2024
SOFA score performs worse than age for predicting mortality in patients with COVID-19
Sherak R, Sajjadi H, Khimani N, Tolchin B, Jubanyik K, Taylor R, Schulz W, Mortazavi B, Haimovich A. SOFA score performs worse than age for predicting mortality in patients with COVID-19. PLOS ONE 2024, 19: e0301013. PMID: 38758942, PMCID: PMC11101117, DOI: 10.1371/journal.pone.0301013.Peer-Reviewed Original ResearchConceptsCrisis standards of careIn-hospital mortalityIntensive care unitAcademic health systemSequential Organ Failure Assessment scoreCohort of intensive care unitSequential Organ Failure AssessmentStandard of careLogistic regression modelsMortality predictionPredicting in-hospital mortalityHealth systemUnivariate logistic regression modelCrisis standardsDisease morbidityCOVID-19
2021
Racial disparities in the SOFA score among patients hospitalized with COVID-19
Tolchin B, Oladele C, Galusha D, Kashyap N, Showstark M, Bonito J, Salazar MC, Herbst JL, Martino S, Kim N, Nash KA, Tiako M, Roy S, Greeno R, Jubanyik K. Racial disparities in the SOFA score among patients hospitalized with COVID-19. PLOS ONE 2021, 16: e0257608. PMID: 34535009, PMCID: PMC8448580, DOI: 10.1371/journal.pone.0257608.Peer-Reviewed Original ResearchConceptsNon-Hispanic white patientsNon-Hispanic black patientsNon-Hispanic blacksSOFA scoreHours of admissionNon-Hispanic whitesWhite patientsHispanic patientsBlack patientsCOVID-19Yale New Haven Health SystemSequential Organ Failure Assessment scoreOrgan Failure Assessment scoreElevated SOFA scoreRetrospective cohort studyCrisis standardsMedical resourcesFull multivariate modelHospital mortalityCohort studyConsecutive patientsMedian agePrimary outcomeFirst admissionInclusion criteriaThe potential impact of triage protocols on racial disparities in clinical outcomes among COVID-positive patients in a large academic healthcare system
Roy S, Showstark M, Tolchin B, Kashyap N, Bonito J, Salazar MC, Herbst JL, Nash KA, Tiako M, Jubanyik K, Kim N, Galusha D, Wang KH, Oladele C. The potential impact of triage protocols on racial disparities in clinical outcomes among COVID-positive patients in a large academic healthcare system. PLOS ONE 2021, 16: e0256763. PMID: 34529684, PMCID: PMC8445412, DOI: 10.1371/journal.pone.0256763.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBlack or African AmericanConnecticutCOVID-19Delivery of Health CareFemaleHealthcare DisparitiesHispanic or LatinoHospital MortalityHospitals, UniversityHumansMaleMiddle AgedOrgan Dysfunction ScoresPandemicsRetrospective StudiesSARS-CoV-2TriageWhite PeopleYoung AdultConceptsCOVID-positive patientsHigher SOFA scoreSOFA scoreClinical outcomesBlack patientsHospital mortalityICU admissionTriage protocolYale New Haven Health SystemSequential Organ Failure Assessment scoreHealthcare systemLarge academic healthcare systemOrgan Failure Assessment scoreRacial disparitiesSimilar clinical outcomesWorse clinical outcomesAcademic healthcare systemChi-square testRace/ethnicityPredictors of interestRetrospective cohortWhite patientsInsurance statusCOVID patientsTriage tool
2020
Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency.
Tolchin B, Latham SR, Bruce L, Ferrante LE, Kraschel K, Jubanyik K, Hull SC, Herbst JL, Kapo J, Moritz ED, Hughes J, Siegel MD, Mercurio MR. Developing a Triage Protocol for the COVID-19 Pandemic: Allocating Scarce Medical Resources in a Public Health Emergency. The Journal Of Clinical Ethics 2020, 31: 303-317. PMID: 32991327, DOI: 10.1086/jce2020314303.Peer-Reviewed Original ResearchConceptsPublic health emergencyTriage protocolScarce medical resourcesYale New Haven Health SystemMedical resourcesEthical challengesHealth emergencyCOVID-19 pandemicAllocating Scarce Medical ResourcesFuture wavesMajor ethical challengesChronic comorbiditiesPregnant patientsSimilar public health emergenciesHealthcare workersTriage assessmentClinical judgmentCoronavirus diseaseHealth systemSocioeconomic disparitiesRole of ageCOVID-19Less needPublic discussionSecondary goal
2019
Randomized controlled trial of motivational interviewing for psychogenic nonepileptic seizures
Tolchin B, Baslet G, Suzuki J, Martino S, Blumenfeld H, Hirsch LJ, Altalib H, Dworetzky BA. Randomized controlled trial of motivational interviewing for psychogenic nonepileptic seizures. Epilepsia 2019, 60: 986-995. PMID: 30980679, DOI: 10.1111/epi.14728.Peer-Reviewed Original ResearchConceptsPsychogenic nonepileptic seizuresQuality of lifeMI participantsPNES frequencyMotivational interviewingControl participantsNonepileptic seizuresQuaternary care medical centerEmergency department visitsEmergency department utilizationSingle neurologistDepartment visitsTreatment adherenceControl armMedical CenterMI armsSeizuresVisitsTrialsAdherenceParticipantsPsychotherapyAdherentArmReferralAdherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures.
Tolchin B, Dworetzky BA, Martino S, Blumenfeld H, Hirsch LJ, Baslet G. Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures. Neurology 2019, 92: e675-e679. PMID: 30610097, PMCID: PMC6382361, DOI: 10.1212/wnl.0000000000006848.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAdult Survivors of Child AbuseAgedAged, 80 and overCohort StudiesConversion DisorderEmergency Service, HospitalEthnicityFemaleFollow-Up StudiesHumansMaleMiddle AgedMinority GroupsOdds RatioProspective StudiesPsychotherapyQuality of LifeSeizuresTreatment Adherence and ComplianceTreatment OutcomeYoung AdultConceptsPsychogenic nonepileptic seizuresQuality of lifePNES frequencyNonepileptic seizuresProspective cohort studyEmergency department utilizationTime of referralBaseline characteristicsCohort studyED visitsSeizure frequencyED utilizationPotential confoundersWomen's HospitalTreatment outcomesMedium effect sizeLocal therapistsMultivariate modelAdherenceChildhood abuseSeizuresHospitalSignificant reductionOutcomesEffect size
2017
Long‐term adherence with psychiatric treatment among patients with psychogenic nonepileptic seizures
Tolchin B, Dworetzky BA, Baslet G. Long‐term adherence with psychiatric treatment among patients with psychogenic nonepileptic seizures. Epilepsia 2017, 59: e18-e22. PMID: 29218816, DOI: 10.1111/epi.13969.Peer-Reviewed Original ResearchConceptsBrief Illness Perception QuestionnairePsychogenic nonepileptic seizuresLong-term adherencePsychiatric treatmentPrior diagnosisNonepileptic seizuresCox proportional hazards regression analysisProportional hazards regression analysisProspective cohort studyHazards regression analysisFirst outpatient visitIllness Perception QuestionnairePercent of subjectsLower scoresCohort studyPsychiatric visitsOutpatient visitsVisit 2Risk factorsFourth visitOne's illnessSurvival analysisNonadherencePerception QuestionnairePatientsAssociation of Periodic and Rhythmic Electroencephalographic Patterns With Seizures in Critically Ill Patients
Ruiz A, Vlachy J, Lee JW, Gilmore EJ, Ayer T, Haider HA, Gaspard N, Ehrenberg JA, Tolchin B, Fantaneanu TA, Fernandez A, Hirsch LJ, LaRoche S. Association of Periodic and Rhythmic Electroencephalographic Patterns With Seizures in Critically Ill Patients. JAMA Neurology 2017, 74: 181-188. PMID: 27992625, DOI: 10.1001/jamaneurol.2016.4990.Peer-Reviewed Original ResearchConceptsRhythmic delta activityDelta activityPeriodic dischargesIll patientsSeizure riskElectroencephalographic patternsStimulation-induced patternsCritically Ill PatientsRisk of seizuresHigher seizure riskAcademic medical centerFrequency-dependent mannerSeizure incidenceIll adultsRisk stratificationHigh prevalenceMedical CenterMAIN OUTCOMEContinuous electroencephalographySeizuresPattern prevalenceMultivariate analysisPatientsClinical decisionRhythmic patterns
2016
Effect of stimulus type and temperature on EEG reactivity in cardiac arrest
Fantaneanu T, Tolchin B, Alvarez V, Friolet R, Avery K, Scirica B, O’Brien M, Henderson G, Lee J. Effect of stimulus type and temperature on EEG reactivity in cardiac arrest. Clinical Neurophysiology 2016, 127: 3412-3417. PMID: 27693940, DOI: 10.1016/j.clinph.2016.09.002.Peer-Reviewed Original ResearchConceptsCardiac arrest patientsNipple pressureTherapeutic hypothermiaArrest patientsDifferent stimulus modalitiesTesting modalitiesModerate agreement ratesReliable outcome predictorsAgreement rateStimulus modalityInterrater agreementCardiac arrestOutcome predictorsEEG reactivityPressure reactivityReactive backgroundBetter outcomesHypothermiaPatientsOutcome determinationNormothermiaModalitiesBackground reactivityStimulus typePrior studies