Alyson McGregor - Academia.edu (original) (raw)

Papers by Alyson McGregor

Research paper thumbnail of Gender-specific Regulatory Challenges to Product Approval: A Panel Discussion

Academic Emergency Medicine, 2014

On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges ... more On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges to Product Approval" was held during the Academic Emergency Medicine consensus conference, "Genderspecific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." The session sought to bring together leaders in emergency medicine (EM) research, authors, and reviewers in EM research publications, as well as faculty, fellows, residents, and students engaged in research and clinical practice. A panel was convened involving a representative from the Office of Women's Health of the U.S. Food and Drug Administration, two pharmaceutical executives, and a clinical EM researcher. The moderated discussion also involved audience members who contributed significantly to the dialogue. Historical background leading up to the session along with the main themes of the discussion are reproduced in this article. These revolve around sex-and gender-specific research, statistical analysis of sex and gender, clinical practice, financial costs associated with pharmaceutical development, adaptive design, and specific recommendations on the regulatory process as it affects the specialty of EM.

Research paper thumbnail of The emerging science of gender-specific emergency medicine

Rhode Island medical journal (2013), 2015

Research paper thumbnail of The Educator's Portfolio: Its Value and Use

Academic Emergency Medicine, 2014

This is a brief presentation about how to develop an effective educator's portfolio. The educator... more This is a brief presentation about how to develop an effective educator's portfolio. The educator's portfolio is a collection of factual documents supporting an individual's expertise as an educator and teacher. It can be used to demonstrate credentials for employment, productivity during evaluations, and merit for promotion. This video reviews the important components of a portfolio including statement about teaching philosophy, evaluations of teaching proficiency, and examples of scholarly activity. It also includes tips on how to maximize a portfolio's effectiveness. This presentation is intended to serve as a guide to emergency physicians in academic institutions.

Research paper thumbnail of Gender disparities in stress test utilization in chest pain unit patients based upon the ordering physician's gender

Critical pathways in cardiology, 2014

Physicians' gender may impact test utilization in the diagnosis of acute cardiovascular disea... more Physicians' gender may impact test utilization in the diagnosis of acute cardiovascular disease. We sought to determine if physician gender affected stress test utilization by patient gender in a low-risk chest pain observation unit. This was a retrospective consecutive cohort study of patients admitted to a chest pain unit in a large volume academic urban emergency department (ED). Inclusion criteria were age>18, American Heart Association low-to-intermediate risk, electrocardiogram nondiagnostic for acute coronary syndrome, and negative initial troponin I. Exclusion criteria were age>75 with a history of coronary artery disease, active comorbid medical problems, or inability to obtain stress testing in the ED for any reason. T-tests were used for univariate comparisons and logistic regression was used to estimate odds ratios (ORs) for receiving testing based on physician gender, controlling for race, insurance, and Thrombolysis In Myocardial Infarction (TIMI) score. Thre...

Research paper thumbnail of Foundations for a Novel Emergency Medicine Subspecialty: Sex, Gender, and Women's Health

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014

Sex and gender affect all aspects of health and disease, including pathophysiology, epidemiology,... more Sex and gender affect all aspects of health and disease, including pathophysiology, epidemiology, presentation, treatment, and outcomes. Sex- and gender-specific medicine (SGM) is a rapidly developing field rooted in women's health; however, inclusion of SGM in emergency medicine (EM) is currently lacking. Incorporating principles of sex, gender, and women's health into emergency care and training curricula is an important first step toward establishing a novel subspecialty. EM is an ideal specialty to cultivate this new field because of its broad interdisciplinary nature, increasing numbers of patient visits, and support from academic medical centers to promote expertise in women's health. This article describes methods used to establish a new multidisciplinary training program in sex, gender, and women's health based in a department of EM. Women's health and SGM program initiatives span clinical care, patient education, clinical research, resident and fellow tr...

Research paper thumbnail of Future Directions in Sex- and Gender-specific Emergency Medicine

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014

The 2014 Academic Emergency Medicine (AEM) consensus conference "Gender-Specific Research in... more The 2014 Academic Emergency Medicine (AEM) consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes" convened a diverse group of stakeholders to target gaps in emergency medicine (EM) sex- and gender-specific research and identify research priorities. At the close of the conference, the executive committee sought feedback from group leaders and conference attendees about the next critical steps in EM sex- and gender-specific research, goals for their own future research, and anticipated barriers in pursuing this research. This article summarizes this feedback on the future directions in sex- and gender-specific research in emergency care and strategies to overcome barriers.

Research paper thumbnail of Sex- and Gender-specific Research Priorities for the Emergency Management of Heart Failure and Acute Arrhythmia: Proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014

The emergency department (ED) is the point of first contact for patients with acute heart failure... more The emergency department (ED) is the point of first contact for patients with acute heart failure and arrhythmias, with 1 million annual ED visits in the United States. Although the total numbers of men and women living with heart failure are similar, female patients are underrepresented in clinical studies, with current knowledge predominantly based on data from male patients. This has led to an underappreciation of the sex-specific differences in clinical characteristics and pathophysiology-based management of heart failure. Similar disparities have been found in management of acute arrhythmias, especially atrial arrhythmias that lead to an increased risk of stroke in women. Additionally, peripartum and postpartum cardiomyopathy represent a diagnostic and treatment dilemma. This article is the result of a breakout session in the cardiovascular and resuscitation work group of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medic...

Research paper thumbnail of The DISPARITY Study: do gender differences exist in Surviving Sepsis Campaign resuscitation bundle completion, completion of individual bundle elements, or sepsis mortality?

Journal of Critical Care, 2014

Women in the emergency department are less likely to receive early goal directed therapy, but gen... more Women in the emergency department are less likely to receive early goal directed therapy, but gender differences in the Surviving Sepsis Campaign (SSC) bundle completion have not been studied [1]. We hypothesized that women have lower SSC resuscitation bundle completion rates. This was a retrospective, observational study in a large urban academic ED at a national SSC site. Consecutive patients (age>18 years) admitted to intensive care with severe sepsis or septic shock and entered into the SSC database from October 2005 to February 2012 were included. Data on overall and individual bundle elements were exported from the database. Bivariate analyses were performed with chi-square tests and t-tests. Multiple logistic regression was then performed with gender as an effect modifier. Eight hundred fourteen patients were enrolled. The mean age was 66 years;, 44.8% were women. There was no association between gender and bundle completion (aOR 0.83, 95% CI 0.58-1.16), controlling for age, race, Sequential Organ Failure Assessment, congestive heart failure, and coagulopathy. In-hospital mortality did not differ by gender. Women were less likely to receive antibiotics within 3 hours (60.5% vs. 68.8%, p=0.01) and less likely to reach a target ScvO2>70 (31.3% vs. 39.5%, P=.05). There were no gender disparities in bundle completion or in-hospital mortality. Further research is needed to examine individual bundle elements and gender specific factors that may affect bundle completion and mortality.

Research paper thumbnail of Evidence for Lamprey GnRH-I and -III-like Molecules in the Brains of the Southern Hemisphere Lampreys Geotria australis and Mordacia mordax

General and Comparative Endocrinology, 2000

The present study has characterized gonadotropic releasing hormone (GnRH)-like molecules in the b... more The present study has characterized gonadotropic releasing hormone (GnRH)-like molecules in the brains of representatives of the two southern hemisphere families of lampreys, Geotriidae and Mordaciidae. Chromatographic and immunocytochemical evidence showed that the brains of Geotria australis and Mordacia mordax contain two forms of GnRH-like molecules. These two forms correspond to lamprey GnRH-I and -III, which were first sequenced from the brain of the anadromous sea lamprey Petromyzon marinus, a representative of the family Petromyzontidae that is found only in the northern hemisphere. In chromatographic studies (HPLC) using lamprey GnRH-I and -III antiserum, two early eluting GnRH forms coeluted with synthetic lamprey GnRH-I and -III standards. Our studies thus indicate that, despite their apparently long period of separation, the three families of extant lampreys have each retained both of the lamprey GnRH (-I and -III forms) molecules. Moreover, immunocytochemical localization of lamprey GnRH indicated that the pattern of its distribution in the adult brain of at least one of these southern hemisphere lampreys (G. australis) is similar to that previously described for P. marinus. Distribution of GnRH in the brain of larval G. australis was not as extensive as that in larval P. marinus, which may account for the later gonadal development in the former species. The fact that lamprey GnRH-I and -III are the dominant GnRH forms in all three families of lampreys implies that these neurohormones have an ancient origin.

Research paper thumbnail of Ovarian torsion: Case–control study comparing the sensitivity and specificity of ultrasonography and computed tomography for diagnosis in the emergency department

European Journal of Radiology, 2014

Objective: Evaluate the sensitivity and specificity of pelvic ultrasound (US) and abdominopelvic ... more Objective: Evaluate the sensitivity and specificity of pelvic ultrasound (US) and abdominopelvic computed tomography (CT) for the identification of ovarian torsion in women presenting to the emergency department with acute lower abdominal or pelvic pain. Materials and methods: This is a retrospective study of 20 cases of ovarian torsion and 20 control patients, all of whom had both US and CT performed in the emergency department. Two radiologists who were blinded to clinical data interpreted all studies as (1) demonstrating an abnormal ovary or not, and (2) suggestive of torsion or not. Sensitivity, specificity and interobserver variation were calculated for each imaging modality. Results: Pelvic US was interpreted as demonstrating an abnormal ovary in 90.0% of ovarian torsion cases by reader 1, and in 100.0% by reader 2, whereas CT was interpreted as revealing an abnormal ovary in 100.0% of torsion cases by both readers. Pelvic US for ovarian torsion was 80.0% sensitive (95% CI, 58.4-91.9%) and 95.0% specific (95% CI, 76.4-99.1%) for reader 1, while 80.0% sensitive (95% CI, 58.4-91.9%) and 85.0% specific (95% CI, 64.0-95.0%) for reader 2. Interobserver agreement for pelvic US was fair (Kappa = 0.60). Abdominopelvic CT for ovarian torsion was 100.0% sensitive (95% CI, 83.9-100.0%) and 85.0% specific (95% CI, 64.0-94.5%) for reader 1, while 90.0% sensitive (95% CI, 69.9-97.2%) and 90.0% specific (95% CI, 69.9-97.2%) for reader 2. Interobserver agreement was excellent (Kappa = 0.85). Conclusion: The diagnostic performance of CT is not shown to be significantly different from that of US in identifying ovarian torsion in this study. These results suggest that when CT demonstrates findings of ovarian torsion, the performance of another imaging exam (i.e. US) that delays therapy is unlikely to improve preoperative diagnostic yield.

Research paper thumbnail of Gender-specific Emergency Care: Part Two

Academic Emergency Medicine, 2013

Gender-specific Emergency Care: Part Two Current research indicates that there are significant ph... more Gender-specific Emergency Care: Part Two Current research indicates that there are significant physiologic differences between men and women that may have important clinical implications in the emergency care of patients. This is a two-part video presentation that reviews eight clinical topics applying the "gender lens" as it relates to the practice of emergency medicine (EM). This part includes substance abuse, trauma, pulmonary, and toxicology. Part 1 reviews cardiovascular, neurology, sports medicine, and pain.

Research paper thumbnail of Gender-specific Emergency Medicine Research: Overview and Opportunities

Academic Emergency Medicine, 2013

Sex and gender are now known to be critical variables that affect health and illness. There is a ... more Sex and gender are now known to be critical variables that affect health and illness. There is a need for investigations that analyze data according to sex and gender as this may affect patient outcomes and thereby change clinical practice. In this brief 30-minute video presentation, we review the effect that sex-and gender-specific research has had on the field of emergency medicine (EM) and present concrete examples of current EM literature that methodically study how sex and gender affect patient presentation, management, and outcomes for acute conditions common to our specialty.

Research paper thumbnail of Inclusion of Gender in Emergency Medicine Research

Academic Emergency Medicine, 2011

Background: Emergency physicians as front-line clinical specialists can directly advance patient ... more Background: Emergency physicians as front-line clinical specialists can directly advance patient care by understanding how gender-specific approaches may affect evaluation and management of diseases in the acute setting. Yet, it is unclear whether the role of gender is systematically examined in research focusing on emergency care.

Research paper thumbnail of Focusing a Gender Lens on Emergency Medicine Research: 2012 Update

Academic Emergency Medicine, 2013

The influence of sex and gender on patient care is just being recognized in emergency medicine (E... more The influence of sex and gender on patient care is just being recognized in emergency medicine (EM). Providers are realizing the need to improve outcomes for both men and women by incorporating sexand gender-specific science into clinical practice, while EM researchers are now beginning to study novel sex-and gender-specific perspectives in the areas of acute care research. This article serves as an update on the sex differences in a variety of acute clinical care topics within the field of EM and showcases opportunities for improving patient care outcomes and expanding research to advance the science of gender-specific emergency care. ACADEMIC EMERGENCY MEDICINE 2013; 20:313-320

Research paper thumbnail of Gender-specific Regulatory Challenges to Product Approval: A Panel Discussion

Academic Emergency Medicine, 2014

On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges ... more On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges to Product Approval" was held during the Academic Emergency Medicine consensus conference, "Genderspecific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." The session sought to bring together leaders in emergency medicine (EM) research, authors, and reviewers in EM research publications, as well as faculty, fellows, residents, and students engaged in research and clinical practice. A panel was convened involving a representative from the Office of Women's Health of the U.S. Food and Drug Administration, two pharmaceutical executives, and a clinical EM researcher. The moderated discussion also involved audience members who contributed significantly to the dialogue. Historical background leading up to the session along with the main themes of the discussion are reproduced in this article. These revolve around sex-and gender-specific research, statistical analysis of sex and gender, clinical practice, financial costs associated with pharmaceutical development, adaptive design, and specific recommendations on the regulatory process as it affects the specialty of EM.

Research paper thumbnail of Gender-specific Regulatory Challenges to Product Approval: A Panel Discussion

Academic Emergency Medicine, 2014

On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges ... more On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges to Product Approval" was held during the Academic Emergency Medicine consensus conference, "Genderspecific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." The session sought to bring together leaders in emergency medicine (EM) research, authors, and reviewers in EM research publications, as well as faculty, fellows, residents, and students engaged in research and clinical practice. A panel was convened involving a representative from the Office of Women's Health of the U.S. Food and Drug Administration, two pharmaceutical executives, and a clinical EM researcher. The moderated discussion also involved audience members who contributed significantly to the dialogue. Historical background leading up to the session along with the main themes of the discussion are reproduced in this article. These revolve around sex-and gender-specific research, statistical analysis of sex and gender, clinical practice, financial costs associated with pharmaceutical development, adaptive design, and specific recommendations on the regulatory process as it affects the specialty of EM.

Research paper thumbnail of The emerging science of gender-specific emergency medicine

Rhode Island medical journal (2013), 2015

Research paper thumbnail of The Educator's Portfolio: Its Value and Use

Academic Emergency Medicine, 2014

This is a brief presentation about how to develop an effective educator's portfolio. The educator... more This is a brief presentation about how to develop an effective educator's portfolio. The educator's portfolio is a collection of factual documents supporting an individual's expertise as an educator and teacher. It can be used to demonstrate credentials for employment, productivity during evaluations, and merit for promotion. This video reviews the important components of a portfolio including statement about teaching philosophy, evaluations of teaching proficiency, and examples of scholarly activity. It also includes tips on how to maximize a portfolio's effectiveness. This presentation is intended to serve as a guide to emergency physicians in academic institutions.

Research paper thumbnail of Gender disparities in stress test utilization in chest pain unit patients based upon the ordering physician's gender

Critical pathways in cardiology, 2014

Physicians' gender may impact test utilization in the diagnosis of acute cardiovascular disea... more Physicians' gender may impact test utilization in the diagnosis of acute cardiovascular disease. We sought to determine if physician gender affected stress test utilization by patient gender in a low-risk chest pain observation unit. This was a retrospective consecutive cohort study of patients admitted to a chest pain unit in a large volume academic urban emergency department (ED). Inclusion criteria were age>18, American Heart Association low-to-intermediate risk, electrocardiogram nondiagnostic for acute coronary syndrome, and negative initial troponin I. Exclusion criteria were age>75 with a history of coronary artery disease, active comorbid medical problems, or inability to obtain stress testing in the ED for any reason. T-tests were used for univariate comparisons and logistic regression was used to estimate odds ratios (ORs) for receiving testing based on physician gender, controlling for race, insurance, and Thrombolysis In Myocardial Infarction (TIMI) score. Thre...

Research paper thumbnail of Foundations for a Novel Emergency Medicine Subspecialty: Sex, Gender, and Women's Health

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014

Sex and gender affect all aspects of health and disease, including pathophysiology, epidemiology,... more Sex and gender affect all aspects of health and disease, including pathophysiology, epidemiology, presentation, treatment, and outcomes. Sex- and gender-specific medicine (SGM) is a rapidly developing field rooted in women's health; however, inclusion of SGM in emergency medicine (EM) is currently lacking. Incorporating principles of sex, gender, and women's health into emergency care and training curricula is an important first step toward establishing a novel subspecialty. EM is an ideal specialty to cultivate this new field because of its broad interdisciplinary nature, increasing numbers of patient visits, and support from academic medical centers to promote expertise in women's health. This article describes methods used to establish a new multidisciplinary training program in sex, gender, and women's health based in a department of EM. Women's health and SGM program initiatives span clinical care, patient education, clinical research, resident and fellow tr...

Research paper thumbnail of Future Directions in Sex- and Gender-specific Emergency Medicine

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014

The 2014 Academic Emergency Medicine (AEM) consensus conference "Gender-Specific Research in... more The 2014 Academic Emergency Medicine (AEM) consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes" convened a diverse group of stakeholders to target gaps in emergency medicine (EM) sex- and gender-specific research and identify research priorities. At the close of the conference, the executive committee sought feedback from group leaders and conference attendees about the next critical steps in EM sex- and gender-specific research, goals for their own future research, and anticipated barriers in pursuing this research. This article summarizes this feedback on the future directions in sex- and gender-specific research in emergency care and strategies to overcome barriers.

Research paper thumbnail of Sex- and Gender-specific Research Priorities for the Emergency Management of Heart Failure and Acute Arrhythmia: Proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2014

The emergency department (ED) is the point of first contact for patients with acute heart failure... more The emergency department (ED) is the point of first contact for patients with acute heart failure and arrhythmias, with 1 million annual ED visits in the United States. Although the total numbers of men and women living with heart failure are similar, female patients are underrepresented in clinical studies, with current knowledge predominantly based on data from male patients. This has led to an underappreciation of the sex-specific differences in clinical characteristics and pathophysiology-based management of heart failure. Similar disparities have been found in management of acute arrhythmias, especially atrial arrhythmias that lead to an increased risk of stroke in women. Additionally, peripartum and postpartum cardiomyopathy represent a diagnostic and treatment dilemma. This article is the result of a breakout session in the cardiovascular and resuscitation work group of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medic...

Research paper thumbnail of The DISPARITY Study: do gender differences exist in Surviving Sepsis Campaign resuscitation bundle completion, completion of individual bundle elements, or sepsis mortality?

Journal of Critical Care, 2014

Women in the emergency department are less likely to receive early goal directed therapy, but gen... more Women in the emergency department are less likely to receive early goal directed therapy, but gender differences in the Surviving Sepsis Campaign (SSC) bundle completion have not been studied [1]. We hypothesized that women have lower SSC resuscitation bundle completion rates. This was a retrospective, observational study in a large urban academic ED at a national SSC site. Consecutive patients (age>18 years) admitted to intensive care with severe sepsis or septic shock and entered into the SSC database from October 2005 to February 2012 were included. Data on overall and individual bundle elements were exported from the database. Bivariate analyses were performed with chi-square tests and t-tests. Multiple logistic regression was then performed with gender as an effect modifier. Eight hundred fourteen patients were enrolled. The mean age was 66 years;, 44.8% were women. There was no association between gender and bundle completion (aOR 0.83, 95% CI 0.58-1.16), controlling for age, race, Sequential Organ Failure Assessment, congestive heart failure, and coagulopathy. In-hospital mortality did not differ by gender. Women were less likely to receive antibiotics within 3 hours (60.5% vs. 68.8%, p=0.01) and less likely to reach a target ScvO2>70 (31.3% vs. 39.5%, P=.05). There were no gender disparities in bundle completion or in-hospital mortality. Further research is needed to examine individual bundle elements and gender specific factors that may affect bundle completion and mortality.

Research paper thumbnail of Evidence for Lamprey GnRH-I and -III-like Molecules in the Brains of the Southern Hemisphere Lampreys Geotria australis and Mordacia mordax

General and Comparative Endocrinology, 2000

The present study has characterized gonadotropic releasing hormone (GnRH)-like molecules in the b... more The present study has characterized gonadotropic releasing hormone (GnRH)-like molecules in the brains of representatives of the two southern hemisphere families of lampreys, Geotriidae and Mordaciidae. Chromatographic and immunocytochemical evidence showed that the brains of Geotria australis and Mordacia mordax contain two forms of GnRH-like molecules. These two forms correspond to lamprey GnRH-I and -III, which were first sequenced from the brain of the anadromous sea lamprey Petromyzon marinus, a representative of the family Petromyzontidae that is found only in the northern hemisphere. In chromatographic studies (HPLC) using lamprey GnRH-I and -III antiserum, two early eluting GnRH forms coeluted with synthetic lamprey GnRH-I and -III standards. Our studies thus indicate that, despite their apparently long period of separation, the three families of extant lampreys have each retained both of the lamprey GnRH (-I and -III forms) molecules. Moreover, immunocytochemical localization of lamprey GnRH indicated that the pattern of its distribution in the adult brain of at least one of these southern hemisphere lampreys (G. australis) is similar to that previously described for P. marinus. Distribution of GnRH in the brain of larval G. australis was not as extensive as that in larval P. marinus, which may account for the later gonadal development in the former species. The fact that lamprey GnRH-I and -III are the dominant GnRH forms in all three families of lampreys implies that these neurohormones have an ancient origin.

Research paper thumbnail of Ovarian torsion: Case–control study comparing the sensitivity and specificity of ultrasonography and computed tomography for diagnosis in the emergency department

European Journal of Radiology, 2014

Objective: Evaluate the sensitivity and specificity of pelvic ultrasound (US) and abdominopelvic ... more Objective: Evaluate the sensitivity and specificity of pelvic ultrasound (US) and abdominopelvic computed tomography (CT) for the identification of ovarian torsion in women presenting to the emergency department with acute lower abdominal or pelvic pain. Materials and methods: This is a retrospective study of 20 cases of ovarian torsion and 20 control patients, all of whom had both US and CT performed in the emergency department. Two radiologists who were blinded to clinical data interpreted all studies as (1) demonstrating an abnormal ovary or not, and (2) suggestive of torsion or not. Sensitivity, specificity and interobserver variation were calculated for each imaging modality. Results: Pelvic US was interpreted as demonstrating an abnormal ovary in 90.0% of ovarian torsion cases by reader 1, and in 100.0% by reader 2, whereas CT was interpreted as revealing an abnormal ovary in 100.0% of torsion cases by both readers. Pelvic US for ovarian torsion was 80.0% sensitive (95% CI, 58.4-91.9%) and 95.0% specific (95% CI, 76.4-99.1%) for reader 1, while 80.0% sensitive (95% CI, 58.4-91.9%) and 85.0% specific (95% CI, 64.0-95.0%) for reader 2. Interobserver agreement for pelvic US was fair (Kappa = 0.60). Abdominopelvic CT for ovarian torsion was 100.0% sensitive (95% CI, 83.9-100.0%) and 85.0% specific (95% CI, 64.0-94.5%) for reader 1, while 90.0% sensitive (95% CI, 69.9-97.2%) and 90.0% specific (95% CI, 69.9-97.2%) for reader 2. Interobserver agreement was excellent (Kappa = 0.85). Conclusion: The diagnostic performance of CT is not shown to be significantly different from that of US in identifying ovarian torsion in this study. These results suggest that when CT demonstrates findings of ovarian torsion, the performance of another imaging exam (i.e. US) that delays therapy is unlikely to improve preoperative diagnostic yield.

Research paper thumbnail of Gender-specific Emergency Care: Part Two

Academic Emergency Medicine, 2013

Gender-specific Emergency Care: Part Two Current research indicates that there are significant ph... more Gender-specific Emergency Care: Part Two Current research indicates that there are significant physiologic differences between men and women that may have important clinical implications in the emergency care of patients. This is a two-part video presentation that reviews eight clinical topics applying the "gender lens" as it relates to the practice of emergency medicine (EM). This part includes substance abuse, trauma, pulmonary, and toxicology. Part 1 reviews cardiovascular, neurology, sports medicine, and pain.

Research paper thumbnail of Gender-specific Emergency Medicine Research: Overview and Opportunities

Academic Emergency Medicine, 2013

Sex and gender are now known to be critical variables that affect health and illness. There is a ... more Sex and gender are now known to be critical variables that affect health and illness. There is a need for investigations that analyze data according to sex and gender as this may affect patient outcomes and thereby change clinical practice. In this brief 30-minute video presentation, we review the effect that sex-and gender-specific research has had on the field of emergency medicine (EM) and present concrete examples of current EM literature that methodically study how sex and gender affect patient presentation, management, and outcomes for acute conditions common to our specialty.

Research paper thumbnail of Inclusion of Gender in Emergency Medicine Research

Academic Emergency Medicine, 2011

Background: Emergency physicians as front-line clinical specialists can directly advance patient ... more Background: Emergency physicians as front-line clinical specialists can directly advance patient care by understanding how gender-specific approaches may affect evaluation and management of diseases in the acute setting. Yet, it is unclear whether the role of gender is systematically examined in research focusing on emergency care.

Research paper thumbnail of Focusing a Gender Lens on Emergency Medicine Research: 2012 Update

Academic Emergency Medicine, 2013

The influence of sex and gender on patient care is just being recognized in emergency medicine (E... more The influence of sex and gender on patient care is just being recognized in emergency medicine (EM). Providers are realizing the need to improve outcomes for both men and women by incorporating sexand gender-specific science into clinical practice, while EM researchers are now beginning to study novel sex-and gender-specific perspectives in the areas of acute care research. This article serves as an update on the sex differences in a variety of acute clinical care topics within the field of EM and showcases opportunities for improving patient care outcomes and expanding research to advance the science of gender-specific emergency care. ACADEMIC EMERGENCY MEDICINE 2013; 20:313-320

Research paper thumbnail of Gender-specific Regulatory Challenges to Product Approval: A Panel Discussion

Academic Emergency Medicine, 2014

On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges ... more On May 13, 2014, a 1-hour panel discussion session titled "Gender-specific Regulatory Challenges to Product Approval" was held during the Academic Emergency Medicine consensus conference, "Genderspecific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." The session sought to bring together leaders in emergency medicine (EM) research, authors, and reviewers in EM research publications, as well as faculty, fellows, residents, and students engaged in research and clinical practice. A panel was convened involving a representative from the Office of Women's Health of the U.S. Food and Drug Administration, two pharmaceutical executives, and a clinical EM researcher. The moderated discussion also involved audience members who contributed significantly to the dialogue. Historical background leading up to the session along with the main themes of the discussion are reproduced in this article. These revolve around sex-and gender-specific research, statistical analysis of sex and gender, clinical practice, financial costs associated with pharmaceutical development, adaptive design, and specific recommendations on the regulatory process as it affects the specialty of EM.