High speed, high risk: the rise of e-scooter injuries in adolescents.

The popularity of eco-friendly electric scooters has led to a rise in significant injuries, especially in adolescents. Teens riding e-scooters are more prone to severe traffic accidents and head injuries compared to those using traditional scooters. Risk-taking behaviors, susceptibility to peer influence, limited road safety experience and a lack of protective headgear exacerbate the risks.

Harnessing the Power of Generative AI for Clinical Summaries: Perspectives From Emergency Physicians.

Study Objective: The workload of clinical documentation contributes to health care costs and professional burnout. The advent of generative artificial intelligence language models presents a promising solution. The perspective of clinicians may contribute to effective and responsible implementation of such tools.

Impact of a Bronchiolitis Clinical Pathway on Management Decisions by Preferred Language.

Background: Clinical pathways standardize healthcare utilization, but their impact on healthcare equity is poorly understood. This study aims to measure the effect of a bronchiolitis pathway on management decisions by preferred language for care.

Methods: We included all emergency department encounters for patients aged 1-12 months with bronchiolitis from 1/1/2010 to 10/31/2020.

Digital Antimicrobial Stewardship Decision Support to Improve Antimicrobial Management.

Objectives: We sought to create a digital application to support clinicians in empiric and pathogen-directed antibiotic ordering based on local susceptibility patterns and evidence-based treatment durations, thereby promoting antimicrobial stewardship.

Methods: We formed a multidisciplinary team that met bimonthly from 2017 to 2018 to design and construct a web-based antimicrobial stewardship platform called Antibiogram + . We used an iterative and agile technical development process with frequent feedback from clinicians.

Factors associated with first-time and repeat blood donation: Adverse reactions and effects on donor behavior.

Background: Blood centers have a dual mission to protect donors and patients; donor safety is paramount to maintaining an adequate blood supply. Elucidating donor factors associated with adverse reactions (AR) is critical to this mission.

Study Design/methods: A retrospective cohort analysis of whole blood donors from 2003 to 2020 was conducted at a single blood center in northern California.

Physician Risk Perception and Testing Behaviors for Children With Fever.

Objectives: Risk tolerance and risk perceptions may impact clinicians' decisions to obtain diagnostic tests. We sought to determine whether physician risk perception was associated with the decision to obtain blood or imaging tests among children who present to the emergency department with fever.

Methods: We conducted a retrospective, cross-sectional study in the Boston Children's Hospital emergency department.

Prediction across healthcare settings: a case study in predicting emergency department disposition.

Several approaches exist today for developing predictive models across multiple clinical sites, yet there is a lack of comparative data on their performance, especially within the context of EHR-based prediction models. We set out to provide a framework for prediction across healthcare settings. As a case study, we examined an ED disposition prediction model across three geographically and demographically diverse sites.

Prediction of patient disposition: comparison of computer and human approaches and a proposed synthesis.

Objective: To compare the accuracy of computer versus physician predictions of hospitalization and to explore the potential synergies of hybrid physician-computer models.

Materials And Methods: A single-center prospective observational study in a tertiary pediatric hospital in Boston, Massachusetts, United States. Nine emergency department (ED) attending physicians participated in the study.

Long-term Effects of an Evidence-based Guideline for Emergency Management of Pediatric Syncope.

Unlabelled: Variability exists in the management of childhood syncope as clinicians balance resource utilization with the need to identify serious diseases. Limited evidence exists regarding the long-term impact of evidence-based guidelines (EBGs) on clinical practices. This study's objective was to measure long-term changes in the management of syncope after implementing a syncope EBG in a single pediatric emergency department following the redistribution of resources to facilitate compliance over time.

Improving the prediction of streptococcal pharyngitis; time to move past exudate alone.

Background: Palatal petechiae are predictive of Group A streptococcal (GAS) pharyngitis. We sought to (a) quantify the value of considering petechiae in addition to exudate, and (b) assess provider incorporation of petechiae's predictive nature for GAS into clinical decision making.

Methods: We conducted a cross-sectional study of patients 3-21 years with sore throat and GAS testing performed in a pediatric emergency department (ED) in 2016.

Identifying Patients at Lowest Risk for Streptococcal Pharyngitis: A National Validation Study.

Objectives: To determine the prevalence of features of viral illness in a national sample of visits involving children tested for group A Streptococcus pharyngitis. Additionally, we sought to derive a decision rule to identify patients with features of viral illness who were at low risk of having group A Streptococcus and for whom laboratory testing might be avoided.

Study Design: Retrospective validation study using data from electronic health records of patients 3-21 years old evaluated for sore throat in a national network of retail health clinics (n = 67 127).

Attending-Provider Handoffs and Pediatric Emergency Department Revisits.

Objective: The objective of this study was to determine if intradepartment attending-provider transitions of care (handoffs) during a pediatric emergency department (ED) encounter were associated with return ED visits resulting in hospitalization.

Methods: We analyzed ED encounters for patients younger than 21 years discharged from a single pediatric ED from January 2013 to February 2017. We classified an encounter as having a handoff when the initial attending and discharging attending differed.

A Bayesian Spatiotemporal Analysis of Pediatric Group A Streptococcal Infections.

Background: Pharyngitis due to group A (GAS) is a common pediatric infection. Physicians might diagnose GAS pharyngitis more accurately when given biosurveillance information about GAS activity. The availability of geographic GAS testing data may be able to assist with real-time clinical decision-making for children with throat infections.

Impact of viral symptoms on the performance of the modified centor score to predict pediatric group A streptococcal pharyngitis.

Background: Clinicians use the Modified Centor Score (MCS) to estimate the risk of group A streptococcal (GAS) pharyngitis in children with sore throat. The Infectious Diseases Society of America (IDSA) recommends neither testing nor treating patients with specific viral symptoms. The goal of this study is to measure the impact of those symptoms on the yield of GAS testing predicted by the MCS.

Patient Ethnicity and Pediatric Visits to the Emergency Department for Fever.

Objectives: Previous research has identified ethnic differences in parents' beliefs about fever, but whether patient ethnicity is associated with health care use for fever is uncertain. Our objectives were to describe the national rate of pediatric visits to the emergency department (ED) for fever and to determine whether there is variation in this rate by patient ethnicity.

Methods: Using the National Hospital Ambulatory Medical Care Survey between 2012 and 2015, we estimated the proportion of ED visits with a complaint of fever by patients 0 to 18 years old and compared this proportion across patient ethnicity.

A method to identify pediatric high-risk diagnoses missed in the emergency department.

Background: Diagnostic error can lead to increased morbidity, mortality, healthcare utilization and cost. The 2015 National Academy of Medicine report "Improving Diagnosis in Healthcare" called for improving diagnostic accuracy by developing innovative electronic approaches to reduce medical errors, including missed or delayed diagnosis. The objective of this article was to develop a process to detect potential diagnostic discrepancy between pediatric emergency and inpatient discharge diagnosis using a computer-based tool facilitating expert review.

Seasonality of Common Pediatric Infectious Diseases.

Background/objective: Traditional sources cite seasonal patterns for common infectious diseases, often based on microbiologic data, but little is known about cyclical trends in clinically diagnosed infectious conditions in the emergency department (ED). We leveraged the publicly available Nationwide Emergency Department Sample database to measure the seasonality of the most common pediatric infectious diseases diagnosed in US EDs.

Methods: We searched the Nationwide Emergency Department Sample database to identify infectious diagnoses comprising at least 1% of all diagnosis codes ascribed to patients 21 years and younger in US EDs from 2009 to 2013.

Patients Visiting Multiple Emergency Departments: Patterns, Costs, and Risk Factors.

Objectives: We sought to characterize the population of patients seeking care at multiple emergency departments (EDs) and to quantify the proportion of all ED visits and costs accounted for by these patients.

Methods: We performed a retrospective, cohort study of deidentified insurance claims for privately insured patients with one of more ED visits between 2010 and 2016. We measured the number of EDs visited by each patient and determined the overall proportion of all ED visits and ED costs accounted for by patients who visit multiple EDs.

Viral Features and Testing for Streptococcal Pharyngitis.

Background And Objectives: The Infectious Diseases Society of America recommends that clinicians forego testing for group A (GAS) pharyngitis in patients with clinical features of viral illness. The prevalence of viral features in patients tested for GAS pharyngitis is not known. The objectives of this study were as follows: to describe the prevalence of viral features in pediatric patients for whom rapid antigen detection tests (RADTs) for GAS pharyngitis are performed; and to compare the prevalence of GAS and the sensitivity of the RADT in patients with and without viral features.