2021
Reflections on New Evidence on Crisis Standards of Care in the COVID-19 Pandemic.
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. Reflections on New Evidence on Crisis Standards of Care in the COVID-19 Pandemic. The Journal Of Clinical Ethics 2021, 32: 358-360. PMID: 34928864, DOI: 10.1086/jce2021324358.Commentaries, Editorials and LettersConceptsSOFA scoreBlack patientsCrisis standardsSequential Organ Failure Assessment scoreOrgan Failure Assessment scoreAccurate prognostic scoresNext public health emergencyCOVID-19 patientsLife-saving medical resourcesMedical resourcesCOVID-19 pandemicSame scoring systemPublic health emergencyPrognostic scoreBody of evidenceRare casePatientsScoring systemTriage purposesAssessment scoresHealth emergencyCareHealthcare systemCOVID-19ScoresThe 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
Triage and justice in an unjust pandemic: ethical allocation of scarce medical resources in the setting of racial and socioeconomic disparities
Tolchin B, Hull SC, Kraschel K. Triage and justice in an unjust pandemic: ethical allocation of scarce medical resources in the setting of racial and socioeconomic disparities. Journal Of Medical Ethics 2020, 47: 200-202. PMID: 33067315, DOI: 10.1136/medethics-2020-106457.Peer-Reviewed Original ResearchBroader social changeEntrenched health disparitiesLife-saving medical resourcesSystemic health inequitiesTriage protocolHealth disparitiesMedical resourcesSocial changeStructural racismSystemic inequitiesScarce medical resourcesHealth inequitiesComparative advantagePublic health emergencyEthical challengesSocioeconomic health disparitiesInequitiesCrisis standardsTriage systemSocioeconomic disparitiesAdequate mechanismsHealth emergencyEthical allocationHealthcare systemDisparities