(Peter Pruitt) Improving Triage Precision in Patients with Subdural Hematoma

Project: Research project

Project Details

Description

Peter Pruitt is an Instructor in the Department of Emergency Medicine and a fellow in the Center for Healthcare Studies – Institute for Public Health and Medicine at Northwestern University, Feinberg School of Medicine. CHS conducts cutting-edge research at the intersection of the clinical and health services domains in order to improve healthcare practices and foster clinical innovation. Dr. Pruitt’s long-term goal is to become an independent investigator in Emergency Medicine research, designing patient-centered, low resource interventions for targeted populations that enable better transitions of care for patients with uncertain outcomes and high risk conditions.
Subdural hematoma is increasing in incidence; it is projected to result in 60,000 hospitalizations annually. However, there are no uniform clinical guidelines for the management of these patients; instead it is site and physician specific. In previous research, Dr. Pruitt has derived a decision rule to identify patients with subdural hematoma at low risk of clinical decline or need for neurosurgical intervention. However, this rule was derived and validated at a single large academic Level I trauma center and now requires external validation using a broader population. This will be facilitated using innovative natural language processing techniques. Additionally, in order to facilitate appropriate implementation of the rule, we will use novel qualitative methods to determine the factors that have the greatest impact on emergency physician triage of patients with subdural hematoma.
The aims of this project are to 1) Determine the patient (e.g. age, sex), clinical (e.g. hematoma size, midline shift, level of consciousness) and system (available resources, distance and cost of transfer) associated with emergency physician risk assessment of patients with SDH and EP resource utilization in caring for these individuals, 2) Develop and validate the accuracy and reliability of a natural language processing algorithm in transforming radiologist generated free-text computed tomography (CT) reports into structured data, and 3) Externally validate and pilot implementation of a clinical decision instrument that identifies low risk iSDH patients, using data from multiple community and academic clinical sites.
With this award, Dr. Pruitt intends to gain skills in three important areas: 1) Qualitative methods, including key informant interviews and ADCE, 2) Bioinformatics and Data Science and 3) Implementation and Dissemination Science. With the focus on novel epidemiologic and clinical research methods, this training application directly aligns with the Society for Academic Emergency Medicine Foundation’s goal to cultivate scientists in the field of Emergency Medicine by focusing on developing sound research skills.
StatusFinished
Effective start/end date7/1/186/30/20

Funding

  • SAEM Research Foundation (RF2018-003)

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