Evidence map›Paper›PMID 36721434›Full record

ArticleAnnals of global health2023

Clinical Outcomes Following the Implementation of a Novel One-Year Training Program in Emergency Medicine in Karachi, Pakistan.

Syed Ghazanfar Saleem, Saima Ali, Adeel Khatri, Sama Mukhtar, Wasfa Farooq, Quratulain Maroof, Muhammad Imran Jamal, Tariq Aziz, Kaniz Farwa Haider, Farah Z Dadabhoy and 1 more

Abstract read
In one paragraph

Article in Annals of global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Syed Ghazanfar SaleemEmergency Services, Indus Hospital and Health Network, Karachi, Pakistan.ORCID 0000-0002-1218-3962
Saima AliEmergency Services, Indus Hospital and Health Network, Karachi, Pakistan.ORCID 0000-0002-5402-9285
Adeel KhatriEmergency Services, Indus Hospital and Health Network, Karachi, Pakistan.ORCID 0000-0002-7362-5058
Sama MukhtarEmergency Services, Indus Hospital and Health Network, Karachi, Pakistan.
Wasfa FarooqPediatric Oncology, Indus Hospital and Health Network, Karachi, Pakistan.
Quratulain MaroofEmergency Services, Indus Hospital and Health Network, Karachi, Pakistan.
Muhammad Imran JamalEmergency Services, Indus Hospital and Health Network, Karachi, Pakistan.
Tariq AzizEmergency Services, Indus Hospital and Health Network, Karachi, Pakistan.
Kaniz Farwa HaiderGerald R. Ford School of Public Policy, University of Michigan, USA.
Farah Z DadabhoyDepartment of Emergency Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.ORCID 0000-0003-4375-768X
Megan M RybarczykDepartment of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.ORCID 0000-0003-1936-8473

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Most Emergency Departments (EDs) in low- and middle-income countries (LMICs), particularly in Pakistan, are staffed by physicians not formally trained in Emergency Medicine (EM). As of January 2022, there were only 13 residency training programs in EM throughout all of Pakistan. Therefore, an intermediate solution-a one-year training program in EM-was developed to build capacity. Objective: To determine the impact of a novel training program in EM on clinical metrics and outcomes. Methods: The first cohort of a novel, one-year training program-the Certification Program in Emergency Medicine (CPEM)-completed the program in June 2019. The program consisted of two arms: CPEM-Clinical (CPEM-C), which included physicians from the Indus Hospital and Health Network (IHHN) ED; and CPEM-Didactic (CPEM-D), which included physicians from EDs across Karachi. Both groups participated in weekly conferences, such as didactics, small group discussions, workshops, and journal clubs. CPEM-C learners also received clinical mentorship from local and international faculty. Mortality, length of stay (LOS), and time-to-evaluation, as well as metrics in four key areas-patients at risk for cardiovascular disease/acute coronary syndrome, sepsis, respiratory illness, and intra-abdominal trauma-were assessed before and after the initial cohort at IHHN and compared with other groups in IHHN. Findings and Conclusions: More than 125,000 patients were seen from July to December 2017 (pre-CPEM) and July to December 2019 (post-CPEM). Overall, there were significant improvements in all clinical metrics and outcomes, with the exception of LOS and time-to-evaluation, and a trend toward improved mortality. In comparing CPEM graduates to other groups in IHHN ED, most metrics and outcomes significantly improved or trended toward improvement, including mortality. Implementation of a medium-duration, intensive EM training program can help improve patient care and the development of EM as a new specialty in lower-resource settings.

Indexed as

Emergency MedicineQuality ImprovementBenchmarkingHumansPakistanQuality Assurance, Health Careclinical outcomeseducationemergency careemergency medicinetraining

Identifiers

PMID36721434
PMCPMC9854282

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.