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  1. Article ; Online: Unintentional use of the word "accident"?

    Bigham, Blair L / Harding, Alex / Goldfrank, Lewis R

    Clinical toxicology (Philadelphia, Pa.)

    2018  Volume 57, Issue 1, Page(s) 73–74

    MeSH term(s) Accidents ; Humans ; Prospective Studies ; Vaccines
    Chemical Substances Vaccines
    Language English
    Publishing date 2018-07-13
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 204476-6
    ISSN 1556-9519 ; 0009-9309 ; 0731-3810 ; 1556-3650
    ISSN (online) 1556-9519
    ISSN 0009-9309 ; 0731-3810 ; 1556-3650
    DOI 10.1080/15563650.2018.1489050
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  2. Article ; Online: Development and perception of surgery-specific goals of care discussions in the preoperative setting: A learning pilot.

    Letica-Kriegel, Allison S / Rosen, Roni / McNeil, Nita / Thompson, Errika / James, Monique / Broach, Vance / Roche, Kara Long / Riportella, Michaela / Ng, Susan / Bernal, Camila / Vaynrub, Max / Downey, Robert / Voigt, Louis / Epstein, Andrew S / Nelson, Judith / Goldfrank, Deborah / Nash, Garrett M

    Journal of surgical oncology

    2024  

    Abstract: Background: Goals of care discussions are infrequently documented in the preoperative period. Furthermore, documentation does not consistently address what matters most to patients, although patient values (PV) are central to person-centered care.: ... ...

    Abstract Background: Goals of care discussions are infrequently documented in the preoperative period. Furthermore, documentation does not consistently address what matters most to patients, although patient values (PV) are central to person-centered care.
    Methods: A multidisciplinary working group was formed. An electronic note comprised of (1) topics of discussion, (2) PV, and (3) advance care planning (ACP), was created and embedded into existing note templates for Gynecologic Surgical Oncology. Surgeons and advanced practice providers (APPs) were educated to conduct and document these conversations in preoperative clinic for patients undergoing cancer surgery for a pilot period. Data were collected regarding usage of the template. Focus groups with surgeons, APPs, and patients were conducted. Qualitative analysis was performed on transcripts.
    Results: During the pilot, 7 surgeon/APP teams utilized the template on a total of 55 notes. Average number of notes completed per surgeon was 7.8 (SD 8.5). Forty-six notes (84%) included topics of discussion, 15 (27%) included PV, 4 (7%) included ACP. Qualitative analysis of focus group transcripts revealed that clinicians and patients perceived the initiative to be useful and important, although implementation barriers were identified.
    Conclusion: Creating a surgery-specific GOC template is feasible. Iterative revisions are needed to increase utility in clinic workflows.
    Language English
    Publishing date 2024-03-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82063-5
    ISSN 1096-9098 ; 0022-4790
    ISSN (online) 1096-9098
    ISSN 0022-4790
    DOI 10.1002/jso.27632
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  3. Article ; Online: Gynecologic Survivorship Tool: Development, Implementation, and Symptom Outcomes.

    Carter, Jeanne / Abu-Rustum, Nadeem R / Saban, Sally / Chen, Ling Y / Vickers, Andrew J / Tin, Amy L / Billanti, Gabriela / Connors, Nicole A / Broach, Vance / Brown, Carol L / Chi, Dennis S / Gardner, Ginger J / Goldfrank, Deborah J / Jewell, Elizabeth L / Leitao, Mario M / Long Roche, Kara C / Mueller, Jennifer J / Sonoda, Yukio / Zivanovic, Oliver

    JCO clinical cancer informatics

    2022  Volume 6, Page(s) e2100154

    Abstract: Purpose: To describe the development and implementation of a new digital health clinical tool (Gynecologic Survivorship Tool [GST]) for symptom management of women surgically treated for gynecologic cancer; to assess its feasibility; and to conduct a ... ...

    Abstract Purpose: To describe the development and implementation of a new digital health clinical tool (Gynecologic Survivorship Tool [GST]) for symptom management of women surgically treated for gynecologic cancer; to assess its feasibility; and to conduct a retrospective review of the data.
    Materials and methods: The GST was developed on the basis of a comprehensive review of the literature, multidisciplinary expert opinion, and feedback from women with a history of gynecologic cancer. It is composed of 17 questions addressing six main categories-gynecologic health (abnormal bleeding/pain), lymphedema, vaginal/vulvar dryness, sexual health, menopause (hot flushes/sleep difficulties), and bowel/urinary issues. An electronic version using the Memorial Sloan Kettering Cancer Center Engage platform was piloted in two clinics for patients with endometrial or cervical cancer. Health information was generated into clinical summaries and identified concerns for actionable response. Associations of symptom and survey time point were assessed by longitudinal models using generalized estimating equations.
    Results: From January 1, 2019, to February 29, 2020, 3,357 GST assessments were assigned to 1,405 patients, with a 71% completion rate (90% within 5 minutes). Sixty-eight percent were performed at home via a patient portal, 32% at follow-ups using a clinic iPad. The most common symptoms were bowel problems, swelling/fluid, pain during examination, vaginal or vulvar dryness, and vaginal bleeding. Implementation challenges included improving patient compliance and ensuring that reports were reviewed by all clinical teams. We developed screening e-mails detailing patients whose assessments were due, planned training sessions for multidisciplinary teams, and incorporated feedback on methods for reviewing symptoms reports.
    Conclusion: The GST demonstrated feasibility, a high completion rate, and minimal time commitment. It was an effective electronic reporting mechanism for patients, enabling the medical team to develop specific strategies for alleviating bothersome symptoms during follow-up.
    MeSH term(s) Female ; Genital Neoplasms, Female/diagnosis ; Genital Neoplasms, Female/therapy ; Humans ; Pain ; Surveys and Questionnaires ; Survivorship ; Uterine Cervical Neoplasms
    Language English
    Publishing date 2022-03-03
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ISSN 2473-4276
    ISSN (online) 2473-4276
    DOI 10.1200/CCI.21.00154
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  4. Article: David R. Boyd lecture in trauma care and emergency medical systems: "The surgical complications of toxins.".

    Goldfrank, L R

    The Journal of emergency medicine

    1999  Volume 17, Issue 6, Page(s) 1055–1064

    Abstract: Toxins have had major roles in our societies for thousands of years. Interactions between surgeons, both generalists and subspecialists, and those caring for poisoned patients have been extensive throughout history. The advancement of the science of ... ...

    Abstract Toxins have had major roles in our societies for thousands of years. Interactions between surgeons, both generalists and subspecialists, and those caring for poisoned patients have been extensive throughout history. The advancement of the science of toxicology, the development of regional poison control centers, the development of emergency medicine, and the development of the subspecialty of medical toxicology have led to more appropriate and creative interactions between medical toxicologists, emergency physicians, and surgeons. This article will review the diverse interfaces between the medical toxicologist and the surgeon.
    MeSH term(s) Emergency Medical Services/trends ; General Surgery ; Humans ; Interprofessional Relations ; Poisoning/etiology ; Poisoning/surgery ; Toxicology/organization & administration ; Toxicology/trends
    Language English
    Publishing date 1999-11
    Publishing country United States
    Document type Journal Article ; Lecture ; Review
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/s0736-4679(99)00141-9
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  5. Article: The state of academic emergency medicine: 1996 SAEM Presidential Address.

    Goldfrank, L R

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    1997  Volume 4, Issue 1, Page(s) 1–3

    MeSH term(s) Education, Medical ; Emergency Medicine/education ; Humans ; Licensure, Medical ; Schools, Medical ; United States
    Language English
    Publishing date 1997-01
    Publishing country United States
    Document type Address ; Editorial
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/j.1553-2712.1997.tb03634.x
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  6. Article: Flumazenil: a pharmacologic antidote with limited medical toxicology utility, or ... an antidote in search of an overdose.

    Goldfrank, L R

    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine

    1997  Volume 4, Issue 10, Page(s) 935–936

    MeSH term(s) Antidotes/adverse effects ; Antidotes/therapeutic use ; Benzodiazepines/poisoning ; Drug Overdose/drug therapy ; Drug Overdose/etiology ; Emergency Medicine ; Flumazenil/adverse effects ; Flumazenil/therapeutic use ; Humans ; Risk Assessment
    Chemical Substances Antidotes ; Benzodiazepines (12794-10-4) ; Flumazenil (40P7XK9392)
    Language English
    Publishing date 1997-10
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 1329813-6
    ISSN 1553-2712 ; 1069-6563
    ISSN (online) 1553-2712
    ISSN 1069-6563
    DOI 10.1111/j.1553-2712.1997.tb03653.x
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  7. Article: The troubled road to universal health care.

    Goldfrank, L R

    Annals of emergency medicine

    1997  Volume 30, Issue 6, Page(s) 737–738

    Abstract: In our country the increasing commercialization of medicine is taking control of our medical school faculties, hospitals, and education. There is an overemphasis on health care efficiency, with a dramatic decrease in the commitment to research, an ... ...

    Abstract In our country the increasing commercialization of medicine is taking control of our medical school faculties, hospitals, and education. There is an overemphasis on health care efficiency, with a dramatic decrease in the commitment to research, an increase in the cost of medical education and resultant staggering student debt, an increasing number of medically uninsured, and an ever-widening gap between the best that American medicine can offer and that which the indigent receive.
    MeSH term(s) Commerce/trends ; Delivery of Health Care/economics ; Delivery of Health Care/trends ; Education, Medical/trends ; Research/trends ; United States ; Universal Health Insurance
    Language English
    Publishing date 1997-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603080-4
    ISSN 1097-6760 ; 0196-0644
    ISSN (online) 1097-6760
    ISSN 0196-0644
    DOI 10.1016/s0196-0644(97)70036-2
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  8. Article ; Online: Including frequent emergency department users with severe alcohol use disorders in research: assessing capacity.

    McCormack, Ryan P / Gallagher, Timothy / Goldfrank, Lewis R / Caplan, Arthur L

    Annals of emergency medicine

    2015  Volume 65, Issue 2, Page(s) 172–7.e1

    Abstract: Study objective: Frequent emergency department (ED) users with severe alcohol use disorders are often excluded from research, in part because assessing capacity to provide consent is challenging. We aim to assess the feasibility of using the University ... ...

    Abstract Study objective: Frequent emergency department (ED) users with severe alcohol use disorders are often excluded from research, in part because assessing capacity to provide consent is challenging. We aim to assess the feasibility of using the University of California, San Diego Brief Assessment of Capacity to Consent, a 5-minute, easy-to-use, validated instrument, to screen for capacity to consent for research in frequent ED users with severe alcohol use disorders.
    Methods: We prospectively enrolled a convenience sample of 20 adults to assess their capacity to provide consent for participation in 30-minute mixed-methods interviews using the 10-question University of California, San Diego Brief Assessment of Capacity to Consent. Participants were identified through an administrative database, had greater than 4 annual ED visits for 2 years, and had severe alcohol use disorders. The study was conducted with institutional review board approval from March to July 2013 in an urban, public, university ED receiving approximately 120,000 visits per year. Blood alcohol concentration and demographic data were extracted from the medical record.
    Results: We completed assessments for 19 of 20 participants. One was removed because of agitation. Sixteen of 19 participants passed each question and were deemed capable of providing informed consent. Interventions to improve understanding (prompting and material review) were required for 15 of 19 participants. The mean duration to describe the study and perform the assessment was 10.4 minutes (SD 3 minutes). The mean blood alcohol concentration was 211.5 mg/dL (SD 137.4 mg/dL). The 3 patients unable to demonstrate capacity had blood alcohol concentrations of 226 and 348 mg/dL, with 1 not obtained.
    Conclusion: This pilot study supports the feasibility of using the University of California, San Diego Brief Assessment of Capacity to Consent to assess capacity of frequent ED users with severe alcohol use disorders to participate in research. Blood alcohol concentration was not correlated with capacity.
    MeSH term(s) Adult ; Alcohol-Related Disorders ; Emergency Service, Hospital/utilization ; Female ; Humans ; Informed Consent ; Interviews as Topic ; Male ; Mental Competency ; Middle Aged ; Pilot Projects ; Prospective Studies ; Surveys and Questionnaires
    Language English
    Publishing date 2015-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603080-4
    ISSN 1097-6760 ; 0196-0644
    ISSN (online) 1097-6760
    ISSN 0196-0644
    DOI 10.1016/j.annemergmed.2014.09.027
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  9. Article: Health care reform or a return to social darwinism?

    Goldfrank, L R

    Annals of emergency medicine

    1995  Volume 25, Issue 5, Page(s) 692–694

    MeSH term(s) Economic Competition ; Health Care Reform/economics ; Humans ; Models, Economic ; Social Values ; United States
    Language English
    Publishing date 1995-05
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 603080-4
    ISSN 1097-6760 ; 0196-0644
    ISSN (online) 1097-6760
    ISSN 0196-0644
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  10. Article: Emergency medicine.

    Goldfrank, L R

    JAMA

    1995  Volume 273, Issue 21, Page(s) 1673–1674

    Abstract: A survey determined that Medicaid recipients had limited access to outpatient care other than the care received at emergency departments. Recent advances in our understanding of trauma call into question how fluid resuscitation should be performed in the ...

    Abstract A survey determined that Medicaid recipients had limited access to outpatient care other than the care received at emergency departments. Recent advances in our understanding of trauma call into question how fluid resuscitation should be performed in the field.
    MeSH term(s) Emergency Medicine/trends ; Humans ; Public Health ; United States
    Language English
    Publishing date 1995-06-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0098-7484 ; 0254-9077 ; 0002-9955
    ISSN (online) 1538-3598
    ISSN 0098-7484 ; 0254-9077 ; 0002-9955
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