Objective . Despite disparities in availability and quality of emergency care, the extent to which countries with different incomes participate in emergency medicine (EM) research remains understudied. This study evaluated academic productivity in the EM field depending on country income.
Methods . Research published in Scopus-indexed journals of the EM subject area since 2004 was analysed quantitatively. Publication, citation, journal impact, and national socioeconomic data were compared. Automated topic modelling was applied using a latent Dirichlet allocation model.
Results . The analysis included 154,458 publications (89.7% in English) from 177 countries, which received 1,817,635 citations. High-income countries (HIC) outperformed upper-middle-income (UMIC), lower-middle-income (LMIC), and low-income countries (LIC) 11, 41, and 72 fold, respectively, by the weighted (per million population per country) number of publications, and 21, 54, and 171 fold, respectively, by the weighted count of citations. The annual number of publications was predicted to considerably rise for HIC, in less extent for UMIC, and far less for LMIC, but not for LIC. Research productivity showed a significant relationship with national socioeconomic indicators. Based on the topic modelling, HIC paid relatively higher attention to advancements in resuscitation, whereas lower income countries were more focused on injuries.
Conclusion . While global research productivity for EM is progressively rising, lower income countries lag far behind high-income ones. Countries with different incomes have distinct priorities in EM research. The development of country-specific EM research agendas would help boost national academic productivity and determine context-appropriate interventions for improving outcomes in emergency care.
Objective Our objective was to study the clinical monitoring capabilities of a low-cost fitness wristband while measuring patient satisfaction with a mobility permitting device in the emergency department.
Methods Patients enrolled were on continuous three-lead telemetry monitoring in a high acuity zone of the emergency department. Patients were given a fitness band to wear while simultaneously monitored with standard three-lead monitor. A brief survey was conducted upon study end, and data was compared between wristband and three-lead telemetry. Median heart rate (HR) values were calculated, a Bland-Altman plot was generated, and sensitivity and specificity were calculated for comparison of the formal telemetry and the inexpensive wristband.
Results Thirty-four patients with an average age of 61.5 years were enrolled. From June to October 2019, over 100 hours of data were collected. In comparison for comfort, participants scored 9.5 of 10, preferring wristband over telemetry. Using a correlation coefficient graph, we found a significant disparity of HR readings within a telemetry range of 40 to 140 beats/min. An R-value of 0.36 was detected. Using a Bland-Altman plot, we observed a significant difference in HR between the telemetry monitor and the wristband. The sensitivity and specificity of the wristband to detect bradycardia (HR <60 beats/min) were 76% and 86%, respectively, while the sensitivity and specificity of the wristband to detect tachycardia (HR >100 beats/min) were 92% and 51%, respectively.
Conclusion Inexpensive fitness bands cannot be a suitable tool for monitoring patient’s HR because of inaccuracy in detecting bradycardia or tachycardia.
Citations
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Untangling the Wire: Exploring the Overuse of Continuous Telemetry on Regular Nursing Floors F.N.U. Varnika, Siri Vummaneni, Parth Munjal, Benjamin Philip Walters, Vasu Gupta, Rohit Jain Cardiology in Review.2025;[Epub] CrossRef
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In low resource hospitals, strained staffing ratios and lack of telemetry can put patients at risk for clinical deterioration and unexpected cardiac arrest. While traditional telemetry systems can provide real-time continuous vital signs, they are too expensive for widespread use in these settings. At the same time, developed countries such as the United States have been increasingly utilizing remote monitoring systems to shift patient care from hospital to home. While the context is dramatically different, the challenge of monitoring patients in otherwise unmonitored settings is the same. At-home monitoring solutions range from highly comprehensive and expensive systems to inexpensive fitness trackers. In the field of global health, the adoption of this technology has been somewhat limited. We believe that low cost fitness trackers present an opportunity to address the challenge of vital sign monitoring in resource-poor settings at a fraction of the cost of existing technical solutions.
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Can a low-cost exercise monitor provide useful heart rate monitoring for use in low-resource emergency departments? Thomas A. O’Mara, Miguel Armengol de la Hoz, Oren J. Mechanic, Alon Dagan Clinical and Experimental Emergency Medicine.2021; 8(3): 201. CrossRef
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