Examining black and white racial disparities in emergency department consultations by age and gender

Background: Trauma, one of the major concerns in today’s world, exposes societies to important economic, social and health-related problems. Trauma is known to account for 10% of the world’s deaths. Objective: The aim of the study is to evaluate the demographic characteristics of trauma, which is common in emergency services and causes significant loss of workload and function when appropriate diagnosis and treatment methods are not applied, with radiological imaging methods, pain scale and analgesics. Materials and Methods: This prospective study included 1267 patients over the age of 18, who were admitted to the emergency department due to trauma between 1 January and 31 December 2019. The mean age of patients was 47.01 ± 14.97 year, with a male/female ratio of 1.46. 59.3% of the patients were male and 40.7% were female. Patients’ trauma types, radiology results, mortality, numerical pain scale and analgesic administration were evaluated. Results: Numerical pain scale score of trauma patients in the emergency department was 6.23 ± 2.02. Analysis of radiological imaging methods showed significance with age, numerical pain scale, thoracic and lumbar vertebrae, thoracic and abdominal injuries, types of trauma, consultation, hospitalization, analgesics administration and pain severity. Trauma types were insignificant with age and gender, but a significant relationship was found with all other parameters. Pain intensity was not correlated with gender and tetanus application but was significant with other variables. There was significance in radiological imaging methods and diagnostic types between injury types. Types of diagnosis were found to be correlated with imaging methods, orthopedic consultation, numerical pain scale and injury types. There was a significant correlation with the types of diagnosis, analgesia administration, consultation, and pain classification according to the pain rating scale. There was no correlation between age and gender according to pain intensity. However, there was a strong positive correlation with pain scale scores, consultation, hospitalization, types of trauma, administration of analgesia, and a weak correlation with radiological imaging methods. Conclusion: Early pain scale with radiological imaging and analgesic administration in trauma patients can reduce morbidity rates and shorten hospital stay.

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Study of Age and Gender Predilections amongst the Victims of Burns of Domestic Violence

10.53350/pjmhs2115102724 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2724-2725

Author(s):

Javaid Munir ◽

Zulfiqar Ali Buzdar ◽

Zia ul Haq ◽

Muhammad Anwar Sibtain Fazli ◽

Fakhar uz Zaman

Keyword(s):

Emergency Department ◽

Human Life ◽

Age Groups ◽

Gender Disparity ◽

Age And Gender ◽

Heating Mechanism ◽

Accident And Emergency ◽

Accident And Emergency Department ◽

And Gender ◽

Medical University

Background: Human life from conception till death needs some sources of energy or heating mechanism to advance from a day to another in the process of livelihood. From innocent infants falling victims to fires, toddlers to scalds, youth to vitriolage and elders to enmity of a variety of sources or to their own debilitation bring them close to the fire source let them fell a prey to burns. Aim: To observe the age and gender predilections amongst the victims of burns Methods: The study was carried out among 250 victims of burns presented from December 2017 to August 2018 and reported in the Accident and Emergency Department of Mayo Hospital Lahore and filtered in Medicolegal Clinic of King Edward Medical University Lahore. Results: The study revealed maximum involvement of pediatric and geriatric age groups falling victim to burn incidents. In an analysis as a whole almost 84% victims were belonging to these two extremes of ages. Gender disparity showed a slight difference of just 10% showing female preponderance being exposed to burns. Keywords: Burns, Age, Gender, Variation, Disparity

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Racial disparities in automated speech recognition

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1915768117 ◽

2020 ◽

Vol 117 (14) ◽

pp. 7684-7689 ◽

Cited By ~ 8

Author(s):

Allison Koenecke ◽

Andrew Nam ◽

Emily Lake ◽

Joe Nudell ◽

Minnie Quartey ◽

...

Keyword(s):

Speech Recognition ◽

Racial Disparities ◽

Large Scale ◽

Machine Learning Algorithms ◽

Structured Interviews ◽

Black And White ◽

Closed Captioning ◽

Vernacular English ◽

Automated Speech Recognition ◽

And Gender

Automated speech recognition (ASR) systems, which use sophisticated machine-learning algorithms to convert spoken language to text, have become increasingly widespread, powering popular virtual assistants, facilitating automated closed captioning, and enabling digital dictation platforms for health care. Over the last several years, the quality of these systems has dramatically improved, due both to advances in deep learning and to the collection of large-scale datasets used to train the systems. There is concern, however, that these tools do not work equally well for all subgroups of the population. Here, we examine the ability of five state-of-the-art ASR systems—developed by Amazon, Apple, Google, IBM, and Microsoft—to transcribe structured interviews conducted with 42 white speakers and 73 black speakers. In total, this corpus spans five US cities and consists of 19.8 h of audio matched on the age and gender of the speaker. We found that all five ASR systems exhibited substantial racial disparities, with an average word error rate (WER) of 0.35 for black speakers compared with 0.19 for white speakers. We trace these disparities to the underlying acoustic models used by the ASR systems as the race gap was equally large on a subset of identical phrases spoken by black and white individuals in our corpus. We conclude by proposing strategies—such as using more diverse training datasets that include African American Vernacular English—to reduce these performance differences and ensure speech recognition technology is inclusive.

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Etiology and outcome of patients presenting for poisoning to the emergency department in Taiwan: a prospective study

Human & Experimental Toxicology ◽

10.1177/0960327108094609 ◽

2008 ◽

Vol 27 (5) ◽

pp. 373-379 ◽

Cited By ~ 22

Author(s):

H-L Lee ◽

H-J Lin ◽

ST-Y Yeh ◽

C-H Chi ◽

H-R Guo

Keyword(s):

Emergency Department ◽

Prospective Study ◽

Age Groups ◽

Food Poisoning ◽

Relevant Information ◽

Age And Gender ◽

Female Ratio ◽

And Gender ◽

Gender Groups ◽

A Prospective Study

Poisoning is one of the most common reasons for visiting the emergency department in many countries, and the pattern varies from countries to countries and time to time. To compare the etiology and outcome of poisoning patients in different gender and age groups, we conducted a prospective study at the emergency departments of two medical centers in southern Taiwan between January 2001 and December 2002. All cases of poisoning, excluding patients diagnosed as cases of alcohol or food poisoning, were included, and relevant information was collected. There were 1512 cases of poisoning observed with a male to female ratio of 1:1.2 (684/828). Overall, drugs (49.9%) were the main agents involved, and a suicidal attempt (66.1%) was the predominant etiology. A total of 63 fatalities (4.2%) were observed and pesticides, especially paraquat, resulted in most fatalities. Patients aged 19–30 years constituted the most cases, and significant differences in exposure agents, causes, and fatality rates were found among different age and gender groups. The results are compatible with the trend reported by other Asian countries. This study also shows important differences existing in poisoning patients of different age and gender groups. Therefore, different poisoning-prevention strategies should be applied to different groups.

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Impact of the COVID-19 Lockdown on Ophthalmological Assistance in the Emergency Department at a Spanish Primary Level Hospital

Journal of Ophthalmology ◽

10.1155/2021/8023361 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Julio González-Martín-Moro ◽

Elena Guzmán-Almagro ◽

Carlos Izquierdo Rodríguez ◽

Ana Fernández Hortelano ◽

Inmaculada Lozano Escobar ◽

...

Keyword(s):

Emergency Department ◽

Electronic Medical Records ◽

Medical Records ◽

Ocular Tissue ◽

Clinical Expression ◽

Age And Gender ◽

Primary Level ◽

And Gender ◽

Level Hospital ◽

Similar Decrease

Purpose. To analyze the changes in ophthalmological emergencies during the COVID-19 pandemic lockdown at a Spanish primary level hospital. Methods. The number and type of emergencies attended in the emergency department of Hospital Universitario del Henares between March 10 and August 31, 2020 (COVID-19 cohort) were compared with the emergencies attended during the same period of 2019 (pre-COVID-19 cohort). Data on the diagnosis, patient age, and gender was retrospectively collected from the electronic medical records of the hospital. The different diagnoses were organized into “clusters,” which include those conditions that affect the same ocular tissue and that have similar clinical expression. Results. The number of ophthalmological emergencies during the study period was 841, compared to 1343 during the same month of 2019, which represents a reduction of 37.4%. The percentage reduction in each cluster was as follows: conjunctiva (−65.4%), cornea (−35.8%), uveitis (−3.6%), eyelid and orbital and lacrimal (−35.5%), strabismus (−60%), neuro-ophthalmology (−11.8%), retina (−10.6%), cataract (+16.4%), glaucoma (−37%), and miscellaneous (−45.1%). The number of people seen with viral conjunctivitis decreased by −87.1% compared to 2019. Patients with complications due to conjunctivitis also decreased: patients with pseudomembranes dropped from 16 to 4 cases and patients with corneal subepithelial infiltrates from 9 to 3 cases. Conclusions. Most diagnostic clusters showed a similar decrease. Clusters that included vision-threating conditions (retina, neuro-ophthalmology, and uveitis) remained mostly stable. During the COVID-19 lockdown, the diagnosis of adenoviral conjunctivitis decreased nearly 10 times. This fact may represent a decrease in the transmission of these infections.

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An Emergency Department Management on Acute Asthma Exacerbations in Children Younger than 12 Years

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i52b33600 ◽

2021 ◽

pp. 68-71

Author(s):

Waqas Latif ◽

Rehan Zahoor ◽

Maiera Khalid

Keyword(s):

Emergency Department ◽

Medical Practice ◽

Clinical Audit ◽

Acute Asthma ◽

Asthma Management ◽

Age And Gender ◽

Asthma Exacerbations ◽

Emergency Department Management ◽

And Gender ◽

Acute Asthma Exacerbations

Objectives: The main objective of the study is to clinically audit and analyse the acute asthma exacerbations in children younger than 12 years regarding management of emergency department. Methods: This clinical audit was done in Bahawal Victoria Hospital, Bahawalpur during January 2020 till June 2020. We retrospectively revised all the files of children aged 0–12 years who were visited for acute asthma in the Paediatric ED of Hospital. All the patients with a diagnosis of “acute asthma,” “wheezing bronchitis,” and “bronchospasm” were included. Results: A total of 864 patients were seen in the Emergency Department during the study. Of these, a total of 293 patients were seen for a presentation of acute asthma. As some patients had multiple visits, the 293 records represented 278 unique patients. For assessing age and gender distribution of the patients, only data from the first visit were used. Otherwise, each record was treated independently for the purpose of analyses. Conclusion: It is concluded that acute asthma management still remains an area of medical practice that continues to have long-standing difficulties.

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A qualitative exploration of value and waste in a Trinidadian emergency department patient flow process: perspectives of patients and clinicians

Journal of Health Organization and Management ◽

10.1108/jhom-03-2020-0073 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Loren De Freitas ◽

Steve Goodacre ◽

Rachel O'Hara ◽

Praveen Thokala ◽

Seetharaman Hariharan

Keyword(s):

Emergency Department ◽

Single Case ◽

Patient Flow ◽

Emergency Department Patient ◽

Flow Process ◽

Age And Gender ◽

Content Type ◽

Case Study Design ◽

And Gender

PurposeA process that does not include the customer's value may not be effective in providing care. This study aimed to identify value and waste in an emergency department (ED) patient flow process from a patient and clinician perspective.Design/methodology/approachA qualitative case study was conducted in an ED in Trinidad and Tobago. Observations and informal conversational interviews with clinicians (n = 33) and patients (n = 50) explored patient flow, value and waste. Thematic analysis was used to create a framework on valuable and wasteful aspects in the ED patient flow process.FindingsValuable aspects led to direct improvements in the patient's health or an exchange of information in the process. Wasteful aspects were those with no patient activity, no direct ED clinical involvement, or resulted in a perceived inappropriate use of ED resources. However, there was a disparity in responses between clinicians and patients with clinicians identifying more features in the process.Research limitations/implicationsThe single case study design limits the generalizability of findings to other settings. This study did not specifically explore the influence of age and gender on what mattered to patients in ED services. Future studies would benefit from exploring whether there are any age and gender differences in patient perspectives of value and waste. Further research is needed to validate the usefulness of the framework in a wider range of settings and consider demographic factors such as age and gender.Practical implicationsThe study has produced a framework which may be used to improve patient flow in a way that maximized value to its users. A collaborative approach, with active patient involvement, is needed to develop a process that is valuable to all. The single case study design limits the generalizability of findings to other settings.Originality/valueQualitative methods were used to explicitly explore both value and waste in emergency department patient flow, incorporating the patient perspective. This paper provides an approach that decision makers may use to refine the ED patient flow process into one that flows well, improves quality and maximizes value to its users.

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Signs and Symptoms

Emergency Medicine ◽

10.1093/med/9780190852955.003.0001 ◽

2019 ◽

pp. 1-42

Author(s):

Danielle Holtz

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Emergency Medicine ◽

Pattern Recognition ◽

Correct Diagnosis ◽

Signs And Symptoms ◽

Age And Gender ◽

Disease States ◽

And Gender

Patients present to the emergency department (ED) every day with a constellation of signs and symptoms. It is the emergency medicine physician’s job to recognize these signs and symptoms and make the correct diagnosis. Pattern recognition is essential in emergency medicine. This chapter presents questions that cover a wide variety of classic disease states and conditions that may be seen in the ED. Photographs, radiologic images, and electrocardiograms are provided for some of the questions to aid in diagnosis. Risk factors and associations, including the patient’s age and gender, are included and can offer clues to certain disease processes for which a patient may be at more risk.

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