Implications of conducting trend analyses of emergency department visits using publicly released masked design variables.


STUDY OBJECTIVE:We examine whether using public National Hospital Ambulatory Medical Care Survey (NHAMCS) data with masked design variables produces different estimates, standard errors, and confidence intervals (CIs) for the temporal trend of overall and injury-related emergency department (ED) visits compared with using unmasked data housed at the Centers for Disease Control and Prevention. METHODS:We obtained counts of ED visits with their standard errors for unmasked data from published summaries from 1999 through 2006. Public files with masked design variables were used to estimate visit counts and rates with standard errors for each year, using the Taylor series linearization method. Weighted least squares linear regressions were used for trend analysis to estimate the annual change in visits. RESULTS:Compared with using unmasked data, using masked data produced similar estimates of overall ED visit counts and rates for each year from 1999 through 2006 but overestimated standard errors by 27% on average (range 12% to 45%). According to unmasked data, overall ED visit counts increased by 1.973 million annually (standard error 0.747; 95% CI 0.505 to 3.440 million [corrected] ). With masked data, the estimated change was 1.977 million visits annually (standard error 0.894; 95% CI -0.221 to 3.733 million [corrected] ). As for injury-related ED visit counts, masked data overestimated the standard error by 16% for trend. Although neither unmasked nor masked data suggested a statistically significant annual increase of overall or injury-related ED visit rate, masked data overestimated the standard error by 16%. CONCLUSION:Using masked public data overestimated standard errors for trend of counts and rates for overall and injury-related ED visits and resulted in wider CIs.


Ann Emerg Med


Zhu M,Chu H,Rice TM,Carter MW




Has Abstract


2011-06-01 00:00:00














  • Serum levels of smooth muscle heavy-chain myosin in patients with ectopic pregnancy.

    abstract:STUDY OBJECTIVE:Previous studies have suggested that serum markers of smooth muscle destruction have utility in predicting ectopic pregnancy. Our goal was to determine whether a novel marker of muscle destruction, smooth muscle heavy-chain myosin (SMHC), is elevated in the serum of patients with ectopic pregnancy. MET...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章


    authors: Birkhahn RH,Gaeta TJ,Suzuki T,Katoh H,Nagai R,Bove J

    更新日期:2000-08-01 00:00:00

  • Accuracy of noninvasive multiwave pulse oximetry compared with carboxyhemoglobin from blood gas analysis in unselected emergency department patients.

    abstract:STUDY OBJECTIVE:Accurate and timely diagnosis of carbon monoxide (CO) poisoning is difficult because of nonspecific symptoms. Multiwave pulse oximetry might facilitate the screening for occult poisoning by noninvasive measurement of carboxyhemoglobin (COHb), but its reliability is still unknown. We assess bias and prec...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Roth D,Herkner H,Schreiber W,Hubmann N,Gamper G,Laggner AN,Havel C

    更新日期:2011-07-01 00:00:00

  • Propranolol overdose.

    abstract::This is a report of a patient who survived a large propranolol overdose, as documented by toxic blood levels. The signs and symptoms were those of profound inotropic and moderate chronotropic cardiotoxicity which failed to respond to parasympatholytics or catecholamines, but subsequently reversed coincident with the a...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Salzberg MR,Gallagher EJ

    更新日期:1980-01-01 00:00:00

  • Investigation of bone developmental and histopathologic changes from intraosseous infusion.

    abstract:STUDY OBJECTIVE:To evaluate clinical and cellular changes of bone through the rapid growth phase of development after intraosseous infusion of hypertonic or isotonic solutions at slow or fast infusion rates in a pig model. METHODS:This was a prospective, randomized, partially blinded, comparative study using a porcine...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Brickman KR,Rega P,Schoolfield L,Harkins K,Weisbrode SE,Reynolds G

    更新日期:1996-10-01 00:00:00

  • Randomized Trial of Intravenous Lidocaine Versus Hydromorphone for Acute Abdominal Pain in the Emergency Department.

    abstract:STUDY OBJECTIVE:We compare the efficacy and safety of intravenous lidocaine with that of hydromorphone for the treatment of acute abdominal pain in the emergency department (ED). METHODS:This was a randomized, double-blind, clinical trial conducted in 2 EDs in the Bronx, NY. Adults weighing 60 to 120 kg were randomize...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,随机对照试验


    authors: Chinn E,Friedman BW,Naeem F,Irizarry E,Afrifa F,Zias E,Jones MP,Pearlman S,Chertoff A,Wollowitz A,Gallagher EJ

    更新日期:2019-08-01 00:00:00

  • Sports-related pneumothorax.

    abstract::Pneumothorax and pneumomediastinum are rare complications of athletic activity. Spontaneous pneumothorax has been reported in association with several sports, but reports of pneumothorax associated with blunt trauma sustained during sporting activity are rare. We present a case series of patients in whom pneumothorax ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Partridge RA,Coley A,Bowie R,Woolard RH

    更新日期:1997-10-01 00:00:00

  • Successful conversion of unstable supraventricular tachycardia to sinus rhythm with adenosine.

    abstract:STUDY PURPOSE:To evaluate the efficacy of adenosine in the treatment of emergency department patients with unstable paroxysmal supraventricular tachycardia (PSVT). DESIGN:A retrospective chart review conducted over two years. SETTING:A university-affiliated hospital ED. PARTICIPANTS:Patients with unstable PSVT (syst...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Melio FR,Mallon WK,Newton E

    更新日期:1993-04-01 00:00:00

  • Intravenous morphine at 0.1 mg/kg is not effective for controlling severe acute pain in the majority of patients.

    abstract:STUDY OBJECTIVE:The objective was to quantify the analgesic effect of a dose of intravenous morphine, 0.1 mg/kg, to emergency department (ED) patients presenting in acute, severe pain. METHODS:This was a prospective convenience cohort of patients aged 21 to 65 years and presenting to an academic urban ED with acute, s...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Bijur PE,Kenny MK,Gallagher EJ

    更新日期:2005-10-01 00:00:00

  • Epidemiology of trauma: the civilian perspective.

    abstract::Recent interest in civilian trauma as a public health problem dates from the National Academy of Sciences white paper in 1966. Civilian trauma patterns vary depending on locale--blunt trauma predominates in rural and smaller urban areas (65% to 80% of hospital admissions); penetrating trauma in larger urban areas outw...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Baker CC

    更新日期:1986-12-01 00:00:00

  • High-dose hydrocortisone hemisuccinate in scorpion envenomation.

    abstract:STUDY OBJECTIVE:Scorpion envenomation is a common life-threatening hazard in tropical and subtropical countries. Standard treatment is not clearly defined. Many therapies, such as steroids, are prescribed without experimental justification. We sought to assess the efficacy of systematic administration of intravenous hy...

    journal_title:Annals of emergency medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Abroug F,Nouira S,Haguiga H,Elatrous S,Belghith M,Boujdaria R,Touzi N,Bouchoucha S

    更新日期:1997-07-01 00:00:00

  • Emergency physicians' perspectives on their use of health information exchange.

    abstract:STUDY OBJECTIVE:We explore what emergency physicians with access to health information exchange have to say about it and strive to better understand the factors affecting their use of it. METHODS:A qualitative study using grounded theory principles was conducted in 4 urban emergency departments that had health informa...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究


    authors: Thorn SA,Carter MA,Bailey JE

    更新日期:2014-03-01 00:00:00

  • Efficacy and safety of out-of-hospital intravenous metoprolol administration in anterior ST-segment elevation acute myocardial infarction: insights from the METOCARD-CNIC trial.

    abstract:STUDY OBJECTIVE:We seek to examine the efficacy and safety of prereperfusion emergency medical services (EMS)-administered intravenous metoprolol in anterior ST-segment elevation myocardial infarction patients undergoing eventual primary angioplasty. METHODS:This is a prespecified subgroup analysis of the Effect of Me...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Mateos A,García-Lunar I,García-Ruiz JM,Pizarro G,Fernández-Jiménez R,Huertas P,García-Álvarez A,Fernández-Friera L,Bravo J,Flores-Arias J,Barreiro MV,Chayán-Zas L,Corral E,Fuster V,Sánchez-Brunete V,Ibáñez B,METOCARD-CNIC

    更新日期:2015-03-01 00:00:00

  • An overview of the adaptive designs accelerating promising trials into treatments (ADAPT-IT) project.

    abstract::Randomized clinical trials, which aim to determine the efficacy and safety of drugs and medical devices, are a complex enterprise with myriad challenges, stakeholders, and traditions. Although the primary goal is scientific discovery, clinical trials must also fulfill regulatory, clinical, and ethical requirements. In...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Meurer WJ,Lewis RJ,Tagle D,Fetters MD,Legocki L,Berry S,Connor J,Durkalski V,Elm J,Zhao W,Frederiksen S,Silbergleit R,Palesch Y,Berry DA,Barsan WG

    更新日期:2012-10-01 00:00:00

  • Revisiting the "Golden Hour": An Evaluation of Out-of-Hospital Time in Shock and Traumatic Brain Injury.

    abstract:STUDY OBJECTIVE:We evaluate patients with shock and traumatic brain injury who were previously enrolled in an out-of-hospital clinical trial to test the association between out-of-hospital time and outcome. METHODS:This was a secondary analysis of patients with shock and traumatic brain injury who were aged 15 years o...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,随机对照试验


    authors: Newgard CD,Meier EN,Bulger EM,Buick J,Sheehan K,Lin S,Minei JP,Barnes-Mackey RA,Brasel K,ROC Investigators.

    更新日期:2015-07-01 00:00:00

  • Sore throat: to culture or not to culture.

    abstract::The traditional use of the throat culture to guide treatment of potential streptococcal pharyngitis recently has been questioned because of the following facts: antibiotic therapy within the first 48 hours of illness reduces the severity and symptoms of streptococcal pharyngitis; more rapid treatment of streptococcal ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Hedges JR,Lowe RA

    更新日期:1986-03-01 00:00:00

  • The ability of physicians to predict hyperkalemia from the ECG.

    abstract:STUDY OBJECTIVE:To determine whether physicians blinded to the serum potassium level can predict hyperkalemia (potassium concentration of more than 5.0 mmol/L) from the ECG. DESIGN:ECGs of patients at high risk for hyperkalemia were interpreted retrospectively by two physicians blinded not only to the specific clinica...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Wrenn KD,Slovis CM,Slovis BS

    更新日期:1991-11-01 00:00:00

  • MAM-2201 (analytically confirmed) intoxication after "Synthacaine" consumption.

    abstract::Excitatory behavior, xerostomia, chest pain, severe dyspnea, tachycardia (150 beats/min), and mild hypertension (160/80 mm Hg) without ECG abnormalities were observed in a 20-year-old subject 6 hours after nasal insufflation (snorting) of a "legally" obtained white powdered substance sold as Synthacaine. A serum sampl...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Lonati D,Buscaglia E,Papa P,Valli A,Coccini T,Giampreti A,Petrolini VM,Vecchio S,Serpelloni G,Locatelli CA

    更新日期:2014-12-01 00:00:00

  • The emergency management of a medicinal leech bite.

    abstract::Leeches have been used as a medicinal remedy for years untold. Recently, there appears to have been a resurgence in the use of the medicinal leech, Hirudo medicinalis. Presented is the case of a patient who called the emergency department for advice concerning the management of a bleeding leech bite. We discuss briefl...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Adams SL

    更新日期:1989-03-01 00:00:00

  • Core content survey of undergraduate education in emergency medicine.

    abstract::One hundred forty-one medical schools were surveyed to determine the emergency medicine core content topics and skills being taught in the curricula. Responses were obtained from 96 schools through two mailings and a telephone followup. Most topics surveyed were offered in the vast majority of medical schools (greater...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Sanders AB,Criss E,Witzke D

    更新日期:1986-01-01 00:00:00

  • Ventricular tachycardia may masquerade as supraventricular tachycardia in patients with preexisting bundle-branch block.

    abstract::We present the cases of three patients with preexisting bundle-branch block in whom wide-complex tachycardias were considered to be of supraventricular origin because QRS morphologies were essentially unchanged from those during normal sinus rhythm. The patients experienced adverse effects from medications for suprave...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Littmann L,McCall MM

    更新日期:1995-07-01 00:00:00

  • Telephone notification of relatives of emergency and critical care patients.

    abstract::Inconsistency in contacting the families of acutely ill patients can negatively affect relatives and induce stress in emergency department staff. Role clarification and performance guidelines are discussed in the context of a telephone notification of relatives checklist, with staff advised in six specific interventio...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Robinson MA

    更新日期:1982-11-01 00:00:00

  • Appropriate suction device in rescue medicine.

    abstract::In rescue medicine, a suction apparatus must function in a variety of environmental conditions. To find an appropriate device for the Swedish Air Force air rescue service the Laerdal suction device 790,000 was selected for further testing according to international standards for aviation safety. Tests showed that vibr...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Dahlgren BE,Nilsson H,Bjorn P,Skedevik C

    更新日期:1987-12-01 00:00:00

  • Molecular methods: applications for clinical infectious diseases.

    abstract::The application of molecular biology to microbiology has led to a surge of new information about most infectious microorganisms, the pathogenesis of the infections they cause, and the specific microbial antigens involved in the immune response to these infections. The simultaneous application of the same techniques to...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审


    authors: Engleberg NC

    更新日期:1994-09-01 00:00:00

  • Breath alcohol analyzer mistakes methanol poisoning for alcohol intoxication.

    abstract::Breath alcohol analyzers are used to detect ethanol in motorists and others suspected of public intoxication. One concern is their ability to detect interfering substances that may falsely increase the ethanol reading. A 47-year-old-man was found in a public park, acting intoxicated. A breath analyzer test (Intoxilyze...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Caravati EM,Anderson KT

    更新日期:2010-02-01 00:00:00

  • Empiric use of flumazenil in comatose patients: limited applicability of criteria to define low risk.

    abstract:STUDY OBJECTIVE:To develop clinical rules for the safe and effective use of flumazenil in suspected benzodiazepine overdose. METHODS:We assembled a retrospective series of 35 consecutive comatose patients admitted between October 1992 and July 1993 to a toxicologic ICU with the presumptive diagnosis of drug overdose. ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Gueye PN,Hoffman JR,Taboulet P,Vicaut E,Baud FJ

    更新日期:1996-06-01 00:00:00

  • Human envenomation from a wandering garter snake.

    abstract::Garter snake bites are generally innocuous to human beings. We report a case of human envenomation from the Wandering Garter snake (Thamnophis elegans vagrans). The patient, who was bitten on his right third fingertip, rapidly developed local edema, ecchymosis, and hemorrhagic vesicles. Systemic signs and symptoms did...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Gomez HF,Davis M,Phillips S,McKinney P,Brent J

    更新日期:1994-05-01 00:00:00

  • Optimizing emergency department front-end operations.

    abstract::As administrators evaluate potential approaches to improve cost, quality, and throughput efficiencies in the emergency department (ED), "front-end" operations become an important area of focus. Interventions such as immediate bedding, bedside registration, advanced triage (triage-based care) protocols, physician/pract...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审


    authors: Wiler JL,Gentle C,Halfpenny JM,Heins A,Mehrotra A,Mikhail MG,Fite D

    更新日期:2010-02-01 00:00:00

  • Rapid-sequence intubation in head trauma.

    abstract::Elevated intracranial pressure commonly is associated with severe head injury. Emergency airway management technique in the patient who has sustained severe head injury must optimize conditions for intubation, minimize the adverse effects of intubation, and permit rapid and effective management of the elevated intracr...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章,评审


    authors: Walls RM

    更新日期:1993-06-01 00:00:00

  • Systematic Reviews Published in Emergency Medicine Journals Do Not Routinely Search Clinical Trials Registries: A Cross-Sectional Analysis.

    abstract:STUDY OBJECTIVE:Publication bias compromises the validity of systematic reviews. This problem can be addressed in part through searching clinical trials registries to identify unpublished studies. This study aims to determine how often systematic reviews published in emergency medicine journals include clinical trials ...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Keil LG,Platts-Mills TF,Jones CW

    更新日期:2015-10-01 00:00:00

  • Developing a clinical algorithm for early management of cervical spine injury in child trauma victims.

    abstract::To define a subset of injured children for whom emergency cervical spine radiography may be unnecessary, we performed a retrospective chart and radiologic review. Two entry methods were used: All injured children, from birth through 16 years, who had received cervical spine radiographs at The Children's Memorial Hospi...

    journal_title:Annals of emergency medicine

    pub_type: 杂志文章


    authors: Jaffe DM,Binns H,Radkowski MA,Barthel MJ,Engelhard HH 3rd

    更新日期:1987-03-01 00:00:00