Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Gender bias in cardiovascular testing persists after adjustment for presenting characteristics and cardiac risk.
Previous studies have found that female patients receive fewer invasive tests for cardiovascular disease than male patients. The authors assessed whether different clinical characteristics at emergency department presentation account for this gender bias. ⋯ Female patients with potential ACS receive fewer cardiac catheterizations than male patients, even when presenting complaint, history, ECG, and diagnosis are taken into account. The gender bias cannot be explained by differences in presentation or clinical course.
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In September 2006, the Centers for Disease Control and Prevention released its revised recommendations for human immunodeficiency virus (HIV) testing. Prominent among these were the recommendations that emergency departments should perform routine screening for HIV infection. ⋯ It contains the lessons that were learned when such a program was initiated at an academic emergency department. Consideration of these steps will help streamline the establishment of the program, but there should be careful consideration of the program's costs and sustainability before embarking on the process.
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An emergency medicine (EM) clerkship can provide a medical student with a unique educational experience. The authors sought to describe the current experiential curriculum of the EM clerkship, along with methods of evaluation, feedback, and grading. ⋯ Medical students are exposed to a variety of didactic lectures and procedure labs but have similar experiences regarding shift length and work hours. Methods of evaluation of clinical performance vary across clinical sites.
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Despite its importance in improving patient care, the state of published emergency medicine (EM) research is poorly understood. The countries of origin, methodological characteristics, sources of funding, and ongoing trends in this research are unknown. Knowledge of these characteristics has important policy, research, and clinical implications for academic EM. ⋯ Emergency medicine research output is increasing worldwide. The United States is the largest producer of EM research, only a small fraction of which is supported by the NIH. The majority of research published by emergency researchers is published in non-EM journals.
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In part 1 of this series, the authors describe the importance of incomplete data in clinical research, and provide a conceptual framework for handling incomplete data by describing typical mechanisms and patterns of censoring, and detailing a variety of relatively simple methods and their limitations. In part 2, the authors will explore multiple imputation (MI), a more sophisticated and valid method for handling incomplete data in clinical research. This article will provide a detailed conceptual framework for MI, comparative examples of MI versus naive methods for handling incomplete data (and how different methods may impact subsequent study results), plus a practical user's guide to implementing MI, including sample statistical software MI code and a deidentified precoded database for use with the sample code.