2024
Geriatric 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 ResearchMeSH KeywordsAgedAged, 80 and overBostonEmergency Service, HospitalFemaleGeriatric AssessmentHumansMaleMortalityPrognosisTerminal CareConceptsElectronic 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 subgroupsFormative 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 ResearchMeSH KeywordsAdultDecision Support Systems, ClinicalEmergency Service, HospitalHumansInformed ConsentRandomized Controlled Trials as TopicResearch DesignConceptsComputerised 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
Adoption of Emergency Department–Initiated Buprenorphine for Patients With Opioid Use Disorder
Gao E, Melnick E, Paek H, Nath B, Taylor R, Loza A. Adoption of Emergency Department–Initiated Buprenorphine for Patients With Opioid Use Disorder. JAMA Network Open 2023, 6: e2342786. PMID: 37948075, PMCID: PMC10638655, DOI: 10.1001/jamanetworkopen.2023.42786.Peer-Reviewed Original ResearchMeSH KeywordsBuprenorphineEmergency Service, HospitalHumansNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersConceptsHealth care systemED initiationOpioid use disorderBuprenorphine initiationCare systemUse disordersEmergency Department-Initiated BuprenorphineSecondary analysisClinician's roleEmergency department initiationClinical decision support interventionClinical decision support toolProportional hazard modelingCare of patientsNetwork of cliniciansDecision support interventionsAdvanced practice practitionersDose-dependent mannerUnique cliniciansTime-dependent covariatesTrial interventionNonintervention groupED clustersMore effective interventionsNumber of exposuresComputational 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 ResearchMeSH KeywordsAnalgesics, OpioidEmergency Service, HospitalHumansOpioid-Related DisordersPhenotypeRetrospective StudiesConceptsSubstance 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 ResearchMeSH KeywordsAdultAgedCross-Sectional StudiesEmergency Service, HospitalFemaleHumansMaleMedicareMiddle AgedRetrospective StudiesUnited StatesViolenceConceptsHealth 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 ResearchMeSH KeywordsAdultAngiographyCross-Sectional StudiesDizzinessEmergency Service, HospitalHumansStrokeTomography, X-Ray ComputedVertigoConceptsAcute 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 complaintAutomatable end‐of‐life screening for older adults in the emergency department using electronic health records
Haimovich A, Xu W, Wei A, Schonberg M, Hwang U, Taylor R. Automatable end‐of‐life screening for older adults in the emergency department using electronic health records. Journal Of The American Geriatrics Society 2023, 71: 1829-1839. PMID: 36744550, PMCID: PMC10258151, DOI: 10.1111/jgs.18262.Peer-Reviewed Original ResearchMeSH KeywordsAgedCohort StudiesDeathElectronic Health RecordsEmergency Service, HospitalHumansReproducibility of ResultsRetrospective StudiesConceptsAdvance care planningDecision curve analysisLife screeningComorbidity indexCode statusPrognostic modelHealth systemOlder adultsCurve analysisOlder ED patientsPalliative care interventionsObservational cohort studyEmergency department visitsPalliative care servicesElixhauser Comorbidity IndexReceiver-operating characteristic curveIdentification of patientsMultivariable logistic regressionLarge regional health systemLife-limiting illnessRisk older adultsCode status ordersLife Screening ToolMortality predictive modelsElectronic health records
2021
Machine Learning in Emergency Medicine: Keys to Future Success
Taylor RA, Haimovich AD. Machine Learning in Emergency Medicine: Keys to Future Success. Academic Emergency Medicine 2021, 28: 263-267. PMID: 33277733, DOI: 10.1111/acem.14189.Peer-Reviewed Original Research
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 visitsPredicting urinary tract infections in the emergency department with machine learning
Taylor RA, Moore CL, Cheung KH, Brandt C. Predicting urinary tract infections in the emergency department with machine learning. PLOS ONE 2018, 13: e0194085. PMID: 29513742, PMCID: PMC5841824, DOI: 10.1371/journal.pone.0194085.Peer-Reviewed Original ResearchConceptsExtreme gradient boostingGradient boostingXGBoost modelLarge diverse setHigh diagnostic error rateMachineAlgorithmXGBoostError rateDiverse setInadequate diagnostic performancePredictive modelSetPrediction toolsDiagnostic error rateBoostingCommon emergency department (ED) diagnosisFull setModelApplying advanced analytics to guide emergency department operational decisions: A proof-of-concept study examining the effects of boarding
Taylor R, Venkatesh A, Parwani V, Chekijian S, Shapiro M, Oh A, Harriman D, Tarabar A, Ulrich A. Applying advanced analytics to guide emergency department operational decisions: A proof-of-concept study examining the effects of boarding. The American Journal Of Emergency Medicine 2018, 36: 1534-1539. PMID: 29310983, DOI: 10.1016/j.ajem.2018.01.011.Peer-Reviewed Original Research
2016
Determination of a Testing Threshold for Lumbar Puncture in the Diagnosis of Subarachnoid Hemorrhage after a Negative Head Computed Tomography: A Decision Analysis
Taylor RA, Gill H, Marcolini EG, Meyers HP, Faust JS, Newman DH. Determination of a Testing Threshold for Lumbar Puncture in the Diagnosis of Subarachnoid Hemorrhage after a Negative Head Computed Tomography: A Decision Analysis. Academic Emergency Medicine 2016, 23: 1119-1127. PMID: 27378053, DOI: 10.1111/acem.13042.Peer-Reviewed Original ResearchMeSH KeywordsDecision Support TechniquesEmergency Service, HospitalHeadacheHumansMiddle AgedNeuroimagingReference StandardsSpinal PunctureSubarachnoid HemorrhageTomography, X-Ray ComputedConceptsProbabilistic sensitivity analysesNegative head CTAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageLumbar punctureNegative CTTesting thresholdHead CTNormal neurologic findingsContrast-induced nephropathyNonaneurysmal subarachnoid hemorrhageLong-term morbidityHead Computed TomographyTwo-way sensitivity analysesDecision analytic modelProbability of deathNeurologic findingsRenal failureClinical variablesCurrent guidelinesPretest probabilityComputed tomographySecondary aimCTHemorrhageUse 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 ResearchMeSH KeywordsCross-Sectional StudiesEmergency Service, HospitalHumansInsurance, Health, ReimbursementMedicarePoint-of-Care SystemsRural PopulationUltrasonographyUnited StatesUrban PopulationConceptsCare 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 ratesThe Association Between Physician Empathy and Variation in Imaging Use
Melnick ER, O'Brien EG, Kovalerchik O, Fleischman W, Venkatesh AK, Taylor RA. The Association Between Physician Empathy and Variation in Imaging Use. Academic Emergency Medicine 2016, 23: 895-904. PMID: 27343485, PMCID: PMC5884096, DOI: 10.1111/acem.13017.Peer-Reviewed Original ResearchConceptsCT utilizationEmergency physician performanceEmergency physiciansPhysician performanceCT utilization ratesEmergency Department CTPhysician survey respondentsPatient-level variablesCross-sectional studyCohort of physiciansPhysician empathyLarge health systemPsychometric testsMixed effects regression modelsPhysician-based factorsPsychometric scalesSurvey response rateAcademic EDSubset analysisPhysician demographicsHead CTInterphysician variationResponse rateImaging useRTS scoreImpact 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 ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overEmergency Service, HospitalFemaleHumansMaleMiddle AgedPoint-of-Care TestingPropensity ScoreRetrospective StudiesShockUltrasonographyYoung AdultConceptsPOC 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 reductionPrediction of In‐hospital Mortality in Emergency Department Patients With Sepsis: A Local Big Data–Driven, Machine Learning Approach
Taylor RA, Pare JR, Venkatesh AK, Mowafi H, Melnick ER, Fleischman W, Hall MK. Prediction of In‐hospital Mortality in Emergency Department Patients With Sepsis: A Local Big Data–Driven, Machine Learning Approach. Academic Emergency Medicine 2016, 23: 269-278. PMID: 26679719, PMCID: PMC5884101, DOI: 10.1111/acem.12876.Peer-Reviewed Original ResearchConceptsMachine learning approachesElectronic health recordsLearning approachPredictive analyticsMachine learning techniquesRandom forest modelClinical decision support systemBig Data DrivenDecision support systemForest modelLearning techniquesUse casesData-DrivenFacilitate automationTraditional analytic techniquesAnalyticsSupport systemSimple heuristicsNew analyticsHealth recordsSmall setTree modelQuestion of generalizabilityPrediction modelDecision rules
2015
Comparative Effectiveness Research: Alternatives to “Traditional” Computed Tomography Use in the Acute Care Setting
Moore CL, Broder J, Gunn ML, Bhargavan‐Chatfield M, Cody D, Cullison K, Daniels B, Gans B, Hall M, Gaines BA, Goldman S, Heil J, Liu R, Marin JR, Melnick ER, Novelline RA, Pare J, Repplinger MD, Taylor RA, Sodickson AD. Comparative Effectiveness Research: Alternatives to “Traditional” Computed Tomography Use in the Acute Care Setting. Academic Emergency Medicine 2015, 22: 1465-1473. PMID: 26576033, DOI: 10.1111/acem.12831.Peer-Reviewed Original ResearchConceptsAcute care settingCare settingsComputed tomography (CT) useCare of patientsAlternative diagnostic strategiesComputed tomography scanningEssential diagnostic toolTomography useCT useEmergency physiciansEmergency radiologistsComparative effectivenessTomography scanningDiagnostic strategiesDiagnostic toolDelphi techniqueSettingPatientsMedical physicistsPhysiciansCareCTImproving emergency physician performance using audit and feedback: a systematic review
Le Grand Rogers R, Narvaez Y, Venkatesh AK, Fleischman W, Hall MK, Taylor RA, Hersey D, Sette L, Melnick ER. Improving emergency physician performance using audit and feedback: a systematic review. The American Journal Of Emergency Medicine 2015, 33: 1505-1514. PMID: 26296903, DOI: 10.1016/j.ajem.2015.07.039.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Service, HospitalFeedbackHumansMedical AuditMedical Staff, HospitalOutcome Assessment, Health CareConceptsEmergency physician performanceSystematic reviewPhysician performanceStandardized reportingSufficient outcome dataEmergency department settingTreatment effectsQuality of careHealth care settingsFull-text articlesFeedback interventionNumerous clinical conditionsNonrandomized studyBlack checklistDepartment settingInclusion criteriaCare settingsClinical conditionsMethodological qualityOutcome dataEmergency carePRISMA statementPubMed databaseMajority of studiesBlack scoreRedefining Overuse to Include Costs: A Decision Analysis for Computed Tomography in Minor Head Injury
Melnick ER, Keegan J, Taylor RA. Redefining Overuse to Include Costs: A Decision Analysis for Computed Tomography in Minor Head Injury. The Joint Commission Journal On Quality And Patient Safety 2015, 41: 313-ap2. PMID: 26108124, DOI: 10.1016/s1553-7250(15)41041-4.Peer-Reviewed Original ResearchConceptsNet monetary benefitCurrent clinical decision rulesMonetary benefitsInclusion of costsCosts outweigh benefitsDecision analysisDecision analytic modelTwo-way sensitivity analysesDecision rulesProbability of lesionCanadian CT Head RuleMain driversOnly effectivenessCostSignificant impactSensitivity analysisCost of CTThe “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 ResearchMeSH KeywordsClinical CompetenceEchocardiographyEmergency Medical ServicesEmergency Service, HospitalHeart VentriclesHumansPericardial EffusionPoint-of-Care SystemsUnited StatesVena Cava, InferiorConceptsEmergency physiciansCardiac ultrasoundLife-threatening conditionLeft ventricular ejectionAcademic emergency departmentFocused cardiac ultrasoundRelevant clinical informationEmergency medicine literaturePericardial effusionEmergency departmentVentricular ejectionEmergency settingClinical informationFOCUS findingsMedicine literatureYears of experienceEffusionPhysiciansSpecific assessmentUltrasound