Study Designs and Evaluation Models for Emergency Department Public Health Research

Authors

  • Kerry B. Broderick MD,

    1. From the Department of Emergency Medicine, Denver Health Medical Center (KBB, JSH), Denver, CO; the University of Colorado Denver School of Medicine (KBB, JSH), Aurora, CO; the Injury Prevention Center, Department of Emergency Medicine, Warren Alpert School of Medicine at Brown University (MLR), Providence, RI; the Department of Emergency Medicine, University of California, Irvine, and the Center for Trauma and Injury Prevention Research (FV), Irvine, CA; the Department of Emergency Medicine, Yale University School of Medicine (GD, BB), New Haven, CT; the Department of Emergency Medicine, Johns Hopkins University (RER), Baltimore, MD; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA (KVR); and the Department of Epidemiology, Colorado School of Public Health (JSH), Aurora, CO.
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  • Megan L. Ranney MD,

    1. From the Department of Emergency Medicine, Denver Health Medical Center (KBB, JSH), Denver, CO; the University of Colorado Denver School of Medicine (KBB, JSH), Aurora, CO; the Injury Prevention Center, Department of Emergency Medicine, Warren Alpert School of Medicine at Brown University (MLR), Providence, RI; the Department of Emergency Medicine, University of California, Irvine, and the Center for Trauma and Injury Prevention Research (FV), Irvine, CA; the Department of Emergency Medicine, Yale University School of Medicine (GD, BB), New Haven, CT; the Department of Emergency Medicine, Johns Hopkins University (RER), Baltimore, MD; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA (KVR); and the Department of Epidemiology, Colorado School of Public Health (JSH), Aurora, CO.
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  • Federico E. Vaca MD, MPH,

    1. From the Department of Emergency Medicine, Denver Health Medical Center (KBB, JSH), Denver, CO; the University of Colorado Denver School of Medicine (KBB, JSH), Aurora, CO; the Injury Prevention Center, Department of Emergency Medicine, Warren Alpert School of Medicine at Brown University (MLR), Providence, RI; the Department of Emergency Medicine, University of California, Irvine, and the Center for Trauma and Injury Prevention Research (FV), Irvine, CA; the Department of Emergency Medicine, Yale University School of Medicine (GD, BB), New Haven, CT; the Department of Emergency Medicine, Johns Hopkins University (RER), Baltimore, MD; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA (KVR); and the Department of Epidemiology, Colorado School of Public Health (JSH), Aurora, CO.
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  • Gail D’Onofrio MD, MS,

    1. From the Department of Emergency Medicine, Denver Health Medical Center (KBB, JSH), Denver, CO; the University of Colorado Denver School of Medicine (KBB, JSH), Aurora, CO; the Injury Prevention Center, Department of Emergency Medicine, Warren Alpert School of Medicine at Brown University (MLR), Providence, RI; the Department of Emergency Medicine, University of California, Irvine, and the Center for Trauma and Injury Prevention Research (FV), Irvine, CA; the Department of Emergency Medicine, Yale University School of Medicine (GD, BB), New Haven, CT; the Department of Emergency Medicine, Johns Hopkins University (RER), Baltimore, MD; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA (KVR); and the Department of Epidemiology, Colorado School of Public Health (JSH), Aurora, CO.
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  • Richard E. Rothman MD, PhD,

    1. From the Department of Emergency Medicine, Denver Health Medical Center (KBB, JSH), Denver, CO; the University of Colorado Denver School of Medicine (KBB, JSH), Aurora, CO; the Injury Prevention Center, Department of Emergency Medicine, Warren Alpert School of Medicine at Brown University (MLR), Providence, RI; the Department of Emergency Medicine, University of California, Irvine, and the Center for Trauma and Injury Prevention Research (FV), Irvine, CA; the Department of Emergency Medicine, Yale University School of Medicine (GD, BB), New Haven, CT; the Department of Emergency Medicine, Johns Hopkins University (RER), Baltimore, MD; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA (KVR); and the Department of Epidemiology, Colorado School of Public Health (JSH), Aurora, CO.
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  • Karin V. Rhodes MD, MS,

    1. From the Department of Emergency Medicine, Denver Health Medical Center (KBB, JSH), Denver, CO; the University of Colorado Denver School of Medicine (KBB, JSH), Aurora, CO; the Injury Prevention Center, Department of Emergency Medicine, Warren Alpert School of Medicine at Brown University (MLR), Providence, RI; the Department of Emergency Medicine, University of California, Irvine, and the Center for Trauma and Injury Prevention Research (FV), Irvine, CA; the Department of Emergency Medicine, Yale University School of Medicine (GD, BB), New Haven, CT; the Department of Emergency Medicine, Johns Hopkins University (RER), Baltimore, MD; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA (KVR); and the Department of Epidemiology, Colorado School of Public Health (JSH), Aurora, CO.
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  • Bruce Becker MD,

    1. From the Department of Emergency Medicine, Denver Health Medical Center (KBB, JSH), Denver, CO; the University of Colorado Denver School of Medicine (KBB, JSH), Aurora, CO; the Injury Prevention Center, Department of Emergency Medicine, Warren Alpert School of Medicine at Brown University (MLR), Providence, RI; the Department of Emergency Medicine, University of California, Irvine, and the Center for Trauma and Injury Prevention Research (FV), Irvine, CA; the Department of Emergency Medicine, Yale University School of Medicine (GD, BB), New Haven, CT; the Department of Emergency Medicine, Johns Hopkins University (RER), Baltimore, MD; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA (KVR); and the Department of Epidemiology, Colorado School of Public Health (JSH), Aurora, CO.
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  • Jason S. Haukoos MD, MSc

    1. From the Department of Emergency Medicine, Denver Health Medical Center (KBB, JSH), Denver, CO; the University of Colorado Denver School of Medicine (KBB, JSH), Aurora, CO; the Injury Prevention Center, Department of Emergency Medicine, Warren Alpert School of Medicine at Brown University (MLR), Providence, RI; the Department of Emergency Medicine, University of California, Irvine, and the Center for Trauma and Injury Prevention Research (FV), Irvine, CA; the Department of Emergency Medicine, Yale University School of Medicine (GD, BB), New Haven, CT; the Department of Emergency Medicine, Johns Hopkins University (RER), Baltimore, MD; Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA (KVR); and the Department of Epidemiology, Colorado School of Public Health (JSH), Aurora, CO.
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  • This work is the output from a consensus workshop conducted during the May 2009 Academic Emergency Medicine Consensus Conference in New Orleans, LA: “Public Health in the ED: Surveillance, Screening, and Intervention.”

  • Dr. Broderick is supported, in part, by the Substance Abuse and Mental Health Services Administration (SAMHSA; TI18302). Dr. Haukoos is supported, in part, by an Independent Scientist Award (K02 HS017526) from the Agency for Healthcare Research and Quality. Dr. Rothman is supported, in part, by a Health Sciences Grant from Gilead Sciences. Dr. Rhodes is supported, in part, by the National Institute of Mental Health (K23 MH64572). Dr. D’Onofrio is supported, in part, by SAMHSA (CSATIU79T1020253); the National Institutes of Drug Abuse (NIDA; R01DA025991); the National Institutes of Alcohol Abuse and Alcoholism (NIAAA; R01AA14963); and the National Heart, Lung, and Blood Institute (NHLBI; R01 HL081153).

  • Workshop participants included (in alphabetical order) Daniel Andersen, Judith Bernstein, Steven L. Bernstein, Marian Betz, Chris Buresh, Carlos Camargo, Doris Chan, Ethan Cowan, Cinnamon Dixon, Kathryn Dong, Denise Dowd, John Finnell, Charles Gerardo, Brian Geyer, Adit Ginde, Corita Grudzen, Michael Handrigan, Fred Harchelroad, Jason Haukoos, James Heffelfinger, Nancy Holson, Jeffrey Hom, Yu-Hsiang Hsieh, Nina Joyce, Michael Lyons, Ken Malone, Priya Mammen, Nancy Miertschin, Ward Myers, Matt Prekker, Michael S. Radeos, Junaid Razzak, Lynne Richardson, Matthew Scholer, Carolyn Snider, Kirk Stiffler, Ashley Sullivan, Carolyn Synovitz, Breena Taira, Jeffrey J. Thompson, Stephen Wall, Margaret Warner, Lauren Whiteside, Lee Wilbur, and Leslie Zun.

Address for correspondence and reprints: Kerry B. Broderick, MD; e-mail: Kerry.Broderick@dhha.org.

Abstract

Public health research requires sound design and thoughtful consideration of potential biases that may influence the validity of results. It also requires careful implementation of protocols and procedures that are likely to translate from the research environment to actual clinical practice. This article is the product of a breakout session from the 2009 Academic Emergency Medicine consensus conference entitled “Public Health in the ED: Screening, Surveillance, and Intervention” and serves to describe in detail aspects of performing emergency department (ED)-based public health research, while serving as a resource for current and future researchers. In doing so, the authors describe methodologic features of study design, participant selection and retention, and measurements and analyses pertinent to public health research. In addition, a number of recommendations related to research methods and future investigations related to public health work in the ED are provided. Public health investigators are poised to make substantial contributions to this important area of research, but this will only be accomplished by employing sound research methodology in the context of rigorous program evaluation.

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