Document Detail


Emergency Medical Services Outcomes Project III (EMSOP III): the role of risk adjustment in out-of-hospital outcomes research.
MedLine Citation:
PMID:  12085077     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of the Emergency Medical Services Outcomes Project (EMSOP) is to develop a foundation and framework for out-of-hospital outcomes research. Fundamental to that purpose is the identification of priority conditions, risk-adjustment measures (RAMs), and outcome measures. In this third EMSOP article, we examine the topic of risk adjustment, discuss the relevance of risk adjustment for out-of-hospital outcomes research, and recommend RAMs that should be evaluated for potential use in emergency medical services (EMS) research. Risk adjustment allows better judgment about the effectiveness and quality of alternative therapies; it fosters a better comparison of potentially dissimilar groups of patients. By measuring RAMs, researchers account for an important source of variation in their studies. Core RAMs are those measures that might be necessary for out-of-hospital outcomes research involving any EMS condition. Potential core RAMs that should be evaluated for their feasibility, validity, and utility in out-of-hospital research include patient age and sex, race and ethnicity, vital signs, level of responsiveness, Glasgow Coma Scale, standardized time intervals, and EMS provider impression of the presenting condition. Potential core RAMs that could be obtained through linkage to other data sources and that should be evaluated for their feasibility, validity, and utility include principal diagnosis and patient comorbidity. We recommend that these potential core RAMs be systematically evaluated for use in risk adjustment of out-of-hospital patient groups that might be used for outcomes research
Authors:
Herbert G Garrison; Ronald F Maio; Daniel W Spaite; Jeffrey S Desmond; Mary Ann Gregor; Patricia J O'Malley; Ian G Stiell; C Gene Cayten; John L Chew; Ellen J Mackenzie; David R Miller
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  40     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-06-26     Completed Date:  2002-07-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-88     Citation Subset:  AIM; IM    
Affiliation:
Department of Emergency Medicine, The Brody School of Medicine at East Carolina University, Greenville, NC 27858-4354, USA. hgarriso@pcmh.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Child
Data Collection / methods
Documentation / methods
Emergency Medical Services / methods*
Female
Glasgow Coma Scale
Humans
Male
Outcome Assessment (Health Care)
Outcome and Process Assessment (Health Care) / methods*
Reproducibility of Results
Risk Adjustment / methods*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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