Publications by authors named "Hansol Chang"

Article Synopsis
  • The study analyzed the effectiveness and safety of telemedicine for chronic diseases in South Korea during the COVID-19 pandemic, focusing on a temporary telemedicine policy.
  • It utilized national health insurance claims data from before and after the policy's implementation, comparing patients who used telemedicine with those who did not across four chronic diseases.
  • Results indicated that telemedicine improved medication adherence for hypertension and diabetes without increasing hospital admissions, while those who did not use telemedicine faced higher admission rates.
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Objective: This study aimed to identify and analyze the factors influencing Emergency Department Length of Stay (ED LOS) using a nationwide database to improve emergency care efficiency.

Methods: This retrospective study utilized data from the National Emergency Department Information System (NEDIS) in South Korea, covering 25,578,263 ED visits from 2018 to 2022. Patient demographics, clinical characteristics, and ED operational variables were examined.

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Background: Effective communication between patients and healthcare providers in the emergency department (ED) is challenging due to the dynamic nature of the ED environment. This study aimed to trial a chat service enabling patients in the ED and their family members to ask questions freely, exploring the service's feasibility and user experience.

Objectives: To identify the types of needs and inquiries from patients and family members in the ED that could be addressed through the chat service and to assess the user experience of the service.

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Aim: This study introduces RealCAC-Net, an artificial intelligence (AI) system, to quantify carotid artery compressibility (CAC) and determine the return of spontaneous circulation (ROSC) during cardiopulmonary resuscitation.

Methods: A prospective study based on data from a South Korean emergency department from 2022 to 2023 investigated carotid artery compressibility in adult patients with cardiac arrest using a novel AI model, RealCAC-Net. The data comprised 11,958 training images from 161 cases and 15,080 test images from 134 cases.

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Background: Many cases of deep vein thrombosis (DVT) are diagnosed in the emergency department, and abbreviated lower extremity venous point-of-care ultrasound (POCUS) has already shown an accuracy comparable to that of specialists. This study aimed to identify the learning curve necessary for emergency medicine (EM) residents to achieve expertise-level accuracy in diagnosing DVT through a 3-point lower extremity venous POCUS.

Methods: This prospective study was conducted at an emergency department between May 2021 and October 2022.

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Article Synopsis
  • Emergency departments (ED) use triage to prioritize patients, and a new machine learning tool called Score for Emergency Risk Prediction (SERP) was developed to improve this process using data from three Korean hospitals without data sharing.
  • The study analyzed adult emergency visits from 2016 to 2017, focusing on predicting 2-day mortality rates for better patient outcomes.
  • Results indicated that the developed SERP models achieved high accuracy in predicting mortality, with inter-hospital validation showing an area under the ROC curve (AUROC) of at least 0.899, demonstrating effective risk assessment across different hospitals.
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This study aimed to compare the accuracy of real-time trans-tracheal ultrasound (TTUS) with capnography to confirm intubation in cardiopulmonary resuscitation (CPR) while wearing a powered air-purifying respirator (PAPR). This setting reflects increased caution due to contagious diseases. This single-center, prospective, comparative study enrolled patients requiring CPR while wearing a PAPR who visited the emergency department of a tertiary medical center from December 2020 to August 2022.

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Bacteremia is a life-threatening condition that has increased in prevalence over the past two decades. Prompt recognition of bacteremia is important; however, identification of bacteremia requires 1 to 2 days. This retrospective cohort study, conducted from 10 November 2014 to November 2019, among patients with suspected infection who visited the emergency department (ED), aimed to develop and validate a simple tool for predicting bacteremia.

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We sought to determine whether blade size influences the first-pass success (FPS) rate when performing endotracheal intubation (ETI) with a C-MAC video laryngoscope (VL) in emergency department (ED) patients. This single-center, retrospective, observational study was conducted between August 2016 and July 2022. A total of 1467 patients was divided into two categories based on the blade size used during the first ETI attempt: blade-3 (n = 365) and blade-4 groups (n = 1102).

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Article Synopsis
  • To improve resuscitation outcomes during cardiac emergencies, the PReCAP model was created to predict the likelihood of return of spontaneous circulation (ROSC) at the scene of an out-of-hospital cardiac arrest (OHCA).
  • This model analyzes various prehospital data from the Pan-Asian Resuscitation Outcome Study (PAROS) database, which includes a significant number of patients, to provide real-time predictions on key survival metrics.
  • The PReCAP model shows strong predictive capabilities with AUROC scores ranging from 0.80 to 0.93 for different outcomes, indicating its potential use across diverse populations and locations.
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Objective: : This study analyzed trends in emergency department (ED) visits in South Korea using the National Emergency Department Information System (NEDIS) data from 2018 to 2022.

Methods: : This was a retrospective observational study using data from the NEDIS database from 2018 to 2022. Age- and sex-standardized ED visits per 100,000 population, as well as age- and sex-standardized rates for mortality, admission, and transfer, were calculated.

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Background And Purpose: Aneurysmal subarachnoid hemorrhage (ASAH) is a complex disease with higher incidence in women compared to men and in Japan compared to other countries. It was hypothesized that ASAH is consistent with a multistep model of disease. The following assessments were made: (1) the number of steps needed for the disease to occur and (2) whether this number may be different in female versus male and in Japanese versus non-Japanese patients.

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Background: Anxiety and communication difficulties in the emergency department (ED) may increase for various reasons, including isolation due to coronavirus disease 2019 (COVID-19). However, little research on anxiety and communication in EDs exists. This study explored the isolation-related anxiety and communication experiences of ED patients during the COVID-19 pandemic.

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Article Synopsis
  • The study aimed to create a clinical support system using federated learning to improve the triage process in emergency departments by predicting when a revised Korea Triage Acuity Scale (KTAS) is needed.
  • Researchers analyzed data from over 11 million patients across different levels of emergency medical centers in South Korea, using patient demographics and initial KTAS scores to develop the prediction model.
  • The model showed varying performance levels in predicting triage needs across different cohorts, with higher rates of hospital admissions and mortality among patients with revised KTAS scores.
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Article Synopsis
  • The study aims to predict latent shock in patients by analyzing sequential changes in vital signs during emergency department visits.
  • Researchers used a large dataset of over 93,000 ED visits and applied various machine learning models, including logistic regression and neural networks, to create and validate their prediction model.
  • The model showed promising results, with AUROC values indicating strong predictive capability, outperforming traditional methods like the shock index in forecasting latent shock up to three hours in advance.
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This pilot study aimed to develop a new, reliable, and easy-to-use method for the evaluation of diastolic function through the M-mode measurement of mitral valve (MV) movement in the parasternal long axis (PSLA), similar to E-point septal separation (EPSS) used for systolic function estimation. Thirty healthy volunteers from a tertiary emergency department (ED) underwent M-mode measurements of the MV anterior leaflet in the PSLA view. EPSS, A-point septal separation (APSS), A-point opening length (APOL), and E-point opening length (EPOL) were measured in the PSLA view, along with the E and A velocities and e' velocity in the apical four-chamber view.

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Various efforts have been made to diagnose acute cardiovascular diseases (CVDs) early in patients. However, the sole option currently is symptom education. It may be possible for the patient to obtain an early 12-lead electrocardiogram (ECG) before the first medical contact (FMC), which could decrease the physical contact between patients and medical staff.

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Background: In South Korea, after the spread of the Middle East Respiratory Syndrome epidemic was aggravated by long stays in crowded emergency departments (EDs), a 24-hour target policy for EDs was introduced to prevent crowding and reduce patients' length of stay (LOS). The policy requires at least 95% of all patients to be admitted, discharged or transferred from an ED within 24 hours of arrival. This study analyzes the effects of the 24-hour target policy on ED LOS and compliance rates and describes the consequences of the policy.

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Background: This study reports trends in pediatric out-of-hospital cardiac arrest (OHCA) and factors affecting clinical outcomes by age group.

Methods: We identified 4,561 OHCA patients younger than 18 years between January 2009 and December 2018 in the Korean OHCA Registry. The patients were divided into four groups: group 1 (1 year or younger), group 2 (1 to 5 years), group 3 (6 to 12 years), and group 4 (13 to 17 years).

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This study sought to determine whether the C-MAC video laryngoscope (VL) performed better than a direct laryngoscope (DL) when attempting endotracheal intubation (ETI) in the emergency department (ED) while wearing personal protective equipment (PPE). This was a retrospective single-center observational study conducted in an academic ED between February 2020 and March 2022. All emergency medical personnel who participated in any ETI procedure were required to wear PPE.

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Background: Alert fatigue is unavoidable when many irrelevant alerts are generated in response to a small number of useful alerts. It is necessary to increase the effectiveness of the clinical decision support system (CDSS) by understanding physicians' responses.

Objective: This study aimed to understand the CDSS and physicians' behavior by evaluating the clinical appropriateness of alerts and the corresponding physicians' responses in a medication-related passive alert system.

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Background: In the emergency department (ED), the result obtained using the 12-lead electrocardiography (ECG) is the basis for diagnosing and treating patients with chest pain. It was found that performing ECG at the appropriate time could improve treatment outcomes. Hence, a wearable ECG device with a timer can ensure that the findings are continuously recorded.

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