Family-assigned video-interpreting in the pediatric emergency department: A pilot project
Name:
Dr. Colleen Gutman
Email
ckays21@ufl.edu
Phone
(352) 265-5911
Faculty Department/Division
Emergency Medicine
This project is primarily:
Translational
Research Project Description:
Professional interpreting is an evidence-based and federally-mandated means of improving communication with families who use languages other than English (LOE) in healthcare settings. However, across clinical settings, use of professional interpreting remains suboptimal. In the emergency department (ED), the brief and fragmented nature of communication presents unique barriers to professional interpreting. To address these barriers and improve professional interpreting, we are conducting a pilot intervention aimed at increasing the use of professional interpretation in the pediatric ED. The pilot will involve assigning families who use languages other than English to their own video-interpreting device for the duration of their ED stay. We will be collecting and analyzing pilot feasibility and acceptability data. The MSRP student would be responsible for collecting these data and participating in analysis. Data collection would involve tracking device assignments and comparing these to administrative data regarding language need, surveying staff about their experiences with the program, and surveying families who participate in the pilot. The pilot will be covered by both QIPR and IRB. I anticipate the data will be presented at national conferences (with the student having the opportunity to be the first author/presenter on abstracts) and published (with the student having a co-authorship role on publications).
Does this project have an international component or travel?
No
Innovation and Outcomes: a value assessment of telemedicine in ED triage
Faculty Information
Name:
Dr. Brandon Allen
Email
brandonrallen@ufl.edu
Phone
(954) 675-4321
Faculty Department/Division
Emergency Medicine
This project is primarily:
Clinical
Research Project Description:
Background:
The adoption of telemedicine in emergency departments has increased during the COVID-19 pandemic. This research project aims to retrospectively review and analyze data from 2020 to 2022 to assess the impact of incorporating telemedicine as a standard of care for lobby provider initial assessments and medical screening exams in the adult emergency department. Understanding how telemedicine influences productivity and emergency department (ED) metrics is vital for optimizing healthcare delivery in the post-pandemic era.
Hypothesis:
We hypothesize that integrating telemedicine into the initial assessment process in the adult ED will lead to improved productivity, reduced patient wait times, decreased resource utilization, and an overall positive impact on ED metrics. Telemedicine may facilitate timely triage and enhance patient care in the ED setting.
Methods:
This retrospective research project will involve the following steps:
a. Data Collection: Retrieving and analyzing relevant data from 2020 to 2022, including patient records, telemedicine utilization records, and ED metrics such as wait times, length of stay, and resource allocation.
b. Patient Stratification: Stratifying patients into two groups, one that received telemedicine initial assessments and another that did not, for comparison.
c. Data Analysis: Conducting a comprehensive analysis of productivity and ED metrics between the two patient groups to assess the impact of telemedicine integration.
d. Outcome Assessment: Evaluating the effect of telemedicine on patient wait times, length of stay, patient satisfaction, and resource allocation within the adult ED.
e. Cost-Benefit Analysis: Assessing the economic impact of telemedicine implementation on ED operations and overall healthcare cost-effectiveness.
Role of Medical Student:
A medical student will play a valuable role in this research project, gaining hands-on research experience and contributing to the development of more efficient healthcare delivery. Their responsibilities will include:
a. Data Collection: Assisting in the extraction of relevant patient data, telemedicine utilization records, and ED metrics data.
b. Data Preparation: Collaborating with the research team to clean, organize, and structure the data for analysis.
c. Statistical Analysis: Under supervision, the medical student will participate in statistical analyses to identify trends and associations within the data.
d. Literature Review: Conducting a review of current literature related to telemedicine in the ED, productivity enhancement, and patient outcomes.
e. Presentation and Reporting: Co-authoring research reports and participating in presentations or poster sessions to disseminate findings within the medical community.
This research project aims to provide insights into the impact of telemedicine integration in adult ED initial assessments and its implications on productivity and ED metrics. The involvement of a medical student ensures the integration of educational opportunities and valuable research experience.
Does this project have an international component or travel?
No
What’s the big deal between acute myocardial infarction and acute myocardial injury?
Faculty Information
Name:
Dr. Brandon Allen
Email
brandonrallen@ufl.edu
Phone
(954) 675-4321
Faculty Department/Division
Emergency Medicine
This project is primarily:
Clinical
Research Project Description:
Background:
The diagnosis of myocardial infarction (MI) has evolved over time, with the 4th Universal Definition of MI emphasizing the importance of high-sensitivity troponin measurements for diagnosing MI. Elevated troponin levels can indicate myocardial injury or infarction, and accurate differentiation is crucial for appropriate clinical management. This research project aims to retrospectively review and analyze an existing dataset to assess patients with serial troponins greater than the 99th percentile, categorize them as having myocardial infarction or injury based on the 4th Universal Definition of MI, and evaluate the utilization of diagnostic testing in these cases.
Hypothesis:
We hypothesize that by applying the criteria outlined in the 4th Universal Definition of MI, we can accurately distinguish between myocardial infarction and myocardial injury in patients with serial troponins above the 99th percentile. Furthermore, we expect that this differentiation will lead to a better understanding of diagnostic testing utilization and its impact on patient outcomes.
Methods:
This retrospective research project will involve the following steps:
a. Data Collection: Accessing an existing dataset containing patient information, serial troponin measurements, clinical records, and diagnostic testing results. The dataset will serve as the foundation for our analysis.
b. Classification of Patients: Applying the criteria of the 4th Universal Definition of MI, we will classify patients into two groups: those with myocardial infarction (with adjudicated type of MI) and those with myocardial injury (acute vs chronic).
c. Data Analysis: Conducting a comprehensive analysis of the two patient groups, focusing on clinical outcomes, diagnostic test utilization (e.g., coronary angiography, stress testing), and in-hospital events (e.g., mortality, major adverse cardiovascular events).
d. Outcome Assessment: Comparing the outcomes of patients with MI and those with myocardial injury to understand the impact of accurate diagnosis on patient care and prognosis.
e. Utilization Analysis: Evaluating the patterns and appropriateness of diagnostic testing for both groups, exploring whether adherence to the 4th Universal Definition of MI leads to more efficient and effective testing.
Role of Medical Student:
A medical student will play a significant role in this research project, gaining valuable research experience and contributing to the advancement of clinical decision-making. Their responsibilities will include:
a. Data Extraction: Assisting in extracting relevant patient data from electronic health records and databases.
b. Data Preparation: Collaborating with the research team to clean and organize the dataset for analysis.
c. Statistical Analysis: Under supervision, the medical student will participate in statistical analyses and patient chart adjudication, helping to identify associations and trends in the data.
d. Literature Review: Conducting a literature review to stay updated on the latest advancements in troponin-based MI diagnosis and the 4th Universal Definition of MI.
e. Presentation and Reporting: Co-authoring research reports and participating in presentations or poster sessions to share findings with the medical community.
This research project aims to improve the diagnosis of myocardial infarction and myocardial injury, assess the impact on patient outcomes, and evaluate testing utilization in accordance with the 4th Universal Definition of MI. The involvement of a medical student ensures the integration of educational opportunities and hands-on research experience.
Does this project have an international component or travel?
No
Recalibrating the HEART Score with High Sensitivity Troponin
Faculty Information
Name:
Dr. Brandon Allen
Email
brandonrallen@ufl.edu
Phone
(954) 675-4321
Faculty Department/Division
Emergency Medicine
This project is primarily:
Clinical
Research Project Description:
Background:
The HEART score is a widely used clinical decision rule for assessing the risk of acute coronary syndromes in patients presenting with chest pain. It incorporates various clinical parameters, including history, ECG findings, age, risk factors, and troponin levels. Recent advancements in high sensitivity troponin assays have increased the sensitivity and precision of troponin measurements, potentially allowing for more accurate risk stratification. This research project aims to recalibrate and recalculate the HEART score using high sensitivity troponin data to enhance its clinical utility and accuracy.
Hypothesis:
We hypothesize that incorporating high sensitivity troponin measurements into the HEART score will improve its ability to predict the risk of acute coronary syndromes in chest pain patients. The recalibrated HEART score will exhibit higher sensitivity and specificity, leading to more accurate risk stratification and improved patient outcomes.
Methods:
This retrospective research project will involve the following steps:
a. Data Collection: We will access an existing dataset containing clinical information, ECG findings, and troponin measurements of chest pain patients who presented at our institution. This dataset will serve as the basis for our analysis.
b. Recalibration and Recalculation: We will recalibrate the HEART score by incorporating high sensitivity troponin levels into the existing model. Statistical analyses will be employed to identify optimal cut-off values and weighting of troponin within the score.
c. Data Analysis: We will perform a comprehensive analysis of the recalibrated HEART score, evaluating its sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic (ROC) curves. We will also compare the performance of the recalibrated score with the original HEART score.
d. Clinical Impact Assessment: We will assess the potential clinical impact of the recalibrated HEART score, including its ability to identify low-risk patients who can be safely discharged and high-risk patients requiring further evaluation and intervention.
Role of Medical Student:
A medical student will play a pivotal role in this research project, gaining valuable research experience and contributing to the advancement of clinical decision-making tools. Their responsibilities will include:
a. Data Extraction: Assisting in the retrieval of relevant patient data from electronic health records and databases.
b. Data Cleaning and Preparation: Collaborating with the research team to ensure the dataset is appropriately cleaned and formatted for analysis.
c. Statistical Analysis: Under supervision, the medical student will participate in statistical analyses, helping to identify associations and trends in the data.
d. Literature Review: Conducting a literature review to stay updated on the latest advancements in high sensitivity troponin and clinical decision rules.
e. Presentation and Reporting: Co-authoring research reports and participating in presentations or poster sessions to share findings with the medical community.
This research project aims to enhance the clinical utility of the HEART score by recalibrating it with high sensitivity troponin data, ultimately contributing to improved risk stratification and patient care in the evaluation of chest pain. The involvement of a medical student ensures the integration of educational opportunities and hands-on research experience.
Does this project have an international component or travel?
No
DHCR7 Inhibition as Novel Precision Medicine for Sepsis: A Pilot Study
Name:
Dr. Faheem Guirgis
Email
fguirgis@ufl.edu
Phone
(352) 733-1482
Faculty Department/Division
Emergency Medicine
This project is primarily:
Translational
Research Project Description:
Sepsis is a dysregulated, life-threatening response to infection for which there are no effective disease-specific treatments. We recently used artificial intelligence approaches to discover a panel of fifteen measurements including lipoproteins, inflammatory molecules, and clinical features, and established two new sepsis sub-phenotypes, HYPO and NORMO. HYPO sepsis patients had higher mortality and organ failure, lower lipoprotein levels, and worse endothelial dysfunction compared to NORMO patients. HYPO sepsis patients also had higher expression of specific genes, including 7-dehydrocholesterol reductase (DHCR7), which catalyzes a key final step in cholesterol biosynthesis. Inhibition of DHCR7 has been previously shown to modulate immune response and improve defense against infection. In a recent study, we found that of all the lipid genes studied, DHCR7 was significantly upregulated in both derivation and validation cohorts in poor outcome sepsis compared to rapid recovery patients and in 90-day non-survivors. Working with the UF High-Throughput Molecular Screening Center, the primary goal of this proposal is to use high-throughput screening of new molecules and FDA-approved drugs that share the same chemical motif as AY9944 (known DHCR7 inhibitor), to test their DHCR7 inhibitory properties and discover novel precision medicine for sepsis that can be applied to HYPO sepsis sub-phenotype patients. On this project, students will have the opportunity to work with the UF Department of Emergency Medicine in the Division of Research to learn about laboratory techniques surrounding the above assays. If interested, students will also have the opportunity to learn about enrollment of critically ill patients with sepsis from the Adult Emergency Department. They will also be integrated into a transdisciplinary team of investigators including clinician scientists, basic scientists, data scientists, and AI experts to learn about translational research. Students with an interest in acute care, emergency medicine, resuscitation or critical illness are encouraged to apply.
Does this project have an international component or travel?
No