Articles: hospital-emergency-service.
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Randomized Controlled Trial
Exploring differential response to an emergency department-based care transition intervention.
To identify multivariable subgroups of patients with differential responses to a nurse-delivered care transition intervention after an emergency department (ED) visit in a randomized controlled trial (RCT) using an emerging data-driven method. ⋯ Although exploratory, the results of the MoB analysis suggest that patient factors related to social relationships such as marital status may be important contributors to differential response to a care transition intervention after an ED visit. These were characteristics that the investigators had not anticipated or planned to examine in the individual prespecified subgroup analysis. Data-driven methods can yield unexpected findings and contribute to a more complete understanding of differential treatment effects in subgroup analysis, which can inform further work on development of effective care transition interventions in the ED setting.
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Pediatric emergency care · Dec 2021
Randomized Controlled TrialManagement of Wheezy Preschoolers in the Emergency Department: A Discrete Choice Experiment.
This study aimed to elicit pediatric emergency physician's treatment choices for preschool-aged children with wheeze, determine the characteristics of the presenting child that influence treatment choices, and determine whether there is clinical equipoise by eliciting physician willingness to enroll these children in a placebo-controlled trial of corticosteroids. ⋯ Physician treatment choices varied widely indicating clinical equipoise as to the effectiveness of corticosteroids in this population of patients. Management choices with respect to albuterol and corticosteroids were not consistent with published national and international guidelines. In line with this finding, physician's considerable willingness to enroll these children in an RCT may suggest that they are seeking guidance on how to manage these patients.
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Randomized Controlled Trial
Predictive Model-Driven Hotspotting to Decrease Emergency Department Visits: a Randomized Controlled Trial.
Emergency department (ED) visits contribute substantially to health care expenditures. Case management has been proposed as a strategy to address the medical and social needs of complex patients. However, strong research designs to evaluate the effectiveness of such interventions are limited. ⋯ The community case management intervention targeting ED visits was not associated with reduced utilization. Future case management interventions may benefit from additional patient engagement strategies and longer evaluation time periods.
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Pediatric emergency care · Aug 2021
Randomized Controlled TrialDo Parents of Discharged Pediatric Emergency Department Patients Read Discharge Instructions?
The percentage of discharged emergency department (ED) patients who read discharge instructions (DCIs) is unknown. In this study of parents of pediatric ED patients, we attempt to quantify the DCI readership rate and identify variables associated with readership. We hypothesized that few families would read their child's DCIs. ⋯ A minority of parents of patients discharged from the pediatric ED appear to read through their child's DCIs, with Hispanic families and those without private insurance least likely to read. Future research can explore how best to reach these particularly vulnerable families.
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Randomized Controlled Trial
Efficacy of emergency medical center use of a protocol during telephone calls to give medical advice related to fever or gastroenteritis: a cluster randomized controlled trial.
To determine the efficacy of emergency medical center physicians' use of a protocol to guide their management of telephone consultations for fever and gastroenteritis. ⋯ Use of the protocol was associated with fewer unscheduled in-person visits for care and fewer hospital admissions. The protocol is safe and less costly than the centers' usual approaches to giving telephone advice.