Does the number of pages received per hour affect resident productivity?

Background: Workflow interruptions are common for emergency physicians and are shown to have downstream consequences such as patient dissatisfaction, delay in clinical response, and increase in medical error. However, the impact of passive interruptions on physician productivity is unclear and has not been well studied. We sought to evaluate if the number of pages received per hour significantly affects the number of patients seen per hour.

An interpretable machine learning pipeline based on transcriptomics predicts phenotypes of lupus patients.

Machine learning (ML) has the potential to identify subsets of patients with distinct phenotypes from gene expression data. However, phenotype prediction using ML has often relied on identifying important genes without a systems biology context. To address this, we created an interpretable ML approach based on blood transcriptomics to predict phenotype in systemic lupus erythematosus (SLE), a heterogeneous autoimmune disease.

Letter to the editor: testing the effectiveness of MyPROSLE in classifying patients with lupus nephritis.

Because of the clinical heterogeneity among patients with systemic lupus erythematosus (SLE), developing molecular profiles that predict clinical features can be useful in creating a personalized approach to treatment. Toro-Domínguez et al. created a web tool to aid in therapeutic decision making for clinicians that predicts clinical features associated with SLE from blood transcriptomic data.

Machine Learning Methods for Predicting Patient-Level Emergency Department Workload.

Background: Work Relative Value Units (wRVUs) are a component of many compensation models, and a proxy for the effort required to care for a patient. Accurate prediction of wRVUs generated per patient at triage could facilitate real-time load balancing between physicians and provide many practical operational and clinical benefits.

Objective: We examined whether deep-learning approaches could predict the wRVUs generated by a patient's visit using data commonly available at triage.

Single-cell genomic variation induced by mutational processes in cancer.

How cell-to-cell copy number alterations that underpin genomic instability in human cancers drive genomic and phenotypic variation, and consequently the evolution of cancer, remains understudied. Here, by applying scaled single-cell whole-genome sequencing to wild-type, TP53-deficient and TP53-deficient;BRCA1-deficient or TP53-deficient;BRCA2-deficient mammary epithelial cells (13,818 genomes), and to primary triple-negative breast cancer (TNBC) and high-grade serous ovarian cancer (HGSC) cells (22,057 genomes), we identify three distinct 'foreground' mutational patterns that are defined by cell-to-cell structural variation. Cell- and clone-specific high-level amplifications, parallel haplotype-specific copy number alterations and copy number segment length variation (serrate structural variations) had measurable phenotypic and evolutionary consequences.

Impact of a Mandatory Prescription Drug Monitoring Program Check on Emergency Department Opioid Prescribing Rates.

Background: Prescription drug monitoring programs (PDMPs) exist in 49 states to guide opioid prescribing. In 40 states, clinicians must check the PDMP prior to prescribing an opioid. Data on mandated PDMP checks show mixed results on opioid prescribing.

Association of resident characteristics with patterns of patient self-assignment.

Objective: We hypothesized that resident characteristics impact patterns of patient self-assignment in the emergency department (ED). Our goal was to determine if male residents would be less likely than their female colleagues to see patients with sensitive (e.g.

Early, awake proning in emergency department patients with COVID-19.

Objective: Proning has been shown to improve oxygenation and mortality in certain populations of intubated patients with acute respiratory distress syndrome. Small observational analyses of COVID-19 patients suggest awake proning may lead to clinical improvement. Data on safety and efficacy is lacking.

Deep-learning approaches to identify critically Ill patients at emergency department triage using limited information.

Study Objective: Triage quickly identifies critically ill patients, facilitating timely interventions. Many emergency departments (EDs) use emergency severity index (ESI) or abnormal vital sign triggers to guide triage. However, both use fixed thresholds, and false activations are costly.

Information Management in the Emergency Department.

Information management in the emergency department (ED) is a challenge for all providers. The volume of information required to care for each patient and to keep the ED functioning is immense. It must be managed through varying means of communication and in connection with ED information systems.

Assessment of Unintentional Duplicate Orders by Emergency Department Clinicians Before and After Implementation of a Visual Aid in the Electronic Health Record Ordering System.

Importance: Electronic health records allow teams of clinicians to simultaneously care for patients, but an unintended consequence is the potential for duplicate orders of tests and medications.

Objective: To determine whether a simple visual aid is associated with a reduction in duplicate ordering of tests and medications.

Design, Setting, And Participants: This cohort study used an interrupted time series model to analyze 184 694 consecutive patients who visited the emergency department (ED) of an academic hospital with 55 000 ED visits annually.

Variations in Opioid Prescribing Behavior by Physician Training.

Introduction: Opioid abuse has reached epidemic proportions in the United States. Patients often present to the emergency department (ED) with painful conditions seeking analgesic relief. While there is known variability in the prescribing behaviors of emergency physicians, it is unknown if there are differences in these behaviors based on training level or by resident specialty.

Default clinic appointments promote influenza vaccination uptake without a displacement effect.

The majority of U.S. adults do not receive an annual influenza vaccination.

Decision-making Processes among Prostate Cancer Survivors with Rising PSA Levels: Results from a Qualitative Analysis.

Background: Prostate cancer survivors with a rising prostate-specific antigen (PSA) level have few treatment options, experience a heightened state of uncertainty about their disease trajectory that might include the possibility of cancer metastasis and death, and often experience elevated levels of distress as they have to deal with a disease they thought they had conquered. Guided by self-regulation theory, the present study examined the cognitive and affective processes involved in shared decision making between physicians and patients who experience a rising PSA after definitive treatment for prostate cancer.

Methods: In-depth interviews were conducted with 34 prostate cancer survivors who had been diagnosed with a rising PSA (i.

Using the common sense model of self-regulation to understand the relationship between symptom reporting and trait negative affect.

Background/purpose: Based on the Common Sense Model of Self-Regulation, we examined if the relationship of trait NA to physical symptom reporting was moderated by life events and illness representations.

Methods: This relationship was examined using a cross-sectional dataset of 554 elderly adults.

Results: A significant three-way interaction demonstrated that individuals who reported the greatest severity of physical symptoms were higher in trait NA, and reported more life events and a chronic illness history.

Using the Common Sense Model of Self-regulation to review the effects of self-monitoring of blood glucose on glycemic control for non-insulin-treated adults with type 2 diabetes.

Purpose: This systematic review examined the relationship between self-monitoring of blood glucose (SMBG) and glycemic control in patients with type 2 diabetes. The Common Sense Model of Self-Regulation (CSM) served as a theoretical framework for examining how, when (mediators), and for whom (moderators) SMBG improved glycemic control.

Data Sources: Five databases were searched: Medline, PsychInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health Literature.

Assessing theoretical predictors of long-term medication adherence: patients' treatment-related beliefs, experiential feedback and habit development.

Patient non-adherence to medication is a pervasive problem that contributes to poor patient health and high healthcare costs. Basic research and interventions have focused thus far on behaviour initiation factors, such as patients' illness and treatment beliefs. This paper proposes two processes that occur after behaviour initiation that are theorised to contribute to prediction of long-term medication adherence: 'coherence' of patients' beliefs from experiences with treatment and habit development.

Why do comparative assessments predict health? The role of self-assessed health in the formation of comparative health judgments.

Objective: Research has shown that self-assessments of health are strong predictors of morbidity and mortality regardless of format (i.e., self or comparative).

In vivo kinematics of the scaphoid, lunate, capitate, and third metacarpal in extreme wrist flexion and extension.

Purpose: Insights into the complexity of active in vivo carpal motion have recently been gained using 3-dimensional imaging; however, kinematics during extremes of motion has not been elucidated. The purpose of this study was to determine motion of the carpus during extremes of wrist flexion and extension.

Methods: We obtained computed tomography scans of 12 healthy wrists in neutral grip, extreme loaded flexion, and extreme loaded extension.

The perceived sensitivity to medicines (PSM) scale: an evaluation of validity and reliability.

Objectives: We report on the development and psychometric properties of a scale to measure perceived sensitivity to medicines (PSM). Design.  The internal consistency, test-retest reliability, criterion-related, and predictive validity of the PSM Scale were evaluated using data collected as part of four previously published studies and one unpublished data set.

Heterogeneity in depression symptoms and health status among older adults.

Objectives: We assessed whether distinct classes of depression symptoms could be identified. In addition, we determined how these classes differed in terms of health status.

Methods: Data were analyzed with latent profile analysis.

Physicians' communication of the common-sense self-regulation model results in greater reported adherence than physicians' use of interpersonal skills.

Objectives: Interventions that address patients' illness and treatment representations have improved patient adherence and outcomes when administered by psychologists and/or health educators and focused on a single chronic illness. The current study assesses the potential feasibility/effectiveness of an intervention based on the common-sense self-regulation model (CS-SRM) when administered by providers in a primary care setting.

Design: We designed a prospective, correlational study in order to optimize patients' and providers' time and to gain initial evidence of the CS-SRM-approach's feasibility/effectiveness.

Factors associated with the accuracy of physicians' predictions of patient adherence.

Objective: Physicians are inaccurate in predicting non-adherence in patients, a problem that interferes with physicians': (1) appropriate prescribing decisions and (2) effective prevention/intervention of non-adherence. The purpose of the current study is to investigate potential reasons for the poor accuracy of physicians' adherence-predictions and conditions under which their predictions may be more accurate.

Methods: After the medical encounter, predictions of patient-adherence and other ratings from primary-care physicians (n=24) regarding patient-factors that may have influenced their predictions were collected.