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1. Outcomes of out of hospital cardiac arrest in First Nations and non-First Nations patients in Saskatoon

Author

Owen Scheirer, Prosanta Mondal, Gabe Lafond, Andrew Leach, Tania LaFontaine, Stuart Netherton, Philip J. Davis, and Tim Hillier

Subjects
Emergency Medical Services, medicine.medical_specialty, Population, Disease, Return of spontaneous circulation, Out of hospital cardiac arrest, 03 medical and health sciences, 0302 clinical medicine, Hospital discharge, medicine, Emergency medical services, Humans, Bystander cardiopulmonary resuscitation, 030212 general & internal medicine, education, education.field_of_study, business.industry, Public health, 030208 emergency & critical care medicine, Middle Aged, Cardiopulmonary Resuscitation, Hospitals, Survival Rate, Emergency medicine, Emergency Medicine, business, Out-of-Hospital Cardiac Arrest
Abstract

One in nine (11.7%) people in Saskatchewan identify as First Nations. It is known that First Nations people have a higher burden of cardiovascular disease, but not whether outcomes of out of hospital cardiac arrest are different.We reviewed pre-hospital and inpatient records of patients with out of hospital cardiac arrest between January 1st, 2015 and December 31st, 2017. The population consisted of patients aged 18 years or older with out of hospital cardiac arrest of presumed cardiac origin occurring in the catchment area of Saskatoon's emergency medical services (EMS). Variables of interest included age, gender, First Nations status, EMS response times, bystander cardiopulmonary resuscitation (CPR), and shockable rhythm. Outcomes of interest included return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge.In all, 372 patients sustained out of hospital cardiac arrest, of which 27 were status First Nations. There were no differences between First Nations and non-First Nations patients in terms of shockable rhythms (24% vs 26%; p = 0.80), ROSC (42% vs 41%; p = 0.87), survival to hospital admission (27% vs 33%; p = 0.53), and survival to hospital discharge (15% vs 12%; p = 0.54). First Nations patients with out of hospital cardiac arrest were significantly younger (mean age 46 vs. 65 years; p 0.0001) and had shorter EMS response times (median times 5.3 vs. 6.2 min; p = 0.01) when compared to non-First Nations patients.In Saskatoon, First Nations patients with out of hospital cardiac arrest appear to have similar survival rates when compared with non-First Nations patients. However, First Nations patients sustaining out of hospital cardiac arrest were significantly younger than their non-First Nations counterparts. This highlights a significant public health issue.RéSUMé: INTRODUCTION: Une personne sur neuf (11,7 %) en Saskatchewan s'identifie comme membre des Premières Nations. On sait que le fardeau des maladies cardiovasculaires est plus lourd pour les membres des Premières Nations, mais on ne sait pas si les résultats d’un arrêt cardiaque en dehors de l’hôpital sont différents. MéTHODES/MéTHODOLOGIE: Nous avons examiné les dossiers pré-hospitaliers et les dossiers des patients hospitalisés ayant subi un arrêt cardiaque hors hôpital entre le 1er janvier 2015 et le 31 décembre 2017. La population était composée de patients âgés de 18 ans ou plus ayant subi un arrêt cardiaque hors de l’hôpital d’origine cardiaque présumée survenu dans la Territoire des services médicaux d’urgence (SMU) de Saskatoon. Les variables d’intérêt comprenaient l’âge, le sexe, le statut des Premières Nations, les temps de réponse des SMU, la réanimation cardiorespiratoire (RCR) des témoins et le rythme choquant. Les résultats d’intérêt comprenaient le retour de la circulation spontanée (RCS), la survie à l’admission à l’hôpital et la survie la sortie de l'hôpital. RéSULTATS : Au total, 372 patients ont subi un arrêt cardiaque hors de l'hôpital, dont 27 étaient des Premières Nations inscrites. Il n’y avait aucune différence entre les patients des Premières Nations et les patients non membres des Premières Nations en termes de rythmes choquants (24 % contre 26 %; p = 0.80), RCS (42% contre 41% ; p = 0.87), survie à l'admission à l'hôpital ( 27% contre 33%; p = 0.53) et la survie à la sortie de l'hôpital (15 % contre 12%; p = 0.54). Les patients des Premières Nations ayant subi un arrêt cardiaque hors hôpital étaient significativement plus jeunes (âge moyen 46 ans contre 65 ans ; p 0.0001)) et avaient des temps de réponse plus courts aux SMU (temps médian 5,3 contre 6,2 minutes ; p = 0.01) par rapport aux patients des autres nations. CONCLUSIONS: À Saskatoon, les patients des Premières Nations ayant subi un arrêt cardiaque hors de l'hôpital semblent avoir des taux de survie similaires à ceux des patients non autochtones. Cependant, les patients des Premières Nations qui ont subi un arrêt cardiaque hors de l'hôpital étaient beaucoup plus jeunes que leurs homologues des autres nations. Cela met en évidence un problème de santé publique important.

Published
2020
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2. The Social Media Index as an Indicator of Quality for Emergency Medicine Blogs: A METRIQ Study

Author

Brent Thoma, Teresa M. Chan, Puneet Kapur, Derek Sifford, Marshall Siemens, Michael Paddock, Felix Ankel, Andy Grock, Michelle Lin, Charlotte Alexander, Mohammed Alkhalifah, Abdulaziz S. Almehlisi, Saeed Alqahtani, Scott Anderson, Shelaina Anderson, Colin Andrews, Jocelyn Andruko, Nikytha Antony, Diptesh Aryal, Barbra Backus, Jennifer Baird, Andrew Baker, Sarah Batty, Jared Baylis, Braeden Beaumont, Chris Belcher, Brent Benavides, Michael Benham, Julian Botta, Nicholas Bouchard, Victoria Brazil, Emily Brumfield, Anthony Bryson, Wisarut Bunchit, Kat Butler, Lindy Buzikievich, David Calcara, Rob Carey, Stephen Carroll, Louise Cassidy, Kirsty Challen, Kathryn Chan, Tim Chaplin, Natasha Chatham-Zvelebil, Eric Chen, Lucy Chen, Sushant Chhabra, Alvin Chin, Eric Chochi, Tina Choudhri, Jeremy Christensen, Isabelle Colmers-Gray, Kimberly Connors, Veronica Coppersmith, Abby Cosgrove, Gregory Costello, Kevin Cullison, Andrew D'Alessandro, Kerstin de Wit, Marie Decock, Rayan Delbani, William Denq, Julianna Deutscher, Brendan Devine, Maia Dorsett, Taylor Duda, Justin Dueweke, Teresa Dunphy, Sean Dyer, Karthryn T Eastley, Marcia Edmonds, Ken Edwards, Robert Ehrman, Youness Elkhalidy, Preston Fedor, Brian Ficiur, Caley Flynn, Bill Fraser, Meagan Fu, James Fukakusa, Eric Funk, Damjan Gaco, Viktor Gawlik, Kenn Ghaffarian, Laleh Gharahbaghian, Phil Griffith, Andrew Griffith, Andrew Grock, Tanner Gronowski, Cathy Grossman, Jaroslaw Gucwa, Pawan Gupta, Alexandra Gustafson, Andrew Guy, Mary Haas, Stanislaw Haciski, Emina Hajdinjak, Andrew K. Hall, Regina Hammock, Jan Hansel, Alexander Hart, Larissa Hattin, Brandon Herb, SueLin Hilbert, Jesse Hill, Jeff Hill, Amy Ho, Emily House, Nina House, James Huffman, Charlie Inboriboon, Alex Ireland, Ali Jamal, Mohammad Ali Jamil, Victor Jansen, Zach Jarou, Vivian Jia, Levi Johnston, Drew Kalnow, Seth Kelly, Kyle Kelson, William Kent, Rishi Khakhkhar, Jaasmit Khurana, Ashley Kilp, Scott Knapp, Sebastian Kohler, Ivanna Kruhlak, Nadim Lalani, Samantha Lam, Patrick Lank, Zander Laurie, Kristina Lea, Ernest Leber, Ching-Hsing Lee, Haakon Lenes, Nilantha Lenora, Jesse Leontowicz, Kelly Lien, Yingchun Lin, Andrew Little, Ivy Liu, Harry Liu, Steve Liu, Stephanie Louka, Elise Lovell, David Lowe, Ashley Lubberdink, Jessica Luc, Casey Lyons, Sheng-Hsiang Ma, Hugh MacLeod, Nick Mancuso, Anali Maneshi, Jesse May, John Mayo, Mike McDonnell, Susan McLellan, Carolyn McQuarrie, Julia Nood, Therese Mead, Cory Meeuwisse, Patrick Meloy, Perry Menzies, Anne Messman, Stephen Miazga, Logan Mills, Ken Milne, Allan Mix, Steve Montag, Brendan Moore, Justin Morgenstern, Sarah Mott, P. Mukherj, Ali Mulla, Sheena Nandalal, Taylor Nikel, Sean Nugent, Morgan Oakland, Werner Oberholzer, Onyeka Otugo, Taofiq Segun Oyedokun, Mike Paddock, Alim Pardhan, Kinjal Patel, Quinten Paterson, Catherine Patocka, Christine Patterson, James Pearlman, Elyse Berger Pelletier, Alexis Pelletier-Bui, Marc Phan, Zafrina Poonja, Aubrey Powell, Kamini Premkumar, Gregor Prosen, Vishal Puri, Tanis Quaife, Ryan Raffel, Ali Raja, Randi Ramunno, Louise Rang, Suzanne Rannazzisi, Shauna Regan, Salim R. Rezaie, Milan Ridderikhof, Vanessa Rogers, Christine Roh, Dra. Maria Rosa Carrillo, Keith Rosenberg, Marina Roure, Sherri Rudinsky, Joshua Rudner, Adeeb Saleh, Will Sanderson, Owen Scheirer, Paul Schofield, Paul Schunk, Evan Schwarz, Parisa Shahrabadi, Eric Shappell, Julia Sheffield, Jonathan Sherbino, Manpreet Singh, Hector C Singson, Dave Slessor, Sam Smith, Paula Sneath, Robert Sobehart, Kerry Spearing, James Stempien, Britni Sternard, Tara Stratton, Katherine Stuart, Bob Stuntz, Michael Susalla, Colleen Sweeney, Loice Swisher, Henry Swoboda, Shahbaz Syed, Taku Taira, Nikhil Tambe, Richard Tang, Elisha Targonsky, Rachel Taylor, Alan Taylor, Todd Taylor, Paxton Ting, Gerhard Tiwald, Kelvin Tran, Evelyn Tran, Jason Trickovic, Paul Trinquero, Seth Trueger, Aaron Tyagi, Manrique Umana, Patrick Vallance, Patricia Van den Berg, Luis Vargas, Rene Verbeek, Sandra Viggers, Zlata Vlodaver, Matthew Wagner, Noorin Walji, Joe Walter, Miranda Wan, Rachel Wang, Gregory Wanner, Wyatt Warawa, Mike Ward, Jennifer Weekes, Kristen Weersink, Cara Weessies, Anna Whalen-Browne, Brian Whiteside, Matthew Willis, Jonas Wilmer, Nelson Wong, Mark Woodcroft, Rob Woods, Lawrence Yau, Jessica Yee, Calvin Yeh, Simon York Ming Huang, Katherine Yurkiw, Fareen Zaver, Alexander Zozula, Emergency Department, Graduate School, ACS - Heart failure & arrhythmias, and ACS - Diabetes & metabolism

Subjects
Adult, Male, medicine.medical_specialty, Index (economics), Blogging, Cross-sectional study, media_common.quotation_subject, education, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Social media, Quality (business), 030212 general & internal medicine, media_common, Web site, business.industry, 030208 emergency & critical care medicine, Critical appraisal, Cross-Sectional Studies, Emergency medicine, Emergency Medicine, Gestalt psychology, Female, business, Social Media
Abstract

Study objective Online educational resources such as blogs are increasingly used for education by emergency medicine clinicians. The Social Media Index was developed to quantify their relative impact. The Medical Education Translational Resources: Indicators of Quality (METRIQ) study was conducted in part to determine the association between the Social Media Index score and quality as measured by gestalt and previously derived quality instruments. Methods Ten blogs were randomly selected from a list of emergency medicine and critical care Web sites. The 2 most recent clinically oriented blog posts published on these blogs were evaluated with gestalt, the Academic Life in Emergency Medicine Approved Instructional Resources (ALiEM AIR) score, and the METRIQ-8 score. Volunteer raters (including medical students, emergency medicine residents, and emergency medicine attending physicians) were identified with a multimodal recruitment methodology. The Social Media Index was calculated in February 2016, November 2016, April 2017, and December 2017. Pearson's correlations were calculated between the Social Media Index and the average rater gestalt, ALiEM AIR score, and METRIQ-8 score. Results A total of 309 of 330 raters completed all ratings (93.6%). The Social Media Index correlated moderately to strongly with the mean rater gestalt ratings (range 0.69 to 0.76) and moderately with the mean rater ALiEM AIR score (range 0.55 to 0.61) and METRIQ-8 score (range 0.53 to 0.57) during the month of the blog post's selection and for 2 years after. Conclusion The Social Media Index's correlation with multiple quality evaluation instruments over time supports the hypothesis that it is associated with overall Web site quality. It can play a role in guiding individuals to high-quality resources that can be reviewed with critical appraisal techniques.

Published
2018

3. Individual Gestalt Is Unreliable for the Evaluation of Quality in Medical Education Blogs: A METRIQ Study

Author

Brent Thoma, Stefanie S. Sebok-Syer, Keeth Krishnan, Marshall Siemens, N. Seth Trueger, Isabelle Colmers-Gray, Rob Woods, Emil Petrusa, Teresa Chan, Charlotte Alexander, Mohammed Alkhalifah, Saeed Alqahtani, Scott Anderson, Shelaina Anderson, Colin Andrews, Jocelyn Andruko, Felix Ankel, Nikytha Antony, Diptesh Aryal, Barbra Backus, Jennifer Baird, Andrew Baker, Sarah Batty, Jared Baylis, Braeden Beaumont, Chris Belcher, Brent Benavides, Michael Benham, Elyse Berger Pelletier, Julian Botta, Nicholas Bouchard, Victoria Brazil, Emily Brumfield, Anthony Bryson, Wisarut Bunchit, Kat Butler, Lindy Buzikievich, David Calcara, Rob Carey, Stephen Carroll, Casey Lyons, Louise Cassidy, Kirsty Challen, Tim Chaplin, Natasha Chatham-Zvelebil, Eric Chen, Lucy Chen, Sushant Chhabra, Alvin Chin, Eric Chochi, Tina Choudhri, Jeremy Christensen, Kimberly Connors, Veronica Coppersmith, Abby Cosgrove, Gregory Costello, Kevin Cullison, Andrew D'Alessandro, Kerstin de Wit, Marie Decock, Rayan Delbani, William Denq, Julianna Deutscher, Brendan Devine, Maia Dorsett, Taylor Duda, Justin Dueweke, Teresa Dunphy, Sean Dyer, Kathryn T. Eastley, Marcia Edmonds, Ken Edwards, Robert Ehrman, Youness Elkhalidy, Preston Fedor, Brian Ficiur, Caley Flynn, Bill Fraser, Meagan Fu, James Fukakusa, Eric Funk, Damjan Gaco, Viktor Gawlik, Kenn Ghaffarian, Laleh Gharahbaghian, Phil Griffith, Andrew Griffith, Andrew Grock, Tanner Gronowski, Cathy Grossman, Jaroslaw Gucwa, Pawan Gupta, Alexandra Gustafson, Andrew Guy, Mary Haas, Stanislaw Haciski, Emina Hajdinjak, Andrew K. Hall, Regina Hammock, Jan Hansel, Alexander Hart, Larissa Hattin, Brandon Herb, SueLin Hilbert, Jesse Hill, Jeff Hill, Amy Ho, Emily House, Nina House, James Huffman, Charlie Inboriboon, Alex Ireland, Mohammed Ali Jamal, Victor Jansen, Zach Jarou, Vivian Jia, Levi Johnston, Drew Kalnow, Puneet Kapur, Seth Kelly, Kyle Kelson, William Kent, Rishi Khakhkhar, Jaasmit Khurana, Ashley Kilp, Scott Knapp, Sebastian Kohler, Ivanna Kruhlak, Nadim Lalani, Samantha Lam, Patrick Lank, Zander Laurie, Kristina Lea, Ernest Leber, Ching-Hsing Lee, Haakon Lenes, Nilantha Lenora, Jesse Leontowicz, Kelly Lien, Yingchun Lin, Michelle Lin, Andrew Little, Ivy Liu, Harry Liu, Steve Liu, Stephanie Louka, Elise Lovell, David Lowe, Ashley Lubberdink, Jessica Luc, Sheng-Hsiang Ma, Hugh MacLeod, Nick Mancuso, Anali Maneshi, Dra. Maria Rosa Carrillo, Jesse May, John Mayo, Mike McDonnell, Susan McLellan, Carolyn McQuarrie, Julia Nood, Therese Mead, Cory Meeuwisse, Patrick Meloy, Perry Menzies, Anne Messman, Stephen Miazga, Logan Mills, Ken Milne, Allan Mix, Steve Montag, Brendon Moore, Justin Morgenstern, Sarah Mott, P. Mukherj, Ali Mulla, Sheena Nandalal, Taylor Nikel, Sean Nugent, Morgan Oakland, Werner Oberholzer, Onyeka Otugo, Taofiq Segun Oyedokun, Mike Paddock, Alim Pardhan, Kinjal Patel, Quinten Paterson, Catherine Patocka, Christine Patterson, James Pearlman, Alexis Pelletier-Bui, Marc Phan, Zafrina Poonja, Aubrey Powell, Kamini Premkumar, Gregor Prosen, Vishal Puri, Tanis Quaife, Ryan Raffel, Ali Raja, Randi Ramunno, Louise Rang, Suzanne Rannazzisi, Shauna Regan, Milan Ridderikhof, Vanessa Rogers, Christine Roh, Keith Rosenberg, Marina Roure, Sherri Rudinsky, Joshua Rudner, Adeeb Saleh, Will Sanderson, Owen Scheirer, Paul Schofield, Paul Schunk, Evan Schwarz, Parisa Shahrabadi, Eric Shappell, Julia Sheffield, Jonathan Sherbino, Manpreet Singh, Hector C. Singson, Dave Slessor, Sam Smith, Paula Sneath, Robert Sobehart, Kerry Spearing, James Stempien, Britni Sternard, Tara Stratton, Katherine Stuart, Bob Stuntz, Michael Susalla, Colleen Sweeney, Loice Swisher, Henry Swoboda, Shahbaz Syed, Taku Taira, Nikhil Tambe, Richard Tang, Elisha Targonsky, Rachel Taylor, Alan Taylor, Todd Taylor, Paxton Ting, Gerhard Tiwald, Kelvin Tran, Evelyn Tran, Jason Trickovic, Paul Trinquero, Seth Trueger, Aaron Tyagi, Manrique Umana, Patrick Vallance, Patricia Van den Berg, Luis Vargas, Rene Verbeek, Sandra Viggers, Zlata Vlodaver, Matthew Wagner, Noorin Walji, Joe Walter, Miranda Wan, Rachel Wang, Gregory Wanner, Wyatt Warawa, Mike Ward, Jennifer Weekes, Kristen Weersink, Cara Weessies, Anna Whalen-Browne, Brian Whiteside, Matthew Willis, Jonas Wilmer, Nelson Wong, Mark Woodcroft, Lawrence Yau, Jessica Yee, Calvin Yeh, Simon York Ming Huang, Katherine Yurkiw, Fareen Zaver, Alexander Zozula, Graduate School, Emergency Department, ACS - Heart failure & arrhythmias, and ACS - Diabetes & metabolism

Subjects
Adult, Male, Students, Medical, Blogging, Intraclass correlation, media_common.quotation_subject, education, MEDLINE, Likert scale, 03 medical and health sciences, 0302 clinical medicine, Evaluation methods, Medicine, Humans, Quality (business), Generalizability theory, 030212 general & internal medicine, Reliability (statistics), media_common, Medical education, Education, Medical, business.industry, Internship and Residency, Reproducibility of Results, 030208 emergency & critical care medicine, Gestalt Theory, Emergency Medicine, Gestalt psychology, Female, Clinical Competence, Educational Measurement, business, Social Media
Abstract

Study objective Open educational resources such as blogs are increasingly used for medical education. Gestalt is generally the evaluation method used for these resources; however, little information has been published on it. We aim to evaluate the reliability of gestalt in the assessment of emergency medicine blogs. Methods We identified 60 English-language emergency medicine Web sites that posted clinically oriented blogs between January 1, 2016, and February 24, 2016. Ten Web sites were selected with a random-number generator. Medical students, emergency medicine residents, and emergency medicine attending physicians evaluated the 2 most recent clinical blog posts from each site for quality, using a 7-point Likert scale. The mean gestalt scores of each blog post were compared between groups with Pearson's correlations. Single and average measure intraclass correlation coefficients were calculated within groups. A generalizability study evaluated variance within gestalt and a decision study calculated the number of raters required to reliably (>0.8) estimate quality. Results One hundred twenty-one medical students, 88 residents, and 100 attending physicians (93.6% of enrolled participants) evaluated all 20 blog posts. Single-measure intraclass correlation coefficients within groups were fair to poor (0.36 to 0.40). Average-measure intraclass correlation coefficients were more reliable (0.811 to 0.840). Mean gestalt ratings by attending physicians correlated strongly with those by medical students (r=0.92) and residents (r=0.99). The generalizability coefficient was 0.91 for the complete data set. The decision study found that 42 gestalt ratings were required to reliably evaluate quality (>0.8). Conclusion The mean gestalt quality ratings of blog posts between medical students, residents, and attending physicians correlate strongly, but individual ratings are unreliable. With sufficient raters, mean gestalt ratings provide a community standard for assessment.

Published
2016

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