. Payment Innovation in Emergency Care: A Case for Global Clinician Budgets. Annals Of Emergency Medicine 2024, 84: 305-312. PMID: 38691065, DOI: 10.1016/j.annemergmed.2024.04.002.Peer-Reviewed Original ResearchClinician groupsClinical workloadEmergency departmentPopulation health programsUS emergency departmentsClinician staffingPopulation healthWorkforce attritionEmergency careHealth programsGovernment payorsED capacityHospital incentivesHospital boardsImprove equityClinician servicesLow reimbursementImprove qualityFinancial incentivesReimbursement ratesFunding modelsReimbursementGlobal budgetState-level legislationFinancial pressuresGeriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modified Delphi Development of a High-Risk Prescription List for Older Emergency Department Patients
Skains R, Koehl J, Aldeen A, Carpenter C, Gettel C, Goldberg E, Hwang U, Kocher K, Southerland L, Goyal P, Berdahl C, Venkatesh A, Lin M. Geriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modified Delphi Development of a High-Risk Prescription List for Older Emergency Department Patients. Annals Of Emergency Medicine 2024, 84: 274-284. PMID: 38483427, PMCID: PMC11343681, DOI: 10.1016/j.annemergmed.2024.01.033.Peer-Reviewed Original ResearchOlder ED patientsHigh-risk prescriptionsED patientsHigh-risk medication usePrescribed high-risk medicationsEmergency departmentHigh-risk medicationsEnd of lifeShort-term adverse eventsAdverse drug eventsQuestionnaire response rateEmergency department patientsDrug eventsRound 2Prescription refillsPhysician expertsMedication useSkeletal muscle relaxantsDepartment patientsMedication categoriesAdverse eventsRisk of short-term adverse eventsMedication classesMedical indicationsPrescription listReliability of a Measure of Admission Intensity for Emergency Physicians
Janke A, Oskvarek J, Zocchi M, Cai A, Litvak O, Pines J, Venkatesh A. Reliability of a Measure of Admission Intensity for Emergency Physicians. Annals Of Emergency Medicine 2024, 84: 295-304. PMID: 38430082, DOI: 10.1016/j.annemergmed.2024.02.002.Peer-Reviewed Original ResearchED admission ratesIntraclass correlation coefficientAdmission ratesEmergency departmentAverage admission rateMeasures of emergency departmentValue-based care programsInternational Classification of DiseasesClassification of DiseasesLinear probability modelsMultilevel linear probability modelsCare programED visitsInternational ClassificationEmergency physiciansDiagnosis codesCorrelation coefficientPhysiciansIdentifying high-Reduce variationIntraclassStandard deviationAdmissionClinical conditionsAssess stabilityThe Clinical Emergency Data Registry: Structure, Use, and Limitations for Research
Lin M, Sharma D, Venkatesh A, Epstein S, Janke A, Genes N, Mehrotra A, Augustine J, Malcolm B, Goyal P, Griffey R. The Clinical Emergency Data Registry: Structure, Use, and Limitations for Research. Annals Of Emergency Medicine 2024, 83: 467-476. PMID: 38276937, DOI: 10.1016/j.annemergmed.2023.12.014.Peer-Reviewed Original ResearchConceptsEmergency departmentData elementsAmerican College of Emergency PhysiciansData RegistryParticipating emergency departmentsElectronic health recordsClinical data registryEmergency careHealth recordsEmergency medicineEmergency physiciansDe-identifiedBilling dataAmerican CollegeImprove data qualityCompletion of data elementsRegistryMultiple data elementsDemographic dataResearch usePatient demographicsReporting purposesData collectionCentral databaseClinical characteristics
2023
Development of the COMET tool: Caregiver‐reported Outcome Measure for Emergency care Transitions
Gettel C, Galske J, Uzamere I, Serina P, Hernandez‐Bigos K, Mane S, Chen K, Ottilie‐Kovelman S, Sandoval J, Venkatesh A, Cohen A, Monin J, Fried T, Hwang U. Development of the COMET tool: Caregiver‐reported Outcome Measure for Emergency care Transitions. Alzheimer's & Dementia 2023, 19 DOI: 10.1002/alz.074213.Peer-Reviewed Original ResearchCare transitionsOutcome measuresCare partnersED discharge processPhase 3Results Phase 1Phase 2Health care systemPhase 1Candidate itemsAcute illnessED encountersEmergency departmentCare considerationsPhase 4Outcome assessmentConclusion DevelopmentScreening toolCare systemResearch team membersContent validityPoor communicationEDMultidisciplinary stakeholdersDelphi approachInequities 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 studyCost-Effectiveness of CT, CTA, MRI, and Specialized MRI for Evaluation of Patients Presenting to the Emergency Department With Dizziness.
Tu L, Melnick E, Venkatesh A, Sheth K, Navaratnam D, Yaesoubi R, Forman H, Mahajan A. Cost-Effectiveness of CT, CTA, MRI, and Specialized MRI for Evaluation of Patients Presenting to the Emergency Department With Dizziness. American Journal Of Roentgenology 2023, 222: e2330060. PMID: 37937837, DOI: 10.2214/ajr.23.30060.Peer-Reviewed Original ResearchQuality-adjusted life yearsEvaluation of patientsSecondary prevention measuresEmergency departmentProbabilistic sensitivity analysesConventional MRICumulative quality-adjusted life yearsCost-effective strategyIncremental costNoncontrast CT headAcute stroke treatmentSpecialized MRISelection of patientsHigher quality-adjusted life yearsConventional brain MRIMarkov decision-analytic modelNon-contrast CTNoncontrast head CTHealthcare system perspectiveUse of MRIBase-case analysisPrevention measuresDecision analytic modelGreater quality-adjusted life yearsDeterministic sensitivity analysesRace and Ethnicity and Emergency Department Discharge Against Medical Advice
Tsai J, Janke A, Krumholz H, Khidir H, Venkatesh A. Race and Ethnicity and Emergency Department Discharge Against Medical Advice. JAMA Network Open 2023, 6: e2345437. PMID: 38015503, PMCID: PMC10685883, DOI: 10.1001/jamanetworkopen.2023.45437.Peer-Reviewed Original ResearchConceptsWhite patientsHispanic patientsEmergency departmentCross-sectional studyED visitsBlack patientsDAMA rateMedical adviceMAIN OUTCOMEEthnic disparitiesNationwide Emergency Department SampleNational cross-sectional studyHospital ED visitsEmergency department dischargeHospital-level variationEmergency Department SampleMetropolitan teaching hospitalHealth care resourcesMedian ageGreater morbidityHospital variationUnadjusted analysesTeaching hospitalAdditional adjustmentLower oddsRapid 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 tubesLeveraging a Learning Collaborative Model to Develop and Pilot Quality Measures to Improve Opioid Prescribing in the Emergency Department
Hawk K, Weiner S, Rothenberg C, Bernstein E, D'Onofrio G, Herring A, Hoppe J, Ketcham E, LaPietra A, Nelson L, Perrone J, Ranney M, Samuels E, Strayer R, Sharma D, Goyal P, Schuur J, Venkatesh A. Leveraging a Learning Collaborative Model to Develop and Pilot Quality Measures to Improve Opioid Prescribing in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 225-234. PMID: 37831040, DOI: 10.1016/j.annemergmed.2023.08.490.Peer-Reviewed Original ResearchAtraumatic back painCommunity EDED visitsBack painOpioid prescribing practicesFirst-line treatmentEmergency department patientsOpioid use disorderQuality improvement projectEvidence-based resourcesOpioid administrationOpioid prescriptionsDental painSafe analgesiaDepartment patientsOpioid pillsPrescribing practicesEmergency departmentAmerican CollegeUse disordersMedication safety educationPainOpioidsImprovement projectVisits48 Capabilities of Emergency Departments to Treat Alcohol Use Disorder: Assessment From a Large Quality Improvement Initiative
Weiner S, Venkatesh A, Goyal P, Sharma P, Rothenberg C, Sharma D, Rudowski K, Sambell M, Hawk K. 48 Capabilities of Emergency Departments to Treat Alcohol Use Disorder: Assessment From a Large Quality Improvement Initiative. Annals Of Emergency Medicine 2023, 82: s20. DOI: 10.1016/j.annemergmed.2023.08.067.Peer-Reviewed Original ResearchCT With CTA Versus MRI in Patients Presenting to the Emergency Department With Dizziness: Analysis Using Propensity Score Matching.
Tu L, Navaratnam D, Melnick E, Forman H, Venkatesh A, Malhotra A, Yaesoubi R, Sureshanand S, Sheth K, Mahajan A. CT With CTA Versus MRI in Patients Presenting to the Emergency Department With Dizziness: Analysis Using Propensity Score Matching. American Journal Of Roentgenology 2023, 221: 836-845. PMID: 37404082, DOI: 10.2214/ajr.23.29617.Peer-Reviewed Original ResearchConceptsSecondary stroke prevention medicationsStroke prevention medicationsEmergency departmentPrevention medicationsEchocardiography evaluationPosterior circulation strokeProportion of patientsGroup of patientsPhysical examination findingsNeuroimaging resultsUse of MRIReview of systemsGreater frequencyPropensity-score matchingExamination findingsRetrospective studyED readmissionMedical historyHead CTClinical impactMRI examinationsBrain MRINeck CTADizzinessPatientsAn Outcome Comparison Between Geriatric and Nongeriatric Emergency Departments
Gettel C, Hwang U, Janke A, Rothenberg C, Tomasino D, Schneider S, Goyal P, Venkatesh A. An Outcome Comparison Between Geriatric and Nongeriatric Emergency Departments. Annals Of Emergency Medicine 2023, 82: 681-689. PMID: 37389490, PMCID: PMC10756927, DOI: 10.1016/j.annemergmed.2023.05.013.Peer-Reviewed Original ResearchConceptsGeriatric EDDiagnosis rateED lengthEmergency departmentMedian discharge rateAmerican CollegeRevisit ratesOlder adultsUrinary tract infectionAge categoriesGeriatric Emergency DepartmentHigher diagnosis ratesED visitsTract infectionsMental statusObservational studyDelirium/Outcome comparisonsData registryED statusProcess outcomesED sitesStayAnalytic sampleAdultsNational Institute on Drug Abuse Clinical Trials Network Meeting Report: Advancing Emergency Department Initiation of Buprenorphine for Opioid Use Disorder
Cowan E, Perrone J, Bernstein S, Coupet E, Fiellin D, Hawk K, Herring A, Huntley K, McCormack R, Venkatesh A, D'Onofrio G. National Institute on Drug Abuse Clinical Trials Network Meeting Report: Advancing Emergency Department Initiation of Buprenorphine for Opioid Use Disorder. Annals Of Emergency Medicine 2023, 82: 326-335. PMID: 37178101, PMCID: PMC10524880, DOI: 10.1016/j.annemergmed.2023.03.025.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsOpioid use disorderEmergency departmentUse disordersDrug Abuse Clinical Trials NetworkEffective evidence-based treatmentsEmergency department initiationStandard emergency careMajor public health crisisClinical Trials NetworkEvidence of efficacyNational InstituteEvidence-based treatmentsOpioid overdose deathsTechnology-based interventionsBuprenorphine dosingBuprenorphine initiationPeer-based interventionsPublic health crisisPatient outcomesED staffOverdose deathsEmergency careBuprenorphineTrials NetworkUniversal uptakeManaging opioid waste, cost, and opportunity for drug diversion in the emergency department
Coleska A, Oh A, Rothenberg C, Dinh D, Parwani V, Venkatesh A. Managing opioid waste, cost, and opportunity for drug diversion in the emergency department. The American Journal Of Emergency Medicine 2023, 69: 195-199. PMID: 37172559, DOI: 10.1016/j.ajem.2023.05.001.Peer-Reviewed Original ResearchConceptsDrug diversionContext of opioidEmergency department visitsManagement of painSingle health systemLogistic regression modelsHealth care systemOpioid ordersIntravenous opioidsSevere painDepartment visitsOpioid diversionEmergency departmentIncorrect doseOpioid epidemicOpioidsPrimary analysisMorphineDose orderHealth systemDoseHydromorphoneCare systemDrug shortagesPainClinical Performance Measures for Emergency Department Care for Adults With Intracranial Hemorrhage
Zachrison K, Goldstein J, Jauch E, Radecki R, Madsen T, Adeoye O, Oostema J, Feeser V, Ganti L, Lo B, Meurer W, Corral M, Rothenberg C, Chaturvedi A, Goyal P, Venkatesh A. Clinical Performance Measures for Emergency Department Care for Adults With Intracranial Hemorrhage. Annals Of Emergency Medicine 2023, 82: 258-269. PMID: 37074253, DOI: 10.1016/j.annemergmed.2023.03.015.Peer-Reviewed Original ResearchConceptsIntracranial hemorrhageAcute neurologic emergenciesEmergency department careNontraumatic intracranial hemorrhageCare of patientsClinical performance measuresCommunity EDNeurologic emergencySyndromic approachEmergency departmentEvidence-based targetsHyperacute phaseWarrants further developmentWorkgroup of expertsQuality improvement resourcesCare processesReview of dataQuality improvementHemorrhageInternal quality improvementCareNational sampleBroad implementationEDImprovement resources