Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
Clinical guidelines have supported outpatient treatment of low-risk pulmonary embolism (PE) since 2014, but adoption of this practice has been slow. Direct oral anticoagulant (DOAC) therapy for venous thromboembolism (VTE) is now as common as vitamin K antagonist treatment, but data are sparse regarding outcomes for patients with low-risk PE treated with DOACs as outpatients. We conducted a systematic review of literature on outcomes of outpatient management for PE, including comparisons to inpatient treatment and differences by anticoagulant class. ⋯ Among patients with low-risk PE treated as outpatients, few patients experienced major adverse outcomes such as mortality, recurrent VTE, or major bleeding within 90 days.
-
Randomized Controlled Trial
Improving Follow-Up Attendance for Discharged Emergency Care Patients Using Automated Phone System to Self-Schedule: A Randomized Controlled Trial.
Automated phone appointment reminders have improved adherence with follow-up appointments in a variety of hospital settings, but have mixed results in patients discharged from the emergency department (ED). Increasing adherence to follow-up care has been a priority in the ED to improve patient outcomes and reduce unnecessary future visits. ⋯ An automated self-scheduling phone system significantly improved follow-up adherence after ED discharge, but did not decrease ED revisits.
-
Meta Analysis
Machine Learning versus Usual Care for Diagnostic and Prognostic Prediction in the Emergency Department: A Systematic Review.
Having shown promise in other medical fields, we sought to determine whether machine learning (ML) models perform better than usual care in diagnostic and prognostic prediction for emergency department (ED) patients. ⋯ Our review suggests that ML may have better prediction performance than usual care for ED patients with a variety of clinical presentations and outcomes. However, prediction model reporting guidelines should be followed to provide clinically applicable data. Interventional trials are needed to assess the impact of ML models on patient-centered outcomes.
-
Randomized Controlled Trial
Rapid Administration of Methoxyflurane to Patients in the Emergency Department (RAMPED) Study: A Randomised controlled trial of Methoxyflurane vs Standard care.
The objective was to evaluate the effectiveness of methoxyflurane versus standard care for the initial management of severe pain among adult emergency department (ED) patients. ⋯ Initial management with inhaled methoxyflurane in the ED did not achieve the prespecified substantial reduction in pain, but was associated with clinically significant lower pain scores compared to standard therapy.