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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 118 Research Studies DisplayedKostick-Quenet KM, Lang B, Dorfman N
Patients' and physicians' beliefs and attitudes towards integrating personalized risk estimates into patient education about left ventricular assist device therapy.
This study explored stakeholder attitudes toward the utility, acceptability, usefulness, and best practices for integrating personalized risk (PR) estimates into patient education and decision making about Left Ventricular Assist Device (LVAD). This was a 5-year multi-institutional AHRQ project where the authors conducted 40 interviews with stakeholders (physicians, nurse coordinators, patients, and caregivers) and analyzed using Thematic Content Analysis. All stakeholder groups voiced positive views towards PR integration in decision making. Physicians felt PR can improve their decision making by enhancing insight into outcomes, enhance tailored pre-emptive care, increase confidence in decisions, and reduce bias and subjectivity. All stakeholder groups raised concerns about accuracy, representativeness and relevance of algorithms; predictive uncertainty; utility in relation to physician's expertise; potential negative reactions among patients; and overreliance.
AHRQ-funded; HS027784.
Citation: Kostick-Quenet KM, Lang B, Dorfman N .
Patients' and physicians' beliefs and attitudes towards integrating personalized risk estimates into patient education about left ventricular assist device therapy.
Patient Educ Couns 2024 May; 122:108157. doi: 10.1016/j.pec.2024.108157.
Keywords: Education: Patient and Caregiver, Risk, Cardiovascular Conditions
Neerland C, Slaughter-Acey J, Behrens K
An evidence map for social and structural determinants for maternal morbidity and mortality: a systematic review.
The study aimed to identify social and structural determinants of maternal morbidity and mortality during prenatal and postpartum periods in the U.S. Out of 8,378 references screened, 118 studies were included, covering domains like identity, socioeconomic factors, violence, and trauma. Findings revealed mixed patterns between risk factors and outcomes, with notable attention to depression and mental health. Advancing the field long-term should involve developing comprehensive datasets to thoroughly investigate intersections with biological and medical risk factors.
AHRQ-funded; 75Q80120D00008.
Citation: Neerland C, Slaughter-Acey J, Behrens K .
An evidence map for social and structural determinants for maternal morbidity and mortality: a systematic review.
Obstet Gynecol 2024 Mar; 143(3):383-92. doi: 10.1097/aog.0000000000005489.
Keywords: Social Determinants of Health, Maternal Care, Mortality, Evidence-Based Practice, Risk, Women, Outcomes
Ashburn NP, McCord JK, Snavely AC
Navigating the observation zone: do risk scores help stratify patients with indeterminate high-sensitivity cardiac troponins?
In this research letter the authors described their secondary analysis of the High-Sensitivity Cardiac Troponin I Assays in the United States (HIGH-US) study; their purpose was to assess the best way to evaluate observation zone patients who did not have an ischemic ECG. Their primary finding was that risk scores were unlikely to identify a subset of observation zone patients for early discharge without further monitoring, additional troponin measures, and stress testing or coronary angiography.
AHRQ-funded; HS029017.
Citation: Ashburn NP, McCord JK, Snavely AC .
Navigating the observation zone: do risk scores help stratify patients with indeterminate high-sensitivity cardiac troponins?
Circulation 2024 Jan 2; 149(1):70-72. doi: 10.1161/circulationaha.123.065030..
Keywords: Cardiovascular Conditions, Risk
Engelberg RS, Scheidell JD, Islam N
Associations between incarceration history and risk of hypertension and hyperglycemia: consideration of differences among Black, Hispanic, Asian and White Subgroups.
This study’s objective was to assess racial/ethnic group differences in the association between incarceration and hypertension and hyperglycemia. The authors performed a secondary data analysis using the National Longitudinal Survey of Adolescent to Adult Health (Add Health). They used Poisson regression to estimate the associations between lifetime history of incarceration reported during early adulthood with hypertension and hyperglycemia outcomes measured in mid-adulthood, including incident diagnosis. They evaluated whether associations varied by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, and Asian) with an analytic sample of 4,015 Add Health respondents. Outcome measures included hypertension, systolic blood pressure >130 mmHG, and hyperglycemia. There was no evidence of an association between incarceration and measured health outcomes among non-Hispanic Black and non-Hispanic White participants. Among Hispanic participants, incarceration was associated with hyperglycemia (Adjusted Risk Ratio (ARR): 2.1), but not with hypertension risk. Incarceration was associated with elevated systolic blood pressure (ARR: 3.1) and hypertension (ARR: 1.7) among Asian participants, but not with hyperglycemia risk. Incarceration was associated with incident hypertension (ARR 2.5) among Asian subgroups.
AHRQ-funded; HS026120.
Citation: Engelberg RS, Scheidell JD, Islam N .
Associations between incarceration history and risk of hypertension and hyperglycemia: consideration of differences among Black, Hispanic, Asian and White Subgroups.
J Gen Intern Med 2024 Jan; 39(1):5-12. doi: 10.1007/s11606-023-08327-9..
Keywords: Vulnerable Populations, Racial and Ethnic Minorities, Blood Pressure, Cardiovascular Conditions, Risk
Haimovich AD, Shah MN, Southerland LT
Automating risk stratification for geriatric syndromes in the emergency department.
This study discussed using automated risk stratification to implement screening programs for geriatric syndromes in the emergency department (ED). This method would reduce significant workloads at a time of record-breaking ED patient volumes, staff shortages, and hospital boarding crises. The authors defined the concept of automated risk stratification and screening using existing electronic health record (EHR) data. They discussed progress made in three potential use cases in the ED: falls, cognitive impairment, and end-of-life and palliative care; emphasizing the importance of linking automated screening with systems of healthcare delivery. They found that research progress and operational deployment vary by use case, ranging from deployed solutions in falls screening to algorithmic validation in cognitive impairment and end-of-life care, but should still be considered a potential solution.
AHRQ-funded; HS027735.
Citation: Haimovich AD, Shah MN, Southerland LT .
Automating risk stratification for geriatric syndromes in the emergency department.
J Am Geriatr Soc 2024 Jan; 72(1):258-67. doi: 10.1111/jgs.18594..
Keywords: Elderly, Emergency Department, Risk, Health Information Technology (HIT)
Oke I, Elze T, Miller JW
Surgical approach and reoperation risk in intermittent exotropia in the IRIS Registry.
This cohort study compared the 5-year reoperation rates for children with intermittent exotropia (IXT). Reoperation rates for children with IXT treated with horizontal muscle strabismus surgery using bilateral lateral rectus recession (BLR) vs unilateral lateral rectus recession with medial rectus resection (RR) were compared. The authors examined data obtained from the Intelligent Research in Sight (IRIS) Registry on 7482 children (age, <18 years) with IXT who underwent horizontal eye muscle strabismus surgery, excluding children undergoing initial surgeries involving 3 or more horizontal muscles, vertical muscles, or reoperations. Primary outcome was the adjusted cumulative incidence of repeat horizontal muscle surgery within 5 years after the initial surgery. BLR was performed more frequently than RR (85.3% vs 14.7%), especially in younger children. After data adjustment, the 5-year cumulative incidence of reoperation was 21.3%. The adjusted 5-year cumulative incidence of reoperation was higher for BLR than for RR. Unilateral lateral rectus recession with medial rectus resection was associated with a lower 5-year reoperation risk compared with BLR. Younger age at time of initial surgery was associated with a higher reoperation risk.
AHRQ-funded; HS000063.
Citation: Oke I, Elze T, Miller JW .
Surgical approach and reoperation risk in intermittent exotropia in the IRIS Registry.
JAMA Ophthalmol 2024 Jan; 142(1):48-52. doi: 10.1001/jamaophthalmol.2023.5288..
Keywords: Surgery, Risk
Bennette CS, Ramsey SD, McDermott CL
Predicting low accrual in the National Cancer Institute's cooperative group clinical trials.
The study’s objective was to evaluate the empirical relationship and predictive properties of putative risk factors for low accrual in the National Cancer Institute's (NCI's) Cooperative Group Program, now the National Clinical Trials Network (NCTN). It identified multiple characteristics of NCTN-sponsored trials associated with low accrual and developed a prediction model that can provide a useful estimate of accrual risk based on these factors.
AHRQ-funded; HS023340.
Citation: Bennette CS, Ramsey SD, McDermott CL .
Predicting low accrual in the National Cancer Institute's cooperative group clinical trials.
J Natl Cancer Inst 2016 Feb;108(2). doi: 10.1093/jnci/djv324.
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Keywords: Research Methodologies, Risk
Spatz ES, Jiang X, Lu J
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
The Qingdao Port Cardiovascular Health Study was designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Early findings reveal a significant increase in cardiovascular risk factors (hypertension, diabetes, hyperlipidemia, and body mass index) from 2000 to 2010.
AHRQ-funded; HS023000.
Citation: Spatz ES, Jiang X, Lu J .
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
BMJ Open 2015 Dec 9;5(12):e008403. doi: 10.1136/bmjopen-2015-008403.
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Keywords: Cardiovascular Conditions, Risk, Social Determinants of Health, Patient-Centered Outcomes Research, Prevention
Yu SH, Silverberg JI
Association between atopic dermatitis and depression in US adults.
The researchers sought to determine the prevalence of depression in US adults with atopic dermatitis (AD). They concluded that approximately one in three US adults with AD reported any symptoms of depression and one in three adults with AD met diagnostic criteria for major depressive disorder.
AHRQ-funded; HS023011.
Citation: Yu SH, Silverberg JI .
Association between atopic dermatitis and depression in US adults.
J Invest Dermatol 2015 Dec;135(12):3183-6. doi: 10.1038/jid.2015.337..
Keywords: Depression, Behavioral Health, Risk, Skin Conditions
Ericson JE, Popoola VO, Smith PB
Burden of invasive staphylococcus aureus infections in hospitalized infants.
This study compared demographics and mortality of inf ants with invasive methicillin-resistant S aureus (MRSA) and methicillin-susceptible S aureus (MSSA), to determine the annual proportion of S aureus infections that were MRSA. It found that infant mortality after invasive MRSA and MSSA infections was similar, but MSSA caused more infections and more deaths in infants than MRSA.
AHRQ-funded; HS022872.
Citation: Ericson JE, Popoola VO, Smith PB .
Burden of invasive staphylococcus aureus infections in hospitalized infants.
JAMA Pediatr 2015 Dec;169(12):1105-11. doi: 10.1001/jamapediatrics.2015.2380..
Keywords: Newborns/Infants, Methicillin-Resistant Staphylococcus aureus (MRSA), Mortality, Hospitalization, Risk
Rajaram R, Ju MH, Bilimoria KY
National evaluation of hospital readmission after pulmonary resection.
The study’s objectives were to (1) assess readmission rates and timing after pulmonary resection, (2) report the most common reasons for rehospitalization, and (3) identify risk factors for unplanned readmission after pulmonary resection. It found that experiencing a postoperative complication was strongly associated with unplanned readmission.
AHRQ-funded; HS000078.
Citation: Rajaram R, Ju MH, Bilimoria KY .
National evaluation of hospital readmission after pulmonary resection.
J Thorac Cardiovasc Surg 2015 Dec;150(6):1508-14.e2. doi: 10.1016/j.jtcvs.2015.05.047..
Keywords: Hospital Readmissions, Risk, Surgery, Quality Indicators (QIs), Adverse Events
Olfson M, Gerhard T, Huang C
Premature mortality among adults with schizophrenia in the United States.
The objective of the study was to describe overall and cause-specific mortality rates and standardized mortality ratios for adults with schizophrenia compared with the US general population. In a US national cohort of adults with schizophrenia, excess deaths from cardiovascular and respiratory diseases implicate modifiable cardiovascular risk factors, including especially tobacco use.
AHRQ-funded; HS021112.
Citation: Olfson M, Gerhard T, Huang C .
Premature mortality among adults with schizophrenia in the United States.
JAMA Psychiatry 2015 Dec;72(12):1172-81. doi: 10.1001/jamapsychiatry.2015.1737..
Keywords: Mortality, Behavioral Health, Patient-Centered Outcomes Research, Risk
Du XL, Zhang Y
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
This study sought to determine the relationship between the receipt of colony-stimulating factors (CSFs) with erythropoiesis-stimulating agents (ESAs) and the risk of developing venous thromboembolism (VTE), stroke, heart disease, and myelodysplastic syndrome (MDS) in patients with colorectal cancer. It found that the use of ESAs was significantly associated with a substantially increased risk of MDS in patients with colorectal cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y .
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
Clin Colorectal Cancer 2015 Dec;14(4):e21-31. doi: 10.1016/j.clcc.2015.05.007.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Amarnath AL, Franks P, Robbins JA
Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study.
The researchers aimed to determine the extent to which dual-energy x-ray absorptiometry (DXA) screening is used in accordance with USPSTF recommendations within a regional health system. They concluded that DXA screening was underused in women at increased fracture risk, including women age 65 and over. Meanwhile, DXA screening was common among women at low fracture risk, such as younger women without osteoporosis risk factors.
AHRQ-funded; HS022236.
Citation: Amarnath AL, Franks P, Robbins JA .
Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study.
J Gen Intern Med 2015 Dec;30(12):1733-40. doi: 10.1007/s11606-015-3349-8.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Osteoporosis, Healthcare Utilization, Risk
Kerber KA, Meurer WJ, Brown DL
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
The researchers estimated the ability of bedside information to risk stratify stroke in acute dizziness presentations. They found that in acute dizziness presentations, the combination of ABCD(2) score, general neurologic examination, and a specialized ocular motor examination has the capacity to risk-stratify acute stroke on MRI.
AHRQ-funded; HS018334; HS017690; HS022258.
Citation: Kerber KA, Meurer WJ, Brown DL .
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
Neurology 2015 Nov 24;85(21):1869-78. doi: 10.1212/wnl.0000000000002141..
Keywords: Stroke, Risk, Healthcare Utilization, Shared Decision Making
Curtis JR, Sarsour K, Napalkov P
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Interstitial lung disease (ILD) is a common extra-articular condition in rheumatoid arthritis (RA), but few studies have systematically investigated its incidence and risk factors in patients receiving anti-tumor necrosis factor-alpha (anti-TNFα) agents or alternate mechanisms of action (MOAs). After examining 13,795 episodes of biologic exposure in 11,219 patients, researchers found no significant differences in the risk of ILD and its related complications between RA patients receiving anti-TNFα agents and those receiving alternate MOA agents.
AHRQ-funded; HS018517.
Citation: Curtis JR, Sarsour K, Napalkov P .
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Arthritis Res Ther 2015 Nov 11;17:319. doi: 10.1186/s13075-015-0835-7..
Keywords: Arthritis, Comparative Effectiveness, Medication, Respiratory Conditions, Risk
Crandall CJ, Hovey KM, Andrews CA
Bone mineral density as a predictor of subsequent wrist fractures: findings from the Women's Health Initiative Study.
This paper's objective was to examine associations between the Fracture Risk Assessment Tool (FRAX)-predicted risk of major osteoporotic fracture (MOF), bone mineral density (BMD), BMD change, and wrist fracture. Results showed that lumbar spine and femoral neck BMDs were associated with incident wrist fracture, but the FRAX threshold recommended to identify screening candidates did not identify the majority of women who subsequently experienced wrist fracture.
AHRQ-funded; HS023009.
Citation: Crandall CJ, Hovey KM, Andrews CA .
Bone mineral density as a predictor of subsequent wrist fractures: findings from the Women's Health Initiative Study.
J Clin Endocrinol Metab 2015 Nov;100(11):4315-24. doi: 10.1210/jc.2015-2568.
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Keywords: Injuries and Wounds, Osteoporosis, Risk, Women
Kimberly RP, Rich SS, Cho JH
Characterization of genetic loci that affect susceptibility to inflammatory bowel diseases in African Americans.
The researchers performed a genetic mapping study using the Immunochip to determine whether inflammatory bowel disease (IBD) susceptibility loci in Caucasians also affect risk in African Americans (AAs) and identify new associated loci. In their analysis of 3,308 AA IBD cases and controls, they found that many variants associated with IBD in Caucasians also showed association evidence with these diseases in AAs.
AHRQ-funded; HS021747.
Citation: Kimberly RP, Rich SS, Cho JH .
Characterization of genetic loci that affect susceptibility to inflammatory bowel diseases in African Americans.
Gastroenterology 2015 Nov;149(6):1575-86. doi: 10.1053/j.gastro.2015.07.065..
Keywords: Racial and Ethnic Minorities, Genetics, Risk, Health Information Technology (HIT)
Hignett S, Wolf L, Taylor E
Firefighting to innovation: using human factors and ergonomics to tackle slip, trip, and fall risks in hospitals.
The aim of this study was to use a theoretical model (bench) for human factors and ergonomics (HFE) and a comparison with occupational slips, trips, and falls (STFs) risk management to discuss patient STF interventions (bedside). : Three case studies are used to discuss how HFE has been, or could be, applied to STF risk management.
AHRQ-funded; HS021824.
Citation: Hignett S, Wolf L, Taylor E .
Firefighting to innovation: using human factors and ergonomics to tackle slip, trip, and fall risks in hospitals.
Hum Factors 2015 Nov;57(7):1195-207. doi: 10.1177/0018720815593642.
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Keywords: Patient Safety, Risk, Falls, Hospitals
Persell SD, Brown T, Lee JY
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
The researchers conducted a randomized trial to determine if mailed outreach containing patients’ individualized CVD risk and uncontrolled risk factors followed by telephone discussion with trained lay health workers would improve statin use for primary prevention among community health center patients with moderately high cardiovascular risk. They found that the intervention, led to more cholesterol treatment discussions with primary care clinicians but had little impact on statin prescribing.
AHRQ-funded; HS021141.
Citation: Persell SD, Brown T, Lee JY .
Individualized risk communication and outreach for primary cardiovascular disease prevention in community health centers: randomized trial.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):560-6. doi: 10.1161/circoutcomes.115.001723..
Keywords: Cardiovascular Conditions, Prevention, Community-Based Practice, Clinician-Patient Communication, Risk
Ellis MC, Paugh TA, Dickinson TA
Nadir hematocrit on bypass and rates of acute kidney injury: does sex matter?
Recent literature has suggested that women, although more often exposed to lower nadir hematocrit (Hct), have a lower risk of postoperative renal dysfunction. The researchers assessed whether this relationship held across a large multicenter registry. They found that lower nadir Hct was associated with an increased risk of AKI, and the effect appears to be stronger among men than women.
AHRQ-funded; HS022535; HS022909.
Citation: Ellis MC, Paugh TA, Dickinson TA .
Nadir hematocrit on bypass and rates of acute kidney injury: does sex matter?
Ann Thorac Surg 2015 Nov;100(5):1549-54; discussion 54-5. doi: 10.1016/j.athoracsur.2015.05.080..
Keywords: Risk, Cardiovascular Conditions, Surgery, Adverse Events, Patient Safety
Haukoos JS, Lewis RJ
The propensity score.
The authors discuss studies by Rozé et al and Huybrechts et al that used propensity score matching and propensity score stratification, respectively. They argue that although both methods are more valid in terms of balancing study groups than simple matching or stratification based on baseline characteristics, they vary in their ability to minimize bias. In general, propensity score matching minimizes bias to a greater extent than propensity score stratification.
AHRQ-funded; HS021749.
Citation: Haukoos JS, Lewis RJ .
The propensity score.
JAMA 2015 Oct 20;314(15):1637-8. doi: 10.1001/jama.2015.13480..
Keywords: Research Methodologies, Data, Risk
Chang AL, Hurwitz E, Miyamura J
Maternal risk factors and perinatal outcomes among pacific islander groups in Hawaii: a retrospective cohort study using statewide hospital data.
This study compared perinatal outcomes between Pacific Islander and White women who delivered a singleton liveborn in any Hawaii hospital from January 2010 to December 2011. Significant differences in perinatal outcomes between Pacific Islander and White women and newborns were noted. All Pacific Islander groups had an increased risk of hypertension. Native Hawaiians had the highest risk of low birthweight infants.
AHRQ-funded; HS021903.
Citation: Chang AL, Hurwitz E, Miyamura J .
Maternal risk factors and perinatal outcomes among pacific islander groups in Hawaii: a retrospective cohort study using statewide hospital data.
BMC Pregnancy Childbirth 2015 Oct 05;15:239. doi: 10.1186/s12884-015-0671-4.
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Keywords: Maternal Care, Risk, Racial and Ethnic Minorities, Outcomes, Newborns/Infants
Vogel JA, Seleno N, Hopkins E
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
The objective of this study was to compare prognostic accuracies of the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, ED Sequential Organ Failure Assessment (SOFA) score, and ED base deficit and ED lactate for inhospital mortality in adult trauma patients. It concluded that The Denver ED TOF Score more accurately predicts inhospital mortality in adult trauma patients compared to the other three.
AHRQ-funded; HS017526.
Citation: Vogel JA, Seleno N, Hopkins E .
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
Am J Emerg Med 2015 Oct;33(10):1440-4. doi: 10.1016/j.ajem.2015.07.006..
Keywords: Emergency Medical Services (EMS), Risk, Mortality, Comparative Effectiveness, Emergency Department