Linking Ambulance Trip and Emergency Department Surveillance Data on Opioid-Related Overdose, Massachusetts, 2017

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 47S-53S
Author(s):  
Catherine Rahilly-Tierney ◽  
Arman Altincatal ◽  
Anna Agan ◽  
Stefanie Albert ◽  
Rosa Ergas ◽  
...  
Keyword(s):  
Emergency Department ◽  
Linked Data ◽  
Opioid Overdose ◽  
Data Sets ◽  
Unique Identifier ◽  
Data Set ◽  
Chief Complaints ◽  
Ed Visits ◽  
Data Source ◽  
Counter Data

Objectives Studies describing linkage of ambulance trips and emergency department (ED) visits of patients with opioid-related overdose (ORO) are limited. We linked records of patients experiencing ORO from ambulance trip and ED visit records in Massachusetts during April 1–June 30, 2017. Methods We estimated the positive predictive value of ORO-capturing definitions by examining the narratives and triage notes of a sample of OROs from each data source. Because of a lack of common unique identifiers, we deterministically linked OROs to records in the counter data set on date of birth, incident date, facility, and sex. To validate the linkage strategy, we compared ambulance trip narratives with ED triage notes and chief complaints for a sample of pairs. Results Of 3203 ambulance trips for ORO and 3046 ED visits for ORO, 82% and 63%, respectively, matched a record in the counter data set on date of birth, incident date, facility, and sex. In 200 randomly selected linked pairs from a final linked data set of 3006 paired records, only 5 (3%) appeared to be false matches. Practice Implications This exercise demonstrated the feasibility of linking ORO records between 2 data sets without a unique identifier. Future analyses of the linked data could produce insights not available from analyzing either data set alone. Linkage using 2 rapidly available data sets can actively inform the state’s public health opioid overdose response and allow for de-duplicating counts of OROs treated by ambulance, in an ED, or both.

Heat Waves and Emergency Department Visits Among the Homeless, San Diego, 2012–2019

2022 ◽  
Vol 112 (1) ◽  
pp. 98-106
Author(s):  
Lara Schwarz ◽  
Edward M. Castillo ◽  
Theodore C. Chan ◽  
Jesse J. Brennan ◽  
Emily S. Sbiroli ◽  
...  
Keyword(s):  
Emergency Department ◽  
San Diego ◽  
Heat Waves ◽  
Positive Association ◽  
Emergency Department Visits ◽  
Psychiatric Consultation ◽  
Vulnerability Factors ◽  
Exact Matching ◽  
Data Set ◽  
Ed Visits

Objectives. To determine the effect of heat waves on emergency department (ED) visits for individuals experiencing homelessness and explore vulnerability factors. Methods. We used a unique highly detailed data set on sociodemographics of ED visits in San Diego, California, 2012 to 2019. We applied a time-stratified case–crossover design to study the association between various heat wave definitions and ED visits. We compared associations with a similar population not experiencing homelessness using coarsened exact matching. Results. Of the 24 688 individuals identified as experiencing homelessness who visited an ED, most were younger than 65 years (94%) and of non-Hispanic ethnicity (84%), and 14% indicated the need for a psychiatric consultation. Results indicated a positive association, with the strongest risk of ED visits during daytime (e.g., 99th percentile, 2 days) heat waves (odds ratio = 1.29; 95% confidence interval = 1.02, 1.64). Patients experiencing homelessness who were younger or elderly and who required a psychiatric consultation were particularly vulnerable to heat waves. Odds of ED visits were higher for individuals experiencing homelessness after matching to nonhomeless individuals based on age, gender, and race/ethnicity. Conclusions. It is important to prioritize individuals experiencing homelessness in heat action plans and consider vulnerability factors to reduce their burden. (Am J Public Health. 2022;112(1):98–106. https://doi.org/10.2105/AJPH.2021.306557 )

Abstract WP289: Increasing Emergency Department Use of Advanced Neuroimaging in the Mechanical Thrombectomy Era

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Lauren E Mamer ◽  
Keith E Kocher ◽  
James Cranford ◽  
Phillip A Scott
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Mechanical Thrombectomy ◽  
Ct Perfusion ◽  
Mandatory Reporting ◽  
Data Set ◽  
Stroke Treatment ◽  
Mri Brain ◽  
Ed Visits ◽  
Prospective Longitudinal

Introduction: Data supporting mechanical thrombectomy substantially expanded both the time available for treatment and need for advanced neuroimaging in patients with suspected stroke. These factors potentially increase emergency department (ED) use of neuroimaging resources, though the existence and magnitude of effect is unknown, particularly in a broad hospital population including non-stroke center emergency departments. Hypothesis: ED use of CT-angiography (CTA) and CT-Perfusion (CTP) imaging is both increasing and accelerating from 2013 to 2018. Methods: Prospective, longitudinal, single-state cohort study of ED visits using existing California OSHPD dataset (a mandatory reporting database of all CA-licensed, non-federal, emergency department encounters either discharged or transferred) from 2013 to 2018. NCHCT (CPT 70450), CTA Head (CPT 70496), CTP (CPT 0042T) and MRI Brain (CPT 70553) use in the data set, as determined by Common Procedural Terminology (CPT) codes, was analyzed using descriptive statistics and tests of comparison. Results: All advanced neuroimaging increased during the period. Use of NCHCT increased 61% over the study period, from 2,432 to 3,922 per 100,000 ED visits (p trend < .001). Use of CTA increased 405%, from 39 to 197 per 100,000 encounters (p trend < .001). Use of CTP increased 230%, from 3 to 10 per 100,000 encounters (p trend < .001). Use of MRI Brain increased 19%, from 52 to 62 per 100,000 encounters (p trend < .001). On a year-over-year basis, both CTA and CTP use is accelerating, with substantial increases noted between 2017 and 2018. Conclusions: We identified recent, substantial, temporal changes in CTA and CTP neuroimaging acquisition among CA emergency departments in the nascent mechanical thrombectomy era. Dramatic changes in CTA and CTP use suggest that changes are occurring in ED evaluation of neurological emergencies. If true, this differs substantially from the speed of ED acceptance of rt-PA for stroke treatment. Further analysis from the CA OSHPD and other (NEDS) datasets is planned to better understand the patient, hospital, and clinical factors driving these neuroimaging trends in the ED.

scholarly journals Emergency Department Visits for Opioid Overdoses Among Patients With Cancer

2019 ◽  
Vol 112 (9) ◽  
pp. 938-943 ◽  
Author(s):  
Vikram Jairam ◽  
Daniel X Yang ◽  
James B Yu ◽  
Henry S Park
Keyword(s):  
At Risk ◽  
Emergency Department ◽  
Statistical Tests ◽  
Temporal Trends ◽  
The United States ◽  
Emergency Department Visits ◽  
Multivariable Logistic Regression Analysis ◽  
Opioid Overdose ◽  
Patients With Cancer ◽  
Ed Visits

Abstract Background Patients with cancer may be at risk of high opioid use due to physical and psychosocial factors, although little data exist to inform providers and policymakers. Our aim is to examine overdoses from opioids leading to emergency department (ED) visits among patients with cancer in the United States. Methods The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample was queried for all adult cancer-related patient visits with a primary diagnosis of opioid overdose between 2006 and 2015. Temporal trends and baseline differences between patients with and without opioid-related ED visits were evaluated. Multivariable logistic regression analysis was used to identify risk factors associated with opioid overdose. All statistical tests were two-sided. Results Between 2006 and 2015, there were a weighted total of 35 339 opioid-related ED visits among patients with cancer. During this time frame, the incidence of opioid-related ED visits for overdose increased twofold (P &lt; .001). On multivariable regression (P &lt; .001), comorbid diagnoses of chronic pain (odds ratio [OR] 4.51, 95% confidence interval [CI] = 4.13 to 4.93), substance use disorder (OR = 3.54, 95% CI = 3.28 to 3.82), and mood disorder (OR = 3.40, 95% CI = 3.16 to 3.65) were strongly associated with an opioid-related visit. Patients with head and neck cancer (OR = 2.04, 95% CI = 1.82 to 2.28) and multiple myeloma (OR = 1.73, 95% CI = 1.32 to 2.26) were also at risk for overdose. Conclusions Over the study period, the incidence of opioid-related ED visits in patients with cancer increased approximately twofold. Comorbid diagnoses and primary disease site may predict risk for opioid overdose.

Emergency department visits for prescription and synthetic opioid overdoses among patients with cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6579-6579
Author(s):  
Vikram Jairam ◽  
Daniel X. Yang ◽  
James B. Yu ◽  
Henry S. Park
Keyword(s):  
Cervical Cancer ◽  
Emergency Department ◽  
Cancer Patients ◽  
The United States ◽  
Emergency Department Visits ◽  
Cancer Site ◽  
Opioid Overdose ◽  
Patients With Cancer ◽  
Rate Of Increase ◽  
Ed Visits

6579 Background: Patients with cancer may be at high risk of opioid dependence due to physical and psychosocial factors, although little data exists to inform providers and policymakers. Our aim is to examine overdoses from prescription and synthetic opiates leading to emergency department (ED) visits among patients with cancer in the United States. Methods: The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample (HCUP-NEDS) was queried for all patient visits with a primary diagnosis of prescription or synthetic opioid overdose between 2006 and 2015. Baseline differences between patients with and without cancer were assessed using chi-square and ANOVA testing. Overdose rates by primary cancer site were normalized using prevalence data from the Surveillance, Epidemiology, and End Results (SEER) Program. Weighted frequencies were used to create national estimates for all data analyses. Results: There were 682,820 weighted ED visits for synthetic opioid overdose, among which 34,547 (5.1%) visits were also associated with a diagnosis of cancer. During this timeframe, ED visits for opioid overdose among patients with cancer increased 2.5-fold, compared to 1.7-fold among those without cancer. 16.5% of patients with cancer had metastatic disease. Patients with cancer presenting for opioid overdose had higher risk of hospital admission (74.8% vs 49.6%), respiratory intubation (13.2% vs 12.2%), mortality (2.1% vs 1.1%), and cost-of-hospital-stay ($32,665 vs $31,824) compared to their non-cancer counterparts (all P < 0.05). Primary cancers with the highest normalized overdose rates (ED visits per 10,000 patients) were esophagus (134), liver & intrahepatic bile duct (124), and cervical cancer (124). Other common cancers had the following normalized overdose rates: lung (105), head and neck (70), and breast (26). Conclusions: Approximately 5% of all ED visits due to prescription and synthetic opioid overdose are among patients with cancer. The rate of increase in ED visits due to opioid overdose from cancer patients was nearly 50% higher than that from non-cancer patients over the 10-year study period. Patients with esophageal, liver, and cervical cancer may be at highest risk.

scholarly journals THE INFLUENCE OF MAGNITUDES TYPES IN THE NONEXTENSIVITY APPLIED AT THE CIRCUM-PACIFIC SUBDUCTION ZONES

2018 ◽  
Vol 36 (4) ◽  
pp. 1
Author(s):  
Thaís Machado Scherrer ◽  
George Sand França ◽  
Raimundo Silva ◽  
Daniel Brito de Freitas ◽  
Carlos da Silva Vilar
Keyword(s):  
Solid Earth ◽  
Subduction Zone ◽  
Subduction Zones ◽  
Time Interval ◽  
Data Sets ◽  
Data Set ◽  
Different Types ◽  
Data Source ◽  
The Impact

ABSTRACT. Following our own previous work, we reanalyze the nonextensive behavior over the circum-Pacific subduction zones evaluating the impact of using different types of magnitudes in the results. We used the same data source and time interval of our previous work, the NEIC catalog in the years between 2001 and 2010. Even considering different data sets, the correlation between q and the subduction zone asperity is perceptible, but the values found for the nonextensive parameter in the considered data sets presents an expressive variation. The data set with surface magnitude exhibits the best adjustments.Keywords: Nonextensivity, Seismicity, Solid Earth, Earthquake.RESUMO. No mesmo caminho do nosso trabalho anterior, reanalisamos o comportamento não extensivo sobre as zonas de subducção do círcuo de fogo do Pacífico, avaliando o impacto do uso de diferentes tipos de magnitude nos resultados. Utilizamos o mesmo intervalo de dados e fonte de nosso trabalho anterior, do catálogo NEIC entre os anos 2001 e 2010. Mesmo considerando diferentes conjuntos de dados, a correlação entre q e a aspereza das zonas de subducção é perceptível, mas os valores encontrados para o parâmetro não extensivo no conjuntos de dados considerados apresentam uma variação expressiva. O conjunto de dados com magnitude de superfície exibe os melhores ajustes.Palavras-chave: Não extensividade, Sismicidade, Terra Sólida, Terremotos.

scholarly journals Social Determinants of Emergency Department Visits in Mild Compared To Moderate and Severe Asthma

2021 ◽  
Author(s):  
Kamel Alachraf ◽  
Caroline Currie ◽  
William Wooten ◽  
Dmitry Tumin
Keyword(s):  
Emergency Department ◽  
Severe Asthma ◽  
Social Determinants ◽  
Insurance Coverage ◽  
Asthma Severity ◽  
Emergency Department Visits ◽  
Data Set ◽  
The Past ◽  
Children With Asthma ◽  
Ed Visits

Abstract Social determinants of health (SDH) influence emergency department (ED) use among children with asthma. We aimed to examine if SDH were more strongly associated with ED use among children with moderate/severe compared to mild asthma. This study utilized the 2016-2019 data from the National Survey of Children’s Health. Children with asthma ages 0-17 years (N=9,937) were included in the analysis. Asthma severity and all-cause ED use in the past year were reported by caregivers. The association between patient factors and ED visits was evaluated using ordinal logistic regression. Based on the study sample, 29% of children with asthma had moderate/severe asthma. In the mild group, 30% visited the ED at least once in the past 12 months, compared to 49% in the moderate/severe group. SDH associated with ED visits included race/ethnicity, insurance coverage, and parental educational attainment, but the strength of these associations did not vary according to asthma severity. In a nationally-representative data set, SDH were equally predictive of ED use regardless of children’s asthma severity. Interventions to reduce ED use among children with asthma should be considered for children with any severity of asthma, especially children in socially disadvantaged groups at higher risk of ED utilization.

Hybrid Query Execution on Linked Data With Complete Results

2021 ◽  
Vol 17 (1) ◽  
pp. 25-49
Author(s):  
Samita Bai ◽  
Shakeel A. Khoja
Keyword(s):  
Linked Data ◽  
Real Data ◽  
Original Data ◽  
Query Execution ◽  
Data Set ◽  
Source Selection ◽  
Start Up ◽  
Query Logs ◽  
Data Source ◽  
Query Patterns

The link traversal strategies to query Linked Data over WWW can retrieve up-to-date results using a recursive URI lookup process in real-time. The downside of this approach comes with the query patterns having subject unbound (i.e. ?S rdf:type:Class). Such queries fail to start up the traversal process as the RDF pages are subject-centric in nature. Thus, zero-knowledge link traversal leads to the empty query results for these queries. In this paper, the authors analyze a large corpus of real-world SPARQL query logs and identify the Most Frequent Predicates (MFPs) occurring in these queries. The knowledge of these MFPs helps in finding and indexing a limited number of triples from the original data set. Additionally, the authors propose a Hybrid Query Execution (HQE) approach to execute the queries over this index for initial data source selection followed by link traversal process to fetch complete results. The evaluation of HQE on the latest real data benchmarks reveals that it retrieves at least five times more results than the existing approaches.

How to evaluate rainfall estimation performance? - A discussion of metrics, thresholds and aggregations for one year of country-wide CML rainfall estimation

2020 ◽  
Author(s):  
Maximilian Graf ◽  
Christian Chwala ◽  
Julius Polz ◽  
Harald Kunstmann
Keyword(s):  
Performance Metrics ◽  
Temporal Aggregation ◽  
Data Sets ◽  
Rainfall Estimation ◽  
Data Set ◽  
Data Source ◽  
One Year ◽  
Point Line ◽  
Rain Rates ◽  
The Impact

&lt;p&gt;In recent years, so-called opportunistic sensors for measuring rainfall, are attracting more notice due to their broad availability and low financial effort for the scientific community. These sensors are existing devices or infrastructure, which were not intentionally built to measure rainfall, but can deliver rainfall information. One example of such an opportunistic measurement system are Commercial Microwave Links (CMLs), which provide part of the backbone of modern mobile communication. CMLs can deliver path-averaged rainfall information through the relation between rainfall and attenuation along their paths. Before such an opportunistic data source can be used, either as an individual or a merged data product, its performance compared to other rainfall products must be evaluated.&lt;/p&gt;&lt;p&gt;We discuss the selection of performance metrics, spatial and temporal aggregation and rainfall thresholds for the comparison between a German-wide CML network and a gauge-adjusted radar product provided by the German Weather Service. The CML data set consists of nearly 4000 CMLs with minutely readings from which we will present a year of data.&amp;#160;&lt;/p&gt;&lt;p&gt;First, we show the influence of the temporal aggregation on the comparability. With higher resolution, the impact due to small temporal deviations increases. Second, CMLs represent path-averaged rainfall information, while the radar product is gridded. We discuss the choice whether the comparison should be performed on the point, line or grid scale. This choice depends on the desired future applications which already should be considered when selection evaluation tools. Third, the decision to exclude rain rates below a certain threshold or the calculation of performance metrics for certain intervals gives us a more detailed insight in the behavior of both rainfall data sets.&lt;/p&gt;

scholarly journals Revisits within 48 Hours to a Thai Emergency Department

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jiraporn Sri-on ◽  
Adisak Nithimathachoke ◽  
Gregory Philip Tirrell ◽  
Sataporn Surawongwattana ◽  
Shan Woo Liu
Keyword(s):  
Emergency Department ◽  
Chart Review ◽  
Tertiary Care ◽  
Related Factor ◽  
Contributing Factors ◽  
Related Factors ◽  
Chief Complaints ◽  
Ed Visits ◽  
The Mean ◽  
Patient Related Factor

Objective. Emergency department (ED) revisits are a common ED quality measure. This study was undertaken to ascertain the contributing factors of revisits within 48 hours to a Thai ED and to explore physician-related, illness-related, and patient-related factors behind those revisits.Methods. This study was a chart review from one tertiary care, urban Thai hospital from October 1, 2009, to September 31, 2010. We identified patients who returned to the ED within 48 hours for the same or related complaints after their initial discharge. Three physicians classified revisit as physician-related, illness-related, and patient-related factors.Results. Our study included 172 ED patients’ charts. 86/172 (50%) were male and the mean age was38 ± 5.6(SD) years. The ED revisits contributing factors were physician-related factors [86/172 (50.0%)], illness-related factors [61/172 (35.5%)], and patient-related factor [25/172 (14.5%)], respectively. Among revisits classified as physician-related factors, 40/86 (46.5%) revisits were due to misdiagnosis and 36/86 (41.9%) were due to suboptimal management. Abdominal pain [27/86 (31.4%)] was the majority of physician-related chief complaints, followed by fever [16/86 (18.6%)] and dyspnea [15/86 (17.4%)].Conclusion. Misdiagnosis and suboptimal management contributed to half of the 48-hour repeat ED visits in this Thai hospital.

Tailoring data source distributions for fairness-aware data integration

2021 ◽  
Vol 14 (11) ◽  
pp. 2519-2532
Author(s):  
Fatemeh Nargesian ◽  
Abolfazl Asudeh ◽  
H. V. Jagadish
Keyword(s):  
Optimal Solution ◽  
Cost Effective ◽  
Data Sources ◽  
Data Sets ◽  
Multiple Sources ◽  
Data Set ◽  
Demographic Groups ◽  
Reward Function ◽  
Effective Manner ◽  
Data Source

Data scientists often develop data sets for analysis by drawing upon sources of data available to them. A major challenge is to ensure that the data set used for analysis has an appropriate representation of relevant (demographic) groups: it meets desired distribution requirements. Whether data is collected through some experiment or obtained from some data provider, the data from any single source may not meet the desired distribution requirements. Therefore, a union of data from multiple sources is often required. In this paper, we study how to acquire such data in the most cost effective manner, for typical cost functions observed in practice. We present an optimal solution for binary groups when the underlying distributions of data sources are known and all data sources have equal costs. For the generic case with unequal costs, we design an approximation algorithm that performs well in practice. When the underlying distributions are unknown, we develop an exploration-exploitation based strategy with a reward function that captures the cost and approximations of group distributions in each data source. Besides theoretical analysis, we conduct comprehensive experiments that confirm the effectiveness of our algorithms.

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