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
2023
Improving Communication Around the Diagnosis of Dementia.
Tolchin B. Improving Communication Around the Diagnosis of Dementia. Neurology Clinical Practice 2023, 14: e200237. PMID: 38144899, PMCID: PMC10741378, DOI: 10.1212/cpj.0000000000200237.Peer-Reviewed Original Research382 Moral Distress in Resuscitation Policy Implementation During the COVID-19 Pandemic: A Mixed Methods Study
Jubanyik K, Vergara-Greeno R, Welch R, Kim N, Showstark M, Kashyap N, Herbst J, Tolchin B. 382 Moral Distress in Resuscitation Policy Implementation During the COVID-19 Pandemic: A Mixed Methods Study. Annals Of Emergency Medicine 2023, 82: s167-s168. DOI: 10.1016/j.annemergmed.2023.08.410.Peer-Reviewed Original ResearchWork difficulties, work restrictions, and disability benefits in people with functional seizures: A survey study
Woodward J, Asadi-Pooya A, Mildon B, Tolchin B. Work difficulties, work restrictions, and disability benefits in people with functional seizures: A survey study. Epilepsy & Behavior Reports 2023, 23: 100610. PMID: 37645697, PMCID: PMC10460675, DOI: 10.1016/j.ebr.2023.100610.Peer-Reviewed Original ResearchFunctional seizuresWork restrictionsSignificant long-term disabilityOlder ageDisability benefitsLogistic regressionLong-term disabilityWork difficultiesPredictors of unemploymentExperienced disabilityDisability limitationsSeizuresPotential predictorsWork limitationsDemographic informationCurrent employment statusWork accommodationsDisabilityMajority of peopleCliniciansMost respondentsEmployment statusHigh percentageAgePredictors
2022
A Hub and Spoke Model for Improving Access and Standardizing Ethics Consultations Across a Large Healthcare System
Tolchin B, Bruce L, Mercurio M, Latham SR. A Hub and Spoke Model for Improving Access and Standardizing Ethics Consultations Across a Large Healthcare System. The American Journal Of Bioethics 2022, 22: 42-45. PMID: 35420520, DOI: 10.1080/15265161.2022.2044551.Peer-Reviewed Original ResearchMotivational Interviewing for Functional Movement Disorder
Tolchin B, Martino S. Motivational Interviewing for Functional Movement Disorder. Current Clinical Neurology 2022, 223-235. DOI: 10.1007/978-3-030-86495-8_18.Peer-Reviewed Original ResearchFunctional movement disordersFunctional neurological disorderPhysical therapyMovement disordersUse of MIHealthy behaviorsOverview of MIPatients' own reasonsLimited patient engagementPatient adherenceTreatment adherenceBody of evidenceWorse outcomesMedical treatmentPatient engagementTherapeutic interventionsTreatment planNeurological disordersPatientsTherapyMedical settingsMI efficacyDisordersInterventionBehavioral changesVisually sensitive seizures: An updated review by the Epilepsy Foundation
Fisher RS, Acharya JN, Baumer FM, French JA, Parisi P, Solodar JH, Szaflarski JP, Thio LL, Tolchin B, Wilkins AJ, Trenité D. Visually sensitive seizures: An updated review by the Epilepsy Foundation. Epilepsia 2022, 63: 739-768. PMID: 35132632, DOI: 10.1111/epi.17175.Peer-Reviewed Original ResearchConceptsPhotosensitive seizuresAntiseizure drugsPhotoparoxysmal responseEpilepsy FoundationPrevention of seizuresLight-induced seizuresWhite matter tractsSignificant public health hazardSpontaneous seizuresNonsystematic literature reviewGeneralized epilepsyPublic health hazardPhotosensitivity modelAbnormal connectivityOccipital cortexProvocative stimuliSeizuresVisual fieldVisual stimulationBrain imagingColor flashesUpdated reviewEpilepsySelection biasDrugsDecisions With Patients and Families Regarding Aducanumab in Alzheimer Disease, With Recommendations for Consent
Chiong W, Tolchin BD, Bonnie RJ, Busl K, Cruz-Flores S, Epstein LG, Greene EP, Illes J, Kirschen M, Larriviere DG, Mantri S, Rubin MA, Stern BJ, Taylor LP. Decisions With Patients and Families Regarding Aducanumab in Alzheimer Disease, With Recommendations for Consent. Neurology 2022, 98: 154-159. PMID: 34789544, DOI: 10.1212/wnl.0000000000013053.Peer-Reviewed Original Research
2021
Neurology residents’ education in functional seizures
Milligan T, Yun A, LaFrance W, Baslet G, Tolchin B, Szaflarski J, Wong V, Plioplys S, Dworetzky B. Neurology residents’ education in functional seizures. Epilepsy & Behavior Reports 2021, 18: 100517. PMID: 35243288, PMCID: PMC8857462, DOI: 10.1016/j.ebr.2021.100517.Peer-Reviewed Original ResearchFunctional neurological disorderFunctional seizuresNeurology residentsNeurology residency program directorsResidency program directorsEpilepsy monitoring unitEvidence-based treatmentsNeurology resident educationProgram directorsLow response rateResponse rateNeurological disordersFrequent settingPatientsMajority of programsDiagnosisNeurology residencySeizuresClinical rotationsResident educationTreatmentResidencyCurriculum gapsStandardized modelDidactic lecturesAntiseizure Medication Withdrawal in Seizure-Free Patients: Practice Advisory Update Summary
Gloss D, Pargeon K, Pack A, Varma J, French JA, Tolchin B, Dlugos DJ, Mikati MA, Harden C. Antiseizure Medication Withdrawal in Seizure-Free Patients: Practice Advisory Update Summary. Neurology 2021, 97: 1072-1081. PMID: 34873018, DOI: 10.1212/wnl.0000000000012944.Peer-Reviewed Original ResearchConceptsAntiseizure medicationsSeizure recurrenceSeizure freedomASM withdrawalPediatric patientsInsufficient evidenceAntiseizure medication withdrawalSeizure-free adultsSeizure-free patientsNeurology practice parameterSignificant differencesLong-term riskQuality of lifeMedication withdrawalStatus epilepticusEpilepsy surgeryPractice parametersRecurrencePatientsAmerican AcademyEpileptiform EEGMonthsWithdrawalAdultsRiskReflections 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-19ScoresHow to do things with words Two seminars on the naming of functional (psychogenic, non-epileptic, dissociative, conversion, …) seizures
Wardrope A, Dworetzky BA, Barkley GL, Baslet G, Buchhalter J, Doss J, Goldstein LH, Hallett M, Kozlowska K, LaFrance WC, McGonigal A, Mildon B, Oto M, Perez DL, Riker E, Roberts NA, Stone J, Tolchin B, Reuber M. How to do things with words Two seminars on the naming of functional (psychogenic, non-epileptic, dissociative, conversion, …) seizures. Seizure 2021, 93: 102-110. PMID: 34740139, PMCID: PMC9308960, DOI: 10.1016/j.seizure.2021.10.016.Peer-Reviewed Original ResearchConceptsPsychogenic non-epileptic seizuresNon-epileptic attack disorderFunctional seizuresDissociative seizuresNon-epileptic seizuresAmerican Epilepsy SocietyHealth care systemNew diagnostic labelSynchronous electrical activityPatient responseDifferential diagnosisEpilepsy SocietyAttack disorderConversion disorderEpileptic seizuresSeizuresCare systemElectrical activityDiagnostic labelsDiagnosisDisordersEpilepsyPseudoseizuresBrainParoxysmsFunctional seizures are not less important than epilepsy
Asadi-Pooya AA, Brigo F, Tolchin B, Valente KD. Functional seizures are not less important than epilepsy. Epilepsy & Behavior Reports 2021, 16: 100495. PMID: 34805820, PMCID: PMC8585631, DOI: 10.1016/j.ebr.2021.100495.Peer-Reviewed Original ResearchThe role of evidence-based guidelines in the diagnosis and treatment of functional neurological disorder
Tolchin B, Baslet G, Carson A, Dworetzky BA, Goldstein LH, LaFrance WC, Martino S, Perez DL, Reuber M, Stone J, Szaflarski JP. The role of evidence-based guidelines in the diagnosis and treatment of functional neurological disorder. Epilepsy & Behavior Reports 2021, 16: 100494. PMID: 34877515, PMCID: PMC8627961, DOI: 10.1016/j.ebr.2021.100494.Peer-Reviewed Original ResearchEvidence-based guidelinesClinical practice guidelinesPractice guidelinesEvidence-based clinical practice guidelinesFunctional neurological disorderCare of peopleMental health cliniciansFormal clinical trainingInterdisciplinary careBody of evidenceFunctional seizuresHealth cliniciansPsychiatric disordersGuideline developmentNeurological disordersPatient careSystematic reviewAmerican AcademyAmerican Psychiatric AssociationDisorder subtypesMultidisciplinary teamworkDiagnosisCarePsychiatric AssociationTreatmentRacial 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 toolHow Should Clinicians Minimize Harms and Maximize Benefits When Diagnosing and Treating Disorders Without Biomarkers?
Tolchin B, Tolchin DW, Stein MA. How Should Clinicians Minimize Harms and Maximize Benefits When Diagnosing and Treating Disorders Without Biomarkers? The AMA Journal Of Ethic 2021, 23: e530-536. PMID: 34351262, DOI: 10.1001/amajethics.2021.530.Peer-Reviewed Original ResearchAuthor Response: AAN Position Statement: Ethical Issues in Clinical Research in Neurology.
Tolchin B, Conwit R, Epstein L, Russell J. Author Response: AAN Position Statement: Ethical Issues in Clinical Research in Neurology. Neurology 2021, 96: 409. PMID: 38124246, DOI: 10.1212/wnl.0000000000011475.Peer-Reviewed Original ResearchFunctional Seizures
Marcolini E, Tolchin B. Functional Seizures. Emergency Medicine Clinics Of North America 2021, 39: 123-132. PMID: 33218653, DOI: 10.1016/j.emc.2020.09.007.Peer-Reviewed Original ResearchConceptsFunctional seizuresEpileptic seizuresFunctional neurologic disordersElectroencephalography findingsPsychogenic seizuresTherapeutic challengeClinical historyEpileptic dischargesNeurologic disordersConversion disorderSeizuresMental illnessBiopsychosocial modelDisordersSocial factorsSymptomsIllness
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