Research

Our residency has a long history and continued commitment to excellent emergency medicine research. Each of our residents completes at least one scholarly project during their training, and each year several are able to present their work at regional and national conferences. Our stellar research faculty mentor residents from the beginning of residency with formal education on reseach methodology, through the completion of each of their projects. The department and institution provide significant resources towards that end. The Emergency Department has a full time research nurse manager who oversees a research staff of 7 people, two of which are based at our community hospital in Troy, Michigan.  The Beaumont Research Institute provides necessary support (IRB, contracts, statistics, etc.) to conduct small or large scale research. 

Clinical research is active at both Royal Oak and Troy campuses, which provide care for approximately 230,000 patients annually. The focus of our clinical research is on cutting edge interventions which evaluate and treat the critically ill and injured patient. We are unique in that our research studies are performed not only within our four walls, but in different venues including the community, in collaboration with local Emergency Medical Services (EMS) agencies,  our 23-hour Emergency Observation Unit, and inpatient beds in collaboration with other services.  There are basic science labs and biobank available, but we currently do not have any ongoing basic science research.

The scope of emergency research is broad, ranging from long-term outcomes after minor injury to resuscitative care for cardiac arrest patients to comatose patients who are revived from cardiac arrest.  Our clinical researchers coordinate over 25 clinical trials, including physician-initiated single center studies and industry/NIH sponsored multi center trials.

Active Research

Current trials by our staff are focused on a number of  different topics. They include:

Dr. Robert Swor

Predictors of adverse outcome after minor traumatic injury; Telemedicine application of palliative care for patients with advanced severe disease; Optimal method of sedation for patients post cardiac arrest; SaveMi Heart-A statewide initiative to double cardiac arrest survivial in Michigan; Evaluating bystander actions during a cardiac arrest;  Evaluating emergency care of the cancer patient;  Participation in the NIH funded SIREN Network. 

Dr. Carol Clark

Treatment of the emergency patient with severe influenza; Evaluating medications to reverse factor Xa inhibitors; Assessing complications of patients on factor Xa inhibitors; Evaluating devices to measure point of care biomarkers for emergency care; Evaluating if sodium zirconium cyclosilicate with insulin and glucose prove tolerable and efficacious in patients with hyperkalemia (ENERGIZE).

Dr. Kelly Levasseur

Comparison of anaphylaxis in urban vs. suburban populations.

Dr. Brett Todd

Assessing clinical decision making and cognitive error in the emergency department.

Dr. Ronny Otero

Utilization of student research associates in the ED;  Treatment of septic shock with Vitamin C, corticosteroids and thiamine (ACT); Evaluating complications of anti-coagulants in trauma patients; Use of non-invasive respiratory monitors in emergency patients. 

Dr. David Berger

Evaluation and optimization of resuscitation education for residents; Randomized controlled trial of admission vs. observation for mild CHF exacerbations.

Dr. Amit Bahl

Assessing the longevity of standard vs mid-length IV catheters using point of care ultrasound; Use of point of care ultrasound to assess respiratory distress.

 

Dr. Aveh Bastani

Impact of operational improvements on clinical care in the real world.

Dr. Danielle Turner-Lawrence

Utilization of 4-D CT to diagnose acute pulmonary embolism.

 

 

Peer-reviewed publications in 2017

Kowalenko T, Heller BN, Strauss RW, et al. Initial Validity Analysis of the American Board of Emergency Medicine Enhanced Oral Examination. Acad Emerg Med. 2017;24(1):125-129.

Mitzman J, King AM, Fastle RK, Hopson LR, Hoyle JD, Levasseur KA, (Shah PG) et al. You have free access to this contentA Modified Delphi Study for Development of a Pediatric Curriculum for Emergency Medicine Residents. AEM Education and Training. 22 MAR 2017 | DOI: 10.1002/aet2.10021

Feinberg RK, Hu J, Weaver MA, Fillingim RB, Swor RA, Peak DA, Jones JS, Rathlev NK, Lee DC, Domeier RM, Hendry PL, Liberzon I, McLean SA. Stress-Related Psychological Symptoms Contribute to Axial Pain Persistence after Motor Vehicle Collision: Path Analysis Results from A Prospective Longitudinal Study. Pain; 2017 Apr; 158(4): 682-690

Beaudoin FL, Gutman R, Merchant RC, Melissa CA, Swor RA, Jones JS, Lee DC, Peak DA, Domeier RM, Rathlev NK, McLean SA. Persistent pain after motor vehicle collision: Comparative effectiveness of opioids versus non-steroidal anti-inflammatory drugs prescribed from the emergency department- A propensity matched analysis. Pain.; 2017 Feb; 158(2): 289-295

Linnstaedt SD, Walker MG, Riker KD, Nyland JE, Hu JM, Rossi C, Swor RA, Jones JS, Diatchenko L, Bortsov AV, Peak DA, McLean SA. Genetic variant rs3750625 in the 3’UTR of ADRA2A affects stress dependent acute pain severity after trauma and alters a microRNA-34a regulatory site. Pain; 2017 Feb; 158(2): 230-239

ECG Predictors of Cardiac Arrhthymias in Older Adults With Syncope. Nishijima DK, Lin AL, Weiss RE, Yagapen AN, Malveau SE, Adler DH, Bastani A, Baugh CW, Caterino JM, Clark CL, Diercks DB, Hollander JE, Nicks BA, Shah MN, Stiffler KA, Storrow AB, Wilber ST, Sun BC. Ann Emerg Med.2017 Dec21.pij:SO196-0644(17)3 1902-9. doi: 10.1016/j.annemergmed.2017.11.014. [Epub ahead of print]

Study design of Real World Evidence for Treatment of Hyperkalemia in the Emergency Department (REVEAL-ED): a multicenter, prospective, observational study.  Rafique Z, Kosiborod M, Clark CL, Singer AJ, Turner S, Miller J, Char D, Peacock WF; REVEAL-ED study investigators.Clin Exp Emerg Med. 2017 Sep 30;4(3):154-159. doi: 10.15441/ceem.17.207. eCollection 2017 Sep.

Burks CE, Jones CW, Braz VA, Swor RA, Richmond NL, Hwang KS, Hollowell AG, Weaver MA, Platts-Mills TF. Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study. J Am Geriatr Soc. 2017 Aug;65(8):1741-1747.

Nicks BA, Shah MN, Bastani A, Baugh CW, Caterino JM, Clark CL, Diercks DB, Hollander JE, Malveau SE, Nishijma DK, Stiffer KA, Storrow AB, Wilber ST, Yagapen AN, Sun BC. Minimizing Attrition for Multi-Site Emergency Care Research.  Acad Emerg Med 2017 Apr: 24(4);458-466. 

Marty FM, Vidal-Puigserver J, Clark C, gupta SK, Merino E, Garot D, Chapman MJ, Jacobs F, Rodriguez-Noriega E, Husa P, Shortino D, Watson HA, Yates PJ, Peppercorn AF.  Intravenous Zanamivir or Oral Oseltamivir for hospitalised patients with influenza: an international, randomised, double-blind, double-dummy, phase 3 trial., Lancet Respir Med 2017 Feb: 5(2): 135-146.

Volz NB, Fringer R, Walters B, Kowalenko T. Prevalence of Horizontal Violence Among Emergency Attending Physicians, Residents, and Physician Assistants. West J Emerg Med. 2017 Feb;18(2):213-218

Platts-Mills TF, Nebolisa BC, Flannigan SA, Richmond NL, Domeier RM, Swor RA, Hendry PL, Peak DA, Rathlev NK, Jones JS, Lee DC, Jones CW, McLean SA. Post-Traumatic Stress Disorder among Older Adults Experiencing Motor Vehicle Collision: A Multicenter Prospective Cohort Study. Am J Geriatr Psychiatry. 2017 Sep;25(9):953-963.

Milling TJ Jr, Clark CL, Feronti C, Song SS, Torbati SS, Fermann GJ, Weiss J, Patel D. Management of Factor Xa inhibitor-associated life-threatening major hemorrhage: A retrospective multi-center analysis. Am J Emerg Med. 2017 Aug 19. pii: S0735-6757(17)30691-5. doi: 10.1016/j.ajem.2017.08.042. [Epub ahead of print] PMID: 28843518

Seltzer M, Menoch M, Chen C. Opportunistic Screening for Exposure to Bullying in the Pediatric Emergency Department. Glob Pediatr Health. 2017;4:2333.

Menoch M, Simon HK, Hirsh D, Shim Y, Baxter AL, Clifton M, Kim D, Sturm JJ. Imaging for Suspected Appendicitis: Variation Between Academic and Private Practice Models. Pediatr Emerg Care. 2017 Mar;33(3):147-151 

Schneider M, Levasseur K. Young Infant With Vomiting. Ann Emerg Med. 2017;69(5):576-631.

Zanyk-McLean K, Sawyer KN*, Paternoster R, Shievitz R, Devlin W, Swor R. Time to Awakening Is Often Delayed in Patients Who Receive Targeted Temperature Management After Cardiac Arrest. Ther Hypothermia Temp Manag. 2017;7(2):95-100.

Steffens C, Clement B, Fales W, Chehade AEH, Putman K, Swor R. Evaluating the Cost and Utility of Mandating Schools to Stock Epinephrine Auto-injectors. Prehosp Emerg Care. 2017;21(5):563-566.

Swor R, Qu L, Putman K, et al. Challenges of Using Probabilistic Linkage Methodology to Characterize Post-Cardiac Arrest Care in Michigan. Prehosp Emerg Care. 2017:1-6. 

Traylor S, Bastani A, Butris-Daut N, et al. Are three ports better than one? An evaluation of flow rates using all ports of a triple lumen central venous catheter in volume resuscitation. Am J Emerg Med. 2017.

Marco CA, Nelson LS, Baren JM, (Kowalenko T) et al. American Board of Emergency Medicine Report on Residency and Fellowship Training Information (2016-2017). Ann Emerg Med. 2017;69(5):640-652.

Debaty G, Labarere J, Frascone RJ, (Swor RA) et al. Long-Term Prognostic Value of Gasping During Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol. 2017;70(12):1467-1476.

Pressman A, Sawyer KN,* Devlin W, Swor R. Association between percutaneous hemodynamic support device and survival from cardiac arrest in the state of Michigan. Am J Emerg Med. 2017: DOI:10.1016/j.ajem.2017.10.036

Richmond NL, Meyer ML, Hollowell AG, Swor RA, et al. Social Support and Pain Outcomes after Trauma Exposure among Older Adults: A Multicenter Longitudinal Study. Clin J Pain. 2017. Sep 14. doi: 10.1097/AJP

Kleinman ME, Goldberger ZD, Rea T,  (Swor RA) et al. 2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardio pulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2017. DOI: 10.1161/CIR.0000000000000539

Goble M, Avula S, Duquette D, Gillary R, Fosse G, Swor RA, Bowers M,  Russell M,  Cutler N.  Sudden Cardiac Arrest Preparedness in Michigan: Partnering with Project ADAM to develop a HEARTSafe Schools state model.  Progress in Pediatric Cardiology. 2017:45:43-48

Harrison NE, Gottlieb M. Comparison of fresh frozen plasma with prothrombin complex concentrate for Warfarin reversal. Annals of Emergency Medicine, Ann Emerg Med. 2017 Jun;69(6):777-779

Nguyen DK, Fleischman RJ, Friedlander S, Zangwill KM. Epidemiology of Admissions From the Emergency Department Among Febrile Infants Younger Than 90 Days in the United States, 2002 to 2012. Pediatr Emerg Care. 2017 Sep 5. doi: 10.1097/PEC.0000000000001262.  

Rezaee ME, Ward CE, Nuanez B, Rezaee DA , Ditkoff J, Halalau A1. Examining 30-day COPD readmissions through the emergency department.  Int J Chron Obstruct Pulmon Dis. 2017 Dec 27;13:109-120. doi: 10.2147/COPD.S147796.

Wakai A, Lawrenson JG, Lawrenson AL, Wang Y, Brown MD, Quirke M, Ghandour O, McCormick R, Walsh CD, Amayem A, Lang E, Harrison N. “Topical non-steroidal anti-inflammatory drugs for analgesia in traumatic corneal abrasions”. Cochrane Database Syst Rev. 2017 May 18;5:CD009781. doi: 10.1002/14651858.CD009781.pub2.

Xiao J, Hamera JA, Hutchinson CH, Berger DA. Bilateral posterior native hip dislocations after fall from standing. Clinical Practice and Cases in Emergency Medicine. 2017 Oct; 1(4). doi: 10.5811/CPCEM.2017.8.35161

Mallat, S., Jurjus, A., Bou Assi, T., Jurjus, A., Shams, A., El Sayegh, S. and Berbari, A. (2017). Markers of arterial stiffness in a sample of Lebanese subjects with Grade I essential hypertension. SAGE Open Medicine, 5, p.205031211771288.

Stroupe KT, Smith BM, Bailey L, Adas J, et al. Medication acquisition by veterans dually eligible for Veterans Affairs and Medicare Part D pharmacy benefits. Am J Health Syst Pharm. Feb 2017;74(3):140-150.PMID:28122756

Abstracts

Gurpal Jones MD; Margaret Menoch MD, Kelly Levasseur DO Impact of a Straight Back Triage Process in a Pediatric Emergency Department, Presented Society for Academic Emergency Medicine annual meeting, Orlando, 2017.

Sefa N*, Jandu S, Sawyer KH*, Swor RA.  Electrocardiographic Changes in Patients Undergoing Therapeutic Hypothermia,  SAEM Annual meeting.  Orlando, May 16-19, 2017.

Presentation and Treatment of Patients with Active Cancer Presenting to the Emergency Departments of the Comprehensive ONCologic Emergencies Research Network (CONCERN-1). (Bastani A)  SAEM annual meeting Orlando, May 16-19, 2017.

Michael J Burla, Jeffrey S Ditkoff and David A Berger. An assessment of length of stay in blunt abdominal trauma patients in the emergency department. SAEM annual meeting Orlando, May 16-19, 2017

Michael J Burla and David A Berger.  An assessment of computerized tomography utilization in the emergency department in the setting of blunt abdominal trauma. SAEM annual meeting Orlando, May 16-19, 2017 

Mengqiao Xi, David A Berger and Kelly N Sawyer* Absence of the "Weekend Effect" on Pulmonary Embolism Mortality: A Closer Look Using Severity Stratification.  SAEM annual meeting Orlando, May 16-19, 2017

Heron L, Shah P, Turner-Lawrence D. Non-Emergency Medicine Residents: Creating An Efficient Workforce, CORD annual meeting, Fort Lauderdale, Fla April, 2017

Faisal Patel MD;* Kelly Levasseur, DO; Margaret Menoch MD Emergency Medical Services Treatment Protocols for Children: Utilization and Adherence in Practice, Presented Pediatric Academic Society annual meeting, San Fransisco, 2017.

Otero RM, Long BS, Sozener, Bassin B, Gunnerson K, Cranford J. Impact of an emergency critical care unit on the disposition of critically ill toxicology patients. Crit Care Med. Vol 44 (12) Suppl 1; 874 pg 294 Honolulu, HI Jan 2017

Clark CL, Shams AH, Chang A, Fermann GJ, Hiestand BC, Kea B, Mace SE, Peacock WF, , Welker JA, Sawyer KN,  Bastani A, D-dimer in Hospitalized Acute Medically Ill Adults and Current Trends in Venous Thromboembolism: Analysis of the DAMIACT Study by Age American College of Emergency Physicians Scientific Assembly, Washington D.C, October 2017

Clark, CL, Shams AH, Chang A, Fermann GJ, Hiestand BC, Kea B, Mace SE, Peacock WF, , Welker JA, Sawyer KN, Swor RA, Bastani. A D-dimer in Acute Medically Ill Adults and Current Thromboprophylaxis: A Multicenter Observational Study Evaluating the Prevalence of Elevated D-dimer in Acute Medically Ill, Hospitalized Adults and Current Thromboprophylaxis Trends: The DAMIACT Study, Initial Data Analysis, International Society of Thrombosis and Haemostasis Transcending Scientific Boundaries, Berlin, West Germany, July 2017

Management Strategies of Patients Receiving FXa Inhibitors or LMWH Admitted for ICH, Society of Critical Care Medicine, Milling TJ, Clark CL, Feronti C, Song SS, Torbati SS, Fermann GJ, Weiss JPatel D, Buciofr I, Neumann WR, Honolulu, HW, 2017

Akram, A, Anderson W, Bastani A. Level III Trauma Activation: A Resource Efficient Way to Improve Geriatric Head Trauma Metrics. SAEM Annual Meeting May 2017, Orlando FL

Caterino, J (Bastani A) Presentation and Treatment of Patients with Active Cancer Presenting to the Emergency Department of the CONCERN Network. SAEM Annual Meeting May 2017, Orlando, FL

Bastani, A, Bozyk P, Sefa N, Anderson W. Moving  Beyond Systemic Inflammatory Response Syndrome (SIRS): Deriving and Validating a Severe Sepsis/Septic Shock Best Practice Alert. SAEM Annual Meeting May 2017, Orlando, FL

Traylor S, Todd B, Heron L, Turner-Lawrence D. Navigating Decision Overload: An Algorithm for Maintaining Resident Organization and Efficiency in the ED. SAEM Annual Meeting May, 2017, Orlando, FL.

Moore JC, Brukhart N, Aufderheide TP, et al (Swor RA). Survival with Favorable Neurological Function Decreases After 15 minutes of CPR in a Non-Linear Manner in Patients with out of Hospital Cardiac Arrest, SAEM Annual Meeting, May 2017, Orlando, FL.

Swor RA, Berger D, Otero RD  Reynolds JJ. Will Extending Time to Neuroprognostication Improve Outcomes After Cardiac Arrest , AHA Resuscitation Science Symposium, Nov, 2017, Anaheim Ca.

Rafique Z, Kosiboraod M, Clark C, Singer A Miller J, et al. EKG changes are not Reliabilty Associated with Hyperkalemia or its Severity,  ACEP Research Forum, Washington DC, October 2017

Bastani A.  Cost Effectiveness Analysis of Physician in Triage at a Community Hospital Emergency Department .

ACEP Research Forum, Washington DC, October 2017

Bastani A.  The Gold Card: A Novel Dispatch Process to Guarantee Timely Specialist Followup. ACEP Research Forum, Washington DC, October 2017

Xiao J, Shah P, Todd B.  How Common Are Cognitive Errors in Cases Presented at Emergency Medicine Resident Morbidity and Mortality Conferences.  ACEP Research Forum, Washington DC, October 2017

Harrison N.  Wide Variation in Whole Body CT Utilization Despite Lack of Mortality Benefit. ACEP Research Forum, Washington DC, October 2017 

Harrison N. The Increasing Practice of Whole Body CT Scanning in Blunt Abdominal Trauma. ACEP Research Forum, Washington DC, October 2017 

Milling TJ, , Feronti C, Clark CL, Song SS, Torbati SS, Fermann GJ, Weiss JPatel D, Buciofr I, Neumann WR Treatment Patterns and Outcomes of Patients Receiving Direct Oral Anticoagulants or Low Molecular Weight Heparin who Experienced Life-threatening Intracranial Hemorrhage.. American Academy of Neurology 69th Annual Meeting, Boston, MA. April 2017

Milling TJ, Clark CL, Feronti C, Song SS, Torbati SS, Fermann GJ, Weiss JPatel D, Buciofr I, Neumann WR. 2017 Management Strategies for Patients Receiving FXa Inhibitors or LMWH Admitted for ICH HemorrhageWorld Hemorrhage Conference (WICH), Boston, MA, May 2017

Rafique Z, Kosiboraod M, Clark C, Singer A, Miller J et al. Electrocardiogram changes in Patients with Acute and Chronic Hyperkalemia American College of Emergency Physicians Scientific Assembly, Washington DC, October 2017

Gupta, A Utility of performing serum glucose measurement and Electrocardiogram (EKG) in the outpatient evaluation of pediatric syncope. AAP Bethesda, MD Feb 2017

Mitra A, V. Patel, TPA-induced Angioedema in Ischemic Stroke Patient, presented at Chest Annual Meeting, October 31, 2017; Toronto, ON

Jones G, "Straight back triage in a pediatric emergency department: does it impact quality metrics?", for the Pediatric Academic Societies (PAS) 2017 Meeting, May 6 - 9, in San Francisco, CA

 

Website Contributions, Videoclips, or other Multi-Media Contributions:

Levasseur, K,  Turner-Lawrence, D,  Difficulty Breathing with a Rash: A Pediatric Simulation Case for Residents and Fellows” , Med Ed Portal accepted 3/2017

Jones G, Levasseur K, Menoch M. Tachycardia in a febrile 2-year-old, Photo Display. SAEM Annual Meeting May 2017, Orlando, FL

Seltzer M, Menoch M, Chen C. Opportunistic Screening for Exposure to Bullying in the Pediatric Emergency Department. Glob Pediatr Health. 2017 Jun 21;4:2333794X17714377. doi: 10.1177/2333794X17714377. eCollection 2017. PMID:28680945

Xiao J, Todd B. “Multiple Myeloma Emergencies”. [Web log post]. emDocs. August 29, 2017. http://www.emdocs.net/multiple-myeloma-emergencies/. Date accessed August 30, 2017. 

Michael J. Burla, Danielle E. Turner-Lawrence. EM Mindset: Physician Wellness – A
Resident’s Perspective on Surviving in the ED. emDocs, Aug 8, 2017 

Xiao, J. (2017, June 16). Ultrasound: TAPSE and RV strain [Web log post]. Beaumont EM Resident Blog. Retrieved from: https://beaumontem.wordpress.com/2017/06/16/ultrasound-tapse-and-rv-strain/

Other Publications (non peer-reviewed):

Adas J, Borschke F, Walters BL. Dr. Seldinger and His Wire. MCEP News and Views December, 2016

Deep Venous Thrombosis, Observation Medicine: Principals and Protocols, 1st ed., Mace Sharon (Ed), Wiener, Michelle A, Clark, Carol Lynn, ISBN978-1107022348, Cambridge Press, April 2017