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Article ; Online: Characterizing the Discourse of Popular Diets to Describe Information Dispersal and Identify Leading Voices, Interaction, and Themes of Mental Health: Social Network Analysis.

Eaton, Melissa C / Probst, Yasmine C / Smith, Marc A

JMIR infodemiology

2023 Volume 3, Page(s) e38245

Abstract: Background: Social media has transformed the way health messages are communicated. This has created new challenges and ethical considerations while providing a platform to share nutrition information for communities to connect and for information to ... ...

Abstract	Background: Social media has transformed the way health messages are communicated. This has created new challenges and ethical considerations while providing a platform to share nutrition information for communities to connect and for information to spread. However, research exploring the web-based diet communities of popular diets is limited. Objective: This study aims to characterize the web-based discourse of popular diets, describe information dissemination, identify influential voices, and explore interactions between community networks and themes of mental health. Methods: This exploratory study used Twitter social media posts for an online social network analysis. Popular diet keywords were systematically developed, and data were collected and analyzed using the NodeXL metrics tool (Social Media Research Foundation) to determine the key network metrics (vertices, edges, cluster algorithms, graph visualization, centrality measures, text analysis, and time-series analytics). Results: The vegan and ketogenic diets had the largest networks, whereas the zone diet had the smallest network. In total, 31.2% (54/173) of the top users endorsed the corresponding diet, and 11% (19/173) claimed a health or science education, which included 1.2% (2/173) of dietitians. Complete fragmentation and hub and spoke messaging were the dominant network structures. In total, 69% (11/16) of the networks interacted, where the ketogenic diet was mentioned most, with depression and anxiety and eating disorder words most prominent in the "zone diet" network and the least prominent in the "soy-free," "vegan," "dairy-free," and "gluten-free" diet networks. Conclusions: Social media activity reflects diet trends and provides a platform for nutrition information to spread through resharing. A longitudinal exploration of popular diet networks is needed to further understand the impact social media can have on dietary choices. Social media training is vital, and nutrition professionals must work together as a community to actively reshare evidence-based posts on the web.
Language	English
Publishing date	2023-05-05
Publishing country	Canada
Document type	Journal Article
ISSN	2564-1891
ISSN (online)	2564-1891
DOI	10.2196/38245
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Clinicians' perspectives on the implementation of patient decision aids in the emergency department: A qualitative interview study.

Billah, Tausif / Gordon, Lauren / Schoenfeld, Elizabeth M / Chang, Bernard P / Hess, Erik P / Probst, Marc A

Journal of the American College of Emergency Physicians open

2022 Volume 3, Issue 1, Page(s) e12629

Abstract: Objective: Decision aids (DAs) are tools to facilitate and standardize shared decision making (SDM). Although most emergency clinicians (ECs) perceive SDM appropriate for emergency care, there is limited uptake of DAs in clinical practice. The objective ...

Abstract	Objective: Decision aids (DAs) are tools to facilitate and standardize shared decision making (SDM). Although most emergency clinicians (ECs) perceive SDM appropriate for emergency care, there is limited uptake of DAs in clinical practice. The objective of this study was to explore barriers and facilitators identified by ECs regarding the implementation of DAs in the emergency department (ED). Methods: We conducted a qualitative interview study guided by implementation science frameworks. ECs participated in interviews focused on the implementation of DAs for the disposition of patients with low-risk chest pain and unexplained syncope in the ED. Interviews were recorded and transcribed verbatim. We then iteratively developed a codebook with directed qualitative content analysis. Results: We approached 25 ECs working in urban New York, of whom 20 agreed to be interviewed (mean age, 41 years; 25% women). The following 6 main barriers were identified: (1) poor DA accessibility, (2) concern for increased medicolegal risk, (3) lack of perceived need for a DA, (4) patient factors including lack of capacity and limited health literacy, (5) skepticism about validity of DAs, and (6) lack of time to use DAs. The 6 main facilitators identified were (1) positive attitudes toward SDM, (2) patient access to follow-up care, (3) potential for improved patient satisfaction, (4) potential for improved risk communication, (5) strategic integration of DAs into the clinical workflow, and (6) institutional support of DAs. Conclusions: ECs identified multiple barriers and facilitators to the implementation of DAs into clinical practice. These findings could guide implementation efforts targeting the uptake of DA use in the ED.
Language	English
Publishing date	2022-01-19
Publishing country	United States
Document type	Journal Article
ISSN	2688-1152
ISSN (online)	2688-1152
DOI	10.1002/emp2.12629
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Article ; Online: Evaluation of emergency department visits for mental health complaints during the COVID-19 pandemic.

Sacco, Dana L / Probst, Marc A / Schultebraucks, Katharina / Greene, M Claire / Chang, Bernard P

Journal of the American College of Emergency Physicians open

2022 Volume 3, Issue 3, Page(s) e12728

Abstract: Background: The COVID-19 pandemic has resulted in over 6 million deaths worldwide as of March 2022. Adverse psychological effects on patients and the general public linked to the pandemic have been well documented.: Methods: We conducted a ... ...

Abstract	Background: The COVID-19 pandemic has resulted in over 6 million deaths worldwide as of March 2022. Adverse psychological effects on patients and the general public linked to the pandemic have been well documented. Methods: We conducted a retrospective analysis of adult emergency department (ED) encounters with diagnoses of anxiety, depression, and suicidal ideation using Results: A total of 2816 patient encounters met the inclusion criteria. The study period in 2020 had 31.5% lower overall ED volume seen during the same time period in the previous 3 years (27,874 vs average 40,716 ED encounters). The risk of presenting with anxiety during the study period in 2020 compared to prior 3 years was 1.40 (95% confidence interval [CI] 1.21-1.63), for depression was 1.47 (95% CI 1.28-1.69), and for suicidal ideation was 1.05 (95% CI 0.90-1.23). There was an increase in admissions for depression during the pandemic period (15.2% increase, 95% CI 4.6%-25.7%). Conclusion: There was a relative increase in patients presenting to the ED with complaints of anxiety and depression during the height of the COVID-19 pandemic, while absolute numbers remained stable. Our results highlight the importance of acute care-based mental health resources and interventions to support patients during this pandemic.
Language	English
Publishing date	2022-04-29
Publishing country	United States
Document type	Journal Article
ISSN	2688-1152
ISSN (online)	2688-1152
DOI	10.1002/emp2.12728
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Article ; Online: Computed Tomography Angiography of the Head Is a Reasonable Next Test After a Negative Noncontrast Head Computed Tomography Result in the Emergency Department Evaluation of Subarachnoid Hemorrhage.

Probst, Marc A / Hoffman, Jerome R

Annals of emergency medicine

2016 Volume 67, Issue 6, Page(s) 773–774

Language	English
Publishing date	2016-06
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.2014.03.009
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Article ; Online: Behind the Scenes of Successful Research in Emergency Medicine: Nine Tips for Junior Investigators.

Probst, Marc A / Caputo, Nicholas D / Chang, Bernard P

AEM education and training

2019 Volume 4, Issue Suppl 1, Page(s) S75–S81

Abstract: Education related to clinical research often focuses on methodology, statistics, ethics, and study design. While knowledge of these conventional skills is essential to the operationalization of research, many "soft" skills related to leadership, ... ...

Abstract	Education related to clinical research often focuses on methodology, statistics, ethics, and study design. While knowledge of these conventional skills is essential to the operationalization of research, many "soft" skills related to leadership, communication, and team management are critical to the successful conduct research in the real world. Conducting clinical research in the emergency department is generally a challenging endeavor. Based on our prior experience as clinical researchers and a narrative review of the published literature, we offer nine practical strategies to help junior investigators conduct research. To successfully execute a research study, investigators must know how to motivate their team, create a brand around their study, communicate effectively, maximize clinician and patient engagement, and celebrate victory, among other skills. These skills and strategies are often missing from the formal research education and in peer-reviewed manuscripts but are, in fact, invaluable to the successful development of junior investigators. Thus, we offer the "story behind the study" in an effort to contribute to research education with material that is not typically covered in formal curricula.
Language	English
Publishing date	2019-09-12
Publishing country	United States
Document type	Journal Article
ISSN	2472-5390
ISSN (online)	2472-5390
DOI	10.1002/aet2.10383
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Spanish proficiency and interpreter use among emergency providers: A survey study.

Berk, William A / Lozada, Katleen S / McVane, Ben A / Probst, Marc A

The American journal of emergency medicine

2020 Volume 38, Issue 12, Page(s) 2756–2757

MeSH term(s)	Adult ; Emergency Medicine ; Female ; Humans ; Limited English Proficiency ; Male ; Medical Staff, Hospital ; Middle Aged ; Multilingualism ; Nurse Practitioners ; Physician Assistants ; Physicians ; Professional Competence ; Surveys and Questionnaires ; Translating
Language	English
Publishing date	2020-05-03
Publishing country	United States
Document type	Letter
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2020.04.078
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Zs.A 2005: Show issues

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Article ; Online: Changes in alcohol-related hospital visits during COVID-19 in New York City.

Schimmel, Jonathan / Vargas-Torres, Carmen / Genes, Nicholas / Probst, Marc A / Manini, Alex F

Addiction (Abingdon, England)

2021 Volume 116, Issue 12, Page(s) 3525–3530

Abstract: Background and aims: Increased alcohol consumption has been proposed as a potential consequence of the coronavirus disease 2019 (COVID-19) pandemic. There has been little scrutiny of alcohol use behaviors resulting in hospital visits, which is essential ...

Abstract	Background and aims: Increased alcohol consumption has been proposed as a potential consequence of the coronavirus disease 2019 (COVID-19) pandemic. There has been little scrutiny of alcohol use behaviors resulting in hospital visits, which is essential to guide pandemic public policy. We aimed to determine whether COVID-19 peak restrictions were associated with increased hospital visits for alcohol use or withdrawal. Secondary objectives were to describe differences based on age, sex and race, and to examine alcohol-related complication incidence. Design: Multi-center, retrospective, pre-post study. Setting: New York City health system with five participating hospitals. Participants: Adult emergency department encounters for alcohol use, alcoholic gastritis or pancreatitis or hepatitis, alcohol withdrawal syndrome, withdrawal seizure or delirium tremens. Measurements: Age, sex, race, site and encounter diagnosis. Encounters were compared between 2019 and 2020 for 1 March to 31 May. Findings: There were 2790 alcohol-related visits during the 2019 study period and 1793 in 2020, with a decrease in total hospital visits. Of 4583 alcohol-related visits, median age was 47 years, with 22.3% females. In 2020 there was an increase in percentage of visits for alcohol withdrawal [adjusted odds ratio (aOR) = 1.34, 95% confidence interval (CI) = 1.07-1.67] and withdrawal with complications (aOR = 1.40, 95% CI = 1.14-1.72), and a decline in percentage of hospital visits for alcohol use (aOR = 0.70, 95% CI = 0.59-0.85) and use with complications (aOR = 0.71, 95% CI = 0.58-0.88). It is unknown whether use visit changes mirror declines in other chief complaints. The age groups 18-29 and 60-69 years were associated with increased visits for use and decreased visits for withdrawal, as were non-white race groups. Sex was not associated with alcohol-related visit changes despite male predominance. Conclusions: In New York City during the initial COVID-19 peak (1 March to 31 May 2020), hospital visits for alcohol withdrawal increased while those for alcohol use decreased.
MeSH term(s)	Adult ; COVID-19 ; Emergency Service, Hospital ; Female ; Hospitals ; Humans ; Male ; Middle Aged ; New York City/epidemiology ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2021-06-15
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1141051-6
ISSN	1360-0443 ; 0965-2140
ISSN (online)	1360-0443
ISSN	0965-2140
DOI	10.1111/add.15589
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Article ; Online: Development of a Novel Emergency Department Quality Measure to Reduce Very Low-Risk Syncope Hospitalizations.

Probst, Marc A / Janke, Alexander T / Haimovich, Adrian D / Venkatesh, Arjun K / Lin, Michelle P / Kocher, Keith E / Nemnom, Marie-Joe / Thiruganasambandamoorthy, Venkatesh

Annals of emergency medicine

2022 Volume 79, Issue 6, Page(s) 509–517

Abstract: Study objective: Emergency department (ED) evaluations for syncope are common, representing 1.3 million annual US visits and $2 billion in related hospitalizations. Despite evidence supporting risk stratification and outpatient management, variation in ... ...

Abstract	Study objective: Emergency department (ED) evaluations for syncope are common, representing 1.3 million annual US visits and $2 billion in related hospitalizations. Despite evidence supporting risk stratification and outpatient management, variation in syncope hospitalization rates persist. We sought to develop a new quality measure for very low-risk adult ED patients with syncope that could be applied to administrative data. Methods: We developed this quality measure in 2 phases. First, we used an existing prospective, observational ED patient data set to identify a very low-risk cohort with unexplained syncope using 2 variables: age less than 50 years and no history of heart disease. We then applied this to the 2019 Nationwide Emergency Department Sample (NEDS) to assess its potential effect, assessing for hospital-level factors associated with hospitalization variation. Results: Of the 8,647 adult patients in the prospective cohort, 3,292 (38%) patients fulfilled these 2 criteria: age less than 50 years and no history of heart disease. Of these, 15 (0.46%) suffered serious adverse events within 30 days. In the NEDS, there were an estimated 566,031 patients meeting these 2 criteria, of whom 15,507 (2.7%; 95% confidence interval [CI] 2.48% to 3.00%) were hospitalized. We found substantial variation in the hospitalization rates for this very low-risk cohort, with a median rate of 1.7% (range 0% to 100%; interquartile range 0% to 3.9%). Factors associated with increased hospitalization rates included a yearly ED volume of more than 80,000 (odds ratio [OR] 3.14; 95% CI 2.02 to 4.89) and metropolitan teaching status (OR 1.5; 95% CI 1.24 to 1.81). Conclusion: In summary, our novel syncope quality measure can assess variation in low-value hospitalizations for unexplained syncope. The application of this measure could improve the value of syncope care.
MeSH term(s)	Adult ; Emergency Service, Hospital ; Heart Diseases/complications ; Hospitalization ; Humans ; Middle Aged ; Prospective Studies ; Quality Indicators, Health Care ; Syncope/complications ; Syncope/epidemiology ; Syncope/therapy
Language	English
Publishing date	2022-04-27
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	603080-4
ISSN	1097-6760 ; 0196-0644
ISSN (online)	1097-6760
ISSN	0196-0644
DOI	10.1016/j.annemergmed.2022.03.008
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Zs.A 1344: Show issues

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Article ; Online: Flexible-Interval High-Sensitivity Troponin Velocity for the Detection of Acute Coronary Syndromes.

Suh, Edward Hyun / Probst, Marc A / Tichter, Aleksandr M / Ranard, Lauren S / Amaranto, Andrew / Chang, Betty C / Huynh, Phong Anh / Kratz, Alexander / Lee, Rebekah J / Rabbani, Leroy E / Sacco, Dana L / Einstein, Andrew J

The American journal of cardiology

2023 Volume 203, Page(s) 240–247

Abstract: Many algorithms for emergency department (ED) evaluation of acute coronary syndrome (ACS) using high-sensitivity troponin assays rely on the detection of a "delta," the difference in concentration over a predetermined interval, but collecting specimens ... ...

Abstract	Many algorithms for emergency department (ED) evaluation of acute coronary syndrome (ACS) using high-sensitivity troponin assays rely on the detection of a "delta," the difference in concentration over a predetermined interval, but collecting specimens at specific times can be difficult in the ED. We evaluate the use of troponin "velocity," the rate of change of troponin concentration over a flexible short interval for the prediction of major adverse cardiac events (MACEs) at 30 days. We conducted a prospective, observational study on a convenience sample of 821 patients who underwent ACS evaluation at a high-volume, urban ED. We determined the diagnostic performance of a novel velocity-based algorithm and compared the performance of 1- and 2-hour algorithms adapted from the European Society of Cardiology (ESC) using delta versus velocity. A total of 7 of 332 patients (2.1%) classified as low risk by the velocity-based algorithm experienced a MACE by 30 days compared with 35 of 221 (13.8%) of patients classified as greater than low risk, yielding a sensitivity of 83.3% (95% confidence interval [CI] 68.6% to 93.0%) and negative predictive value (NPV) of 97.9% (95% CI 95.9% to 98.9%). The ESC-derived algorithms using delta or velocity had NPVs ranging from 98.4% (95% CI 96.4% to 99.3%) to 99.6% (95% CI 97.0% to 99.9%) for 30-day MACEs. The NPV of the novel velocity-based algorithm for MACE at 30 days was borderline, but the substitution of troponin velocity for delta in the framework of the ESC algorithms performed well. In conclusion, specimen collection within strict time intervals may not be necessary for rapid evaluation of ACS with high-sensitivity troponin.
MeSH term(s)	Humans ; Troponin ; Acute Coronary Syndrome/diagnosis ; Myocardial Infarction/diagnosis ; Prospective Studies ; Predictive Value of Tests ; Emergency Service, Hospital ; Troponin T ; Biomarkers ; Algorithms
Chemical Substances	Troponin ; Troponin T ; Biomarkers
Language	English
Publishing date	2023-07-26
Publishing country	United States
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2023.06.080
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Article ; Online: Emergency Department Death Rates: The Authors Reply.

Kanzaria, Hemal K / Hsia, Renee Y / Probst, Marc A

Health affairs (Project Hope)

2016 Volume 35, Issue 10, Page(s) 1937

Language	English
Publishing date	2016-10-01
Publishing country	United States
Document type	Letter
ZDB-ID	632712-6
ISSN	1544-5208 ; 0278-2715
ISSN (online)	1544-5208
ISSN	0278-2715
DOI	10.1377/hlthaff.2016.1111
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